Innovations in Practice: Avatar‐based virtual reality in CAMHS talking therapy: two exploratory case studies

Abstract

Background Avatar‐based virtual reality therapy is an emerging digital technology that can be used to assist the treatment of common mental health problems. This may be particularly appealing to young people who are highly familiar with digital technologies and may provide a medium to facilitate communication within face‐to‐face therapy. Method We present two case summaries of young people who used ProReal, who had difficulties engaging in talking therapies. ProReal is a software package providing avatar‐based virtual reality therapy, used as part of talking psychological therapies provided within a CAMHS outpatient clinic. Young people completed pre and postuse routine outcome measures and took part in qualitative interviews assessing their experience of ProReal. Results Outcome measures showed a reduction over time. The two young people felt ProReal was highly accessible, with both young people positively describing how ProReal helped them externalize their inner worlds to help them to reappraise their thoughts, feelings and experiences. They also reported ProReal being a helpful tool to facilitate communication with the clinician. Conclusion These case summaries demonstrate how ProReal can be readily integrated into clinical practice and how it can facilitate communication and therapy with young people who find it difficult to express themselves.

Clinicians' use of and attitudes towards technology to provide and support interventions in child and adolescent mental health services

“…The Oxford Health NHS Foundation Trust is one of seven mental health Global Digital Exemplars (GDE) identified as a digitally advanced mental health trust. The staff in this survey may therefore be more familiar with technology, and indeed, projects around the use of online CBT (IESO), computerised programs (Sleepio; , avatar therapy (ProReal; Falconer, Grist, Davies, & Stallard, 2019) and smartphone apps (BlueIce; Stallard, Porter, & Grist, 2018) are currently underway in this specific Trust. Other Trusts may be at different stages of digital development and may have access to other technological resources, programs and training.…”

Searching for safety: Building meaning bridges using digital imagery in school counselling with a female adolescent, ‘Sally’

“…The interactive landscape can be viewed from any avatar's perspective or from a ‘roaming’ perspective in or above the landscape. Previous projects have evaluated the software's effectiveness and acceptability in prisons, school settings and secondary mental health services (Cooper et al, 2018; Falconer et al, 2019; van Rijn et al, 2015).…”

“…Avatars have also been used in games to promote therapeutic gains and to support self‐expression (Coyle, Doherty, Matthews, & Sharry, 2007; Coyle, Doherty, & Sharry, 2009; Pykhtina et al, 2012). Immersion in a life‐like scenario or using a visual metaphor can help to promote reflection from the user perspective or the perspective of others (Fleming et al, 2015), inter‐ and intrapersonal relation (Hoch et al, 2012; Yuen et al, 2013), greater self‐disclosure (Joinson, 2001), the development of insight, reflection and empathy (B. van Rijn, Cooper, Jackson, & Wild, 2015), and the development of self‐compassion (Falconer, Davies, Grist, & Stallard, 2019; Falconer et al, 2014). Our study involved avatar software developed with such virtues in mind, described later.…”

Learning emotions latent representation with CVAE for text-driven expressive audiovisual speech synthesis

“…Automatic animation of expressive virtual talking heads, or audiovisual speech synthesis, is constantly gaining attention due to its important impact on human machine interaction and its benefits to the fields of health and education for instance [1,2,3,4,5,6,7]. Expressiveness in speech synthesis systems has an added value where the interaction is more natural [8,9].…”