Traffic Life Game

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Case Study Summary
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Overview summary:
The Traffic Life Game was developed by Laura Ogi, a Lead Clinical Psychologist NHS Clinical at Birmingham Community Healthcare NHS Trust (BCH).

The Traffic Life Game is an educational board game that helps adults with learning disabilities to recognise and manage risks associated with all types of relationships. It enables health and social care professionals to discuss sensitive issues with people with learning disabilities, as well as offering a safe environment to talk about important issues, encouraging participants to support one another.
Challenge identified and actions taken :
People with learning disabilities are often excluded from family or peer conversations on issues that may occur during relationships throughout their upbringing. These conversations are normally avoided as it is assumed that they would not understand and because families feel like they should be sheltered. This may result in a lack of exposure to day to day conversations which help gradual developments of relationships. This can lead to people with learning disabilities not being able to recognise potential unsafe situations.

For adults with learning disabilities the grey areas and risks of social, friendships and romantic relationships can be difficult to spot and respond to. However, they have active social lives and relationships, so it is important that they too are supported to discuss issues that come along with all types of relationships. It is important that they can learn how to stay safe and have an enjoyable life.

Therefore, the Traffic Life Game was created to support individuals that may find it difficult to have open conversations about relationships. The board game removes barriers that may be felt by individuals and allows them to discuss any grey areas and risks of social, friendship and romantic relationships. The game helps make right decisions without it being taught which makes it memorable.
Impacts / outcomes:

The Traffic Life Game has had a very positive impact and has many outcomes from it. The board game is simple, entertaining and helps individuals to memorise safe and unsafe situations. The games can have 1-4 players and requires 30 minutes to play. A facilitator is also required.

The game is a traffic light risk assessment system that helps players to recognise and assess risks relating to romantic, social and family issues and situations. During the game, the players are presented with scenarios and asked short questions about how they would respond to everyday life and relationship situations. These questions and scenarios are asked by the facilitator of the game. The facilitator is usually a support worker: they lead the discussion with the players. The facilitator can help the group to talk about the risks and opportunities of the scenario presented and the answers are given points (wiser choices are given higher points).

The players respond to questions asked by holding up a coloured card to indicate how they might respond to the situation asked.
  • Red - it is not safe
  • Amber - I am not sure
  • Green - It is ok to try
Examples of the questions and situations asked are:
  • You’re at a party and your friend makes you drink lots of alcoholic drinks. What do you do?
  • You’re on a date and your date asks for a kiss. What do you do?
  • A stranger approaches you at a party and tries to give you alcoholic drinks. What colour is this?
The participants of the game would then answer these questions with the colour coded cards (red, orange and green) and explain why they chose that card colour. This will then start a discussion between the participants that is usually guided by the facilitator and allows participants to share their thoughts on certain situations and see other people’s point of view. As the facilitator leads discussions on potential risks in each situation, it helps players to decide what the best course of action is. The facilitator then gives the participants points on how they answered, if their decisions were ‘correct’ and safe then they would be rewarded 3 points and if they gave the second safest answer they are given one point. For the wrong answer they do not receive any points.

Furthermore, the game is also not a competitive game where players play against one another- it is about personal growth and understanding. Therefore, the points that are given are to improve participants own understanding of safe and unsafe situations. The points system allows the support workers to monitor if participants are improving in their understanding of unsafe situations. One hopes that the participants would increase their total score as they play the game more times.
There is also an additional activity to the game where the player can build their own character. This is designed to help keep players engaged and interested. The players collect illustrated cards and use them to create a character. These cards consist of hair colour, style and other appearance details.

The intention of the game is to help participants to apply this risk assessment to their daily lives so that they can make safer decisions and internalise the thought process used when playing the game with the group, so they could repeat this when alone in the community. The aim of this game is ultimately to help people discuss topics that they may not have discussed before, as well as learning how to deal with issues in the real world.

  • The game was very successful as the team have seen increased understanding when uncomfortable situations arise.
  • Relationships were getting better for participants who played the board game.
  • Participants were able to apply the game to their lives and make better decisions than they would have done before.
  • It was proven to be useful for when participants were starting to gain more independence in their own personal lives, such as moving out of their family home to supported or independent living.
  • Some participants also moved away from education into employment.
  • There were weekly sessions and the improvements in decision making were measured. They found that decision making was improving and that participants were making safer decisions.
  • The game is portable, flexible and can be used in a range of settings
Supporting quote for the innovation from key stakeholders:
Laura Ogi, clinical lead psychologist in learning disabilities at BCH until 2016, said:

“We started running a relationships group in 2008 to help people with learning disability understand the difference between types of relationship.

“It’s common for people with a learning disability to need support in understanding how to interact appropriately from one social setting to another.

“For example, what is meant by a hug? How do you know whether it is platonic or something else? What if a friend refuses a request for money? It’s understanding that this person can still be your friend…”

Dr Clive Thursfield Research & Innovation Director for Birmingham Community Healthcare NHS Foundation Trust (BCH) commented:

“Having watched the inception and development of the Traffic Life Game through our Innovation team we were very impressed with the focus the game places on teaching emotional and situation awareness to individuals who may otherwise be at risk of learning through experience. The Traffic Life Game is a prime example of the creative methods which we believe can really help individuals early on in their adult lives and which we are proud to support. At BCHC, we look forward to continuing to bring our staff’s insights on patient health to fruition in new and innovative ways...”

When facilitating the game with their service users, staff at Dumbarton Community Health & Care Partnership’s day centre said:

“Very easy to understand and aided in bringing up useful conversation.

“It was very effective in not only helping clients talk about risks but to look at areas we need to work on.”
Which local or national clinical or policy priorities does this innovation address:
This board game was designed to help people with learning disability understand how to form, develop and keep relationships. It helps them understand the risks of different types of relationships and what scenarios are safe and unsafe. It also gives them the chance to talk about the grey areas of relationships by normalising the conversations surrounding the scenario given. The game ensures that people with learning disabilities can process potential risky situations and make good decisions. This innovation was created at BCH.
Plans for the future:
The plan for the future is to promote this game further to other NHS organisations and health professions that work with individuals with learning disabilities, as it is a very useful tool in aiding individuals with making sensible decisions.
Tips for adoption:
The game has been fully developed by Focus Games and is available to buy here:
Contact for further information:
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