It was the middle of the night when I heard a knock on my door. We all dread this knock. We know it must be something bad. And it was.
I opened the door to a Vancouver police officer, who proceeded to inform me of my father’s sudden and tragic death. I was in shock. And I had no idea how much the stress of this event would affect my cognitive abilities for many months to come.
Inside, I was struggling.
Shocked and heartbroken, for the months following my Dad’s death I was barely functioning. It was a fog of confusion, disorientation, and heightened anxiety as I struggled to understand the circumstances of how he died. On the surface, I looked sad but otherwise normal. Yet, how I was doing on the inside was very different.
We often associate trauma with harrowing events like war, violent crime, or natural disaster. This refers to “Big T” trauma. So we may think we’re fine if we’re not dealing with anything we ourselves deem to be deeply threatening. Yet many of us have experienced events that exceed our capacity to cope, leading to a disruption in emotional functioning. This is referred to as “Little T” trauma. Examples of "Little T" trauma include:
- Financial worries or difficulty
- Loss of a significant relationship
- Emotional abuse
- Death of a pet
- Non-life threatening injuries
- Bullying, harassment
Looking at the list above, these life events are sure to impact each of us at one time or another. As designers and researchers, whenever we are engaging with people, we need to be mindful that they may be dealing with some cognitive limitations. Let’s make choices to support them instead of burdening them with more stress.
How stress can impact design research
When people are under stress, they may struggle to make decisions, or not be able to make decisions at all. Which is why designers and researchers need to consider the impact of stress when we’re facilitating design workshops, user research, and interview sessions.
People under stress have limited cognitive abilities. A decline in memory recall, focus and decision-making, and even social interactions are a few of the outcomes when dealing with stressful events.
After experiencing the stressful event of my father’s sudden death, I noticed my own cognitive abilities decline. From this, I gained a deeper understanding of how to deliver better design experiences to accommodate people experiencing varying levels of stress.
When we design, we need to consider the "outliers", those who are on the edges vs. the middle average. Not everyone will be dealing with extreme life stressors (Big T events) like I was, but if we design with the Big T impacts in mind, those who are dealing with everyday stressors (the "middle average") will also benefit. By designing for those on the edges, we should meet the needs of everyone in between.
Designing for possible cognitive limitations
I thought I understood this already, since throughout my career I’ve designed for people navigating complex social challenges—including in the areas of health, legal, and child care. But after my father’s death, I really got it. I was now living with limitations caused by stress on my own mental health and daily routine. I could empathize.
Gaining a deeper understanding of what it’s like for someone struggling with both major and daily stressors helped me create solutions to better support the people we work with. Throughout this three-part series, I will share the strategies we’ve implemented at OXD when designing for those with cognitive limitations.
Part one: memory and stress
I couldn’t even remember to make my daughter toast.
When stressed, we can be forgetful and less likely to remember specific information. The immediate days and weeks after my father’s passing my memory was like a sieve. Past, future, and immediate events were impossible to recall.
My daughter would ask me to make her some toast, I’d say ok, then immediately forget about it. I was late for, or completely forgot about appointments—when before I’d show up at least 15 minutes early.
My long-term memory was also put to the test when I met with various service providers supporting the management of my fathers affairs. They all asked me for the same information: my father’s birth date, date of passing, and other personal information. I couldn’t remember any of it. My cognitive abilities were all affected by an extreme life stressor.
Not everyone will be dealing with major stress events. But by designing for the extreme we’ll also meet the needs of those dealing with “Little T” stress. Here’s how stressors can present related to memory decline when working with participants—and solutions to support them.
1. When participants forget to show up
We take a human-centred design approach in our work at OXD. This means talking to the people we’re designing for, in the form of interviews and research sessions. Often, our schedule is very tight, with back-to-back sessions. This doesn’t allow for any wiggle room when participants don’t show up, are late, or need to reschedule their interview. In all honesty, this used to frustrate me. But it happens to each of us, especially if we’re feeling stressed out.
Help participants plan for and remember appointment times
It’s easy to get caught up in efficiency, striving for order and productivity at all times. But how can we bring some compassion and patience to our scheduling process?
- Send participants an email reminder two days before their appointment. Include details about what to expect during their session.
- Ask participants if they need support for any special needs, and make sure they are comfortable with the steps in process.
- Ask for participants’ preferred method of communication (text, email, phone call). Be aware of what type of channels they have access to and don’t assume they have a phone or data plan.
- Avoid scheduling back-to-back sessions. Build in extra time to allow for late-comers or missed appointments.
Remember, it’s about what works for our participants and their schedules, not what works for us.
2. When participants struggle with getting started
We’ve learned from the work we’ve done in the health, legal, and child care sectors that many people struggle with keeping track of what tasks they need to do. Heightened emotions can make it difficult for them to process what we are saying, remember what they said, or what we are asking them to do.
Create a prioritized checklist for participants
Take the onus off participants to remember details. A simple solution while conducting design research or interviews, is for facilitators to take notes and write down next steps on behalf of participants. Checklists detailing, in priority order, what needs to get done are also helpful when an individual is ready to tackle the task at hand.
3. When participants can’t remember past events
Despite our good intentions, people may feel like they’re being on the spot during interviews or workshops.
The result is often vague recollections and generalities.
Sometimes interview participants end up apologizing and feeling bad that they can’t remember. We want people to walk away feeling good about their experience, not feeling bad about the quality of their memory.
Send interview and workshop materials in advance
To help participants prepare for a session we offer to send them the interview questions and workshop materials ahead of time. We encourage them to write down any related experiences, ideas, and memories before the scheduled session. It’s much easier to recall events when you have time to prepare versus trying to recall them under pressure. A more formal version of this approach is to use a diary study. The goal is to support and design for recognition versus recall, reducing the cognitive burden on the individual.
Conducting design research with empathy and compassion
Stress is inevitable, and we all struggle with it. Infrequent, small amounts of stress can actually be beneficial, helping to motivate us, or take action. But chronic stress negatively impacts our health and our cognitive abilities.
We don’t always know who is experiencing stress at any given time. So when conducting design research and engaging with participants, let’s bring empathy and humanity into our interactions. When people feel safe and supported, they will provide more valuable feedback and help us deliver better digital services.
This is article one of three. Part II addresses the impact of stress on attention and Part III delves into how stress affects our ability to make new decisions and adapt to change.