Design Therapy — A good service by definition?

[Originally posted 24.9.2020 on Medium]

Brit Louise Downe nailed it by defining with 15 principles what good design service is. This came in handy for me, as I was redesigning systemic therapy to make it reflect what I believe in. Instead of being reassured with “trust the design process” to lead to a good service outcome, she gives a list of easy to understand characteristics.

First Things First: What is Service Design?

Service Design in itself is the activity of planning and connecting people, the layout and communication of a service to improve a certain interaction between a service provider and its users. Take for example shipping a letter by mail to a relative. The postal company provides the service of collecting payment and transporting the item from receipt until delivery and you as the user are part of this journey start to finish.

The field of service design is as old as I am — a term coined in the 1980s by Lynn Shostack according to this article on the basics of service design. It is a brief description including poignant drawings of the 3–6 components of service design, including the front and backstage idea. I’ve found it always intriguing that service design was described with a theatre metaphor. There is no actual “stage”, maybe a countertop at most, but since it has been described as a stage, it has been designed and perceived as one.

Next time you order a coffee “on the front stage”, you as the customer or audience don’t see what is happening backstage, i.e. below the counter top, behind the door to the messy storage room and in those digital communications for employees.

Don’t Blame the User — or Service Design Victim

Lou Downe’s 15 principles for good service design are also helpful to understand why certain services have had us cursing, struggling and question ourselves. A common saying is “Don’t blame the user- but the designer”. If you spill your coffee, for instance, perhaps the cup invited you to fill it too high or is hard to hold when hot? If you run into a glass door rushing to enter a building, perhaps the design didn’t clearly tell you whether to pull or push? This is called a #NormanDoor — named after the US engineer and design critic Donald Norman.

In the following, I will list the 15 principles of good service design and relate them to my practice of Design Therapy where I am helping couples achieve relational wellbeing with the “Design Your Future Together” package based on the Design Your Life approach. Design Therapy is also for Individuals in the form of “Design Your Life”, so take a look later.

I will also acknowledge where I still fall short to identify the areas where I need to grow.

What is Pixel Story Studio’s “Design Therapy” for Couples?

The service of design therapy is an innovative form of helping couples achieve relational wellbeing with a “Design Your Future Together” on a short track. I designed this approach by combining systemic psychotherapy and design thinking for mental health amongst committed couples. I also connected the dots, so to speak, of mini services and experiences that I found helpful and needed for better personal, emotional and relational wellbeing. This is another story.

Design Therapy is a service designed in line with the so-called “Design Your Life” approach — using design methods that are often used in business, education, government — stretched to the private life or for the whole self as it spills into work life, into relationships, and into the past and future.

15 Principles of Good Service Design — Applied to Design Therapy

A good service must..

1. Enable a user to complete the outcome they set out to do

Life lining process, past and desired experience is flooring and powerful.

If a couple seeks design therapy to improve their relational wellbeing, good services deliver exactly that. This requires an attentive gathering of information of what that desired outcome would be. Whether two people come to me to stop bickering as much or to use their time together more positively instead of managing the day to day agendas - there is a range of presented issues.

To get feedback on “completing” the outcome, I use repeated mapping and measuring during design therapy, such as the wheel of *relational* life and the relational wellbeing checkup. As with other self & together work, couples get as much out as they put into design therapy.

2. Be easy to find

When a couple looks for “couple future planning” or “design your life together” these exact search terms come up in my outreach communication. I aim to use everyday language and avoid disciplinary jargon (nice try..). And as for finding me — I have a cozy practice space for sessions and groups, a dedicated website (www.designtherapy.org) and tele therapy options in 2020 to be inclusive.

However, if you had trouble finding design therapy, i.e. a couple therapy service that is innovative, brief and positive, I love to hear from you.

3. Clearly explain its purpose

The “why” and purpose of Design Therapy is right in the subtitle — helping achieve wellbeing, by “Design your Life” for Individuals & “Design Your Future Together” for Couples. The beautiful idea is to make relational psychotherapy / systemic therapy and available for playful exploration of the status quo. This way, couples invest in their future and in prevention rather than treatment of accumulated problems. The exciting idea is to take on your future dreams and fears - respecting them equally.

Option A in 2020: Work on Project Skylon at Dffrnt Media, Option B: Get laid off and go full time into “Design Therapy”. You know the answer.

Another WHY is the opportunity of involving those who have been reluctant to traditional couple therapy by offering a playful, appealing experience. Design Therapy is designing with the couple, not just for them. It is hence empowering instead of making someone dependent on my expertise.

And in light of the global pandemic, it becomes very obvious that having back up plans for other futures makes sense. Many face job loss or collapse of a under 1.5m economy — here Design Therapy comes in handy for individuals with asking “what else?” and “what if?”

4. Set the expectations a user has of it

The individual or client couple can expect a professional standard of couple psychotherapy with proper design thinking and doing tools to liven them up. Professional means that couple therapy is an established profession with college programs, continuing education options and quality assuring organizations behind it. That’s all embodied by the design therapist.

The unknown part of what the exact presented problem(s), challenges and dreams will be and hence what the learning, discovery as a result will be, play a role in adjusting the expectations, of course. For instance, I cannot promise to make you a “fire proof life design” or “to fix your marriage”. Yet I can offer a collaborative, inclusive, emotional & cognitive process that considers all parties.

Other known parts are empathic listening, reliable scheduling and service offering, professional demeanor and respectful communication. For instance, some couples report they were denied counseling for unknown reasons. You can always expect brief, to the point and empathic communication from me.

5. Be agnostic of organisational structures

The organization, in this case Pixel Story Studio housing Design Therapy, has its own rules, lives, values and needs. Yet unless relevant for the client or couple, most of these will be filtered out or withheld unless they serve the client or rather — the therapeutic connection. This is one reason why couple therapists keep a rather blank and neutral online presence so that the couple can concentrate on its own story, refrain from forming a relationship with the therapist beyond the sessions and treatment space.

Keeping secrets on Instagram. https://www.instagram.com/designtherapyspace/

This is conveniently expressed in the idea of “non dual relationships”. You cannot be your design therapist’s best friend or have other major relationships with them (sister, employee, etc). It is best for you to be agnostic of their other personas.

Yet, and this goes back to the fact that Design Therapy is a new approach, you can co-create your level of not knowing, too. You can find your Design Therapist to share a varying degree of her origin and believes such as here — and explore this aspect together, too.

6. Require the minimum possible steps to complete

Design Therapy is in line with Brief Therapy models, which are time limited and present oriented. Psychoanalytic therapy, in contrast, has no end in sight and could carry on for years.

Design Therapy can last anywhere from 1 orientation session to 6 sessions of a journey. Ideally, repeated checkins occur to adjust one’s progress and wellbeing. As Design Therapy has a future-orientation, it allows for open add ons and adjustment as needed. Are you facing a new challenge and prefer support, call your design therapist.

To give an example of a couple who took the leap and left their old live behind — to live in a remote location for remote work. They arrived at this plan within 6 sessions and have shared about their happiness with digital post card.

7. Be consistent throughout

Design Therapy is consistent because it is based on a clear why and set of values, i.e. wellbeing and positivity, wholesomeness, embodiment, connection, self actualization, progress and integration.

The why is also “wellbeing” and not mere “getting by”. Some might say “just lower your expectation to not be disappointed”, yet I believe that you can be accepting and ambitious to live the life you seek, dream of and are made for.

One law of nature clearly says “there is constant change”, so a person, the environment and subparts of relationships will change — grow or fall apart, yet with the DYL approach one can have a consistent attitude towards all that is changing. For instance, you cannot control whether your partner will choose you every day for the rest of your life, yet you can choose your values and reactions to all that happens.

Hot Flow Yoga — Rivierenbuurt in Amsterdam. How similar or different are classes?

Lastly, if you recommend Design Therapy to another couple, they will receive the same basic healing experience, because Design Therapy is consistent — based on values, thoughtful design (in the sense of Vision in Product & Service Design) and holding relational sustainability very high.

A real life example for inconsistent service are sometimes yoga students — under one room and brand, there are often varying teaching styles — depending on the level of control by the leaders. It is a trade off, for sure: allow each yoga teacher to do their thing or align them on quality standards and flow sequence?

8. Have no dead ends

Clear way-finding is a wonderful service, even to those potential clients that are not a good fit for Design Therapy. Design Therapy makes hereby clear that it is not for clients in clear need of mental health treatment because their life is at risk.

Design Therapy is NOT for suicidal clients, for clients with impaired life quality (as reflected in 51 or less points on the GAF).

Similarly, Design Therapy is not for high-crisis couples (domestic violence, emotional or physical abuse) and those cases where reporting to third parties is necessary (acute risk of harming oneself or others). During the starter session, the design therapist will scan for prohibiting circumstances direct to more qualified services to move you on.

Design Therapy fits in to the Western infrastructure of mental health and design services. It is truly for those who wish to up their game, attain personal wellbeing for themselves and in their relationships — whether they have “notable couple issues” or not (because who does’t?).

9. Be usable by everyone, equally

Making the good service of Design Therapy usable for everyone who needs it, regardless of their circumstances or abilities is only partially possible. On the one hand, Design Therapy is affordable and a self pay service for now (Accreditation with health insurances coming soon). Yet with a good business model, possible future pro bono or discounted models are thinkable.

It also offers sessions on a sliding scale upon discussion with the therapist. Yet a minimum service fee will always be required.

It is available in English, German, and offers understanding of Dutch. Yet I am aware speech, and a certain level of cognitive ability is required. I hope to bring this approach to other language domains and cognitive spheres, too.

10. Respond to change quickly

Design Therapy uses a design thinking and doing approach which is quick, adaptive, iterative in response to information, needs and ideas. For instance, the couple may state “We came here for X” yet then specifies what brings them to design their future together, X1 can quickly become X2 or X3.

Similarly, language and human interactions is made for quick responses. Each question and summary statement quickly picks up change to feed it back.

Designing marble, however, that would be more slow paced..

11. Work in a way that is familiar

Therapy is a basic familiar script. A script is a template or basic idea of how something works. Therapy works in such a way that someone has a psychological, relational or feeling issue and seeks professional help. You first reach out or call, go to the practice to experience the talk and doing therapy, after some time, commitment and treatment, you leave relieved and feeling better.

Adding Design to Therapy means adding deliberate choices to create a desired, improved, and more pleasant outcome. Most people are familiar with design in terms of interior design, product design, or maybe even app design since the omnipresence of smart phone. Design makes things good.

12. Encourage the right behaviors from users and staff

Here come the ethics. Right behavior is behavior that serves human beings in their systems. Such a “right” behavior is dependent on subjective values (give everything to my partner or prioritize myself) and on universal values (harm no other). This right behavior will be discussed with the clients — individuals and couples - and pursued, optimized for.

For instance, “right behavior” in couples therapy is expressing fondness and admiration. Or turning towards one another to allow for friendship, shared meaning. Of course, such couple behavior needs to be balanced and dosed.

For individuals, “right behavior” often includes basic balanced communication where an individuals asks questions and responds, monitors the interest of the other and looks out for his or her own enjoyment. Sounds basic, yet we can probably all benefit from a refresher of this.

13. Clearly explain why a decisions has been made

Transparency and comprehension is key in building trust and also maintaining commitment and investment in therapeutic work. Hence, a design therapist can explain the rationale behind certain interventions — is something done to increase positive behavior or to express deep concerns? Is an explorative exercise done to experience play or to discover new avenues?

BTW: what’s the minimum age of design therapists, anyway?

As a facilitator of the process, the design therapist always works with an agenda that she or he can share upon request.

14. Make it easy to get human assistance

Design Therapy is deeply connected to human centered design — both design by a human and for humans. It believes in the high value of human connection, human needs and human communication for human wellbeing.

Since help, assistance and support are so critical in social learning for growth — human assistance is always a menu option.

For instance, an older sibling will assist a younger sibling with reaching a cup, a spouse will assist his partner in touching his vulnerable feelings and a design therapist will assist a couple with holding the space for emotional experiences, with providing resources and empathic words and with also blocking harmful behavior.

This service design criteria may have been meant for website platforms — if amazon sells $1,000 merchandise to you yet then is hard to reach when something failed. Is human assistance of service to you?

15. Require no prior knowledge to use

It would be tough to imagine a high threshold service where a design therapy client would have to read a book first to come in. Instead, being human and motivated is enough to use and experience Design Therapy. That’s the bar.

In a way, every first touchpoint with Design Therapy is already intervening and educating, so knowledge is built slowly and steadily. So that the clients speaks more “design” and “therapy” talk by the end of their package.

Most importantly, they will end or exit with more knowledge about themselves and resourceful humans who seek to connect, to flourish, to be safe and wild. One cannot know at the beginning what will be known in the end.