Designing for Long-Term Emotion Regulation: A Breathing Biofeedback Game for Women in Compulsory Isolation Drug Rehabilitation Centers

In the rehabilitation process of women with substance use disorders, difficulties in emotion regulation represent a major risk factor for relapse, while shame, low self-esteem, and cognitive impairments further undermine their ability to learn and sustain emotion regulation skills. To address the lack of research on long-term skill transfer among marginalized populations in closed environments, we designed and evaluated a seven-day phased breathing biofeedback game based on low-cost audio input. The game was intended to support skill acquisition and transfer, strengthen self-efficacy and self-acceptance, and sustain attention and long-term engagement. In a six-week controlled study involving 60 participants, the results demonstrated that the game not only maintained high levels of engagement but also effectively improved breathing skills, facilitated their transfer into daily life, and alleviated negative emotions. Finally, we discussed and reflected on five design implications that emerged from these findings.