Computer-Aided Learning for Managing Stress

CALMS revolves around the use of Emotional Manipulatives (EM) developed at Boston Children's
Hospital (BCH). EM are single and multi-user biofeedback games designed to enhance executive
control of emotion. The intervention and EM in CALMS were adapted from those used in Anger
Control Training (ACT) with Regulate and Gain Emotional Control (RAGE-Control). In a
randomized controlled trial at BCH, ACT and RAGE-Control relative to "sham" video-game play
without biofeedback led to significantly greater reductions of aggression in adolescents and
greater improvement in family functioning.

In this feasibility study, family dyads will participate in 12 sessions aimed at

1. enhancing engagement through the use of video and other games,

2. enhancing stress resilience through biofeedback, education, and individualized
stress-reduction practice, and

3. harnessing the power of the family to enhance contextual learning and the generality and
duration of effects.

Clinical, self-report, and heart rate measures will be assessed at baseline, 4, 8, and 12
week assessments.

Inclusion Criteria:

- Currently Meet or Have Met Criteria of Prodromal Syndromes (COPS) according to the
SIPS within the past 2 years

- Estimated IQ > 70

- Speak fluent English

- Have at least one parent or adult family member who also speaks fluent English and is
willing to participate

Exclusion Criteria:

- Physical limitations precluding effective use of biofeedback videogames

- Co-morbid psychiatric disorders, including substance disorders, but only if they
better explain COPS symptoms or make participation counter-indicated.

- Active suicidal ideation or attempts within the past 2 months unless being actively
monitored and treated for this by a clinician