A randomised controlled test of emotional attributes of a virtual coach within a virtual reality (VR) mental health treatment

Abstract

We set out to test whether positive non-verbal behaviours of a virtual coach can enhance people's engagement in automated virtual reality therapy. 120 individuals scoring highly for fear of heights participated. In a two-by-two factor, between-groups, randomised design, participants met a virtual coach that varied in warmth of facial expression (with/without) and affirmative nods (with/without). The virtual coach provided a consultation about treating fear of heights. Participants rated the therapeutic alliance, treatment credibility, and treatment expectancy. Both warm facial expressions (group difference = 7.44 [3.25, 11.62], p = 0.001, $${eta}_{p}^{2}$$ eta p 2 =0.10) and affirmative nods (group difference = 4.36 [0.21, 8.58], p = 0.040, $${eta}_{p}^{2}$$ eta p 2 = 0.04) by the virtual coach independently increased therapeutic alliance. Affirmative nods increased the treatment credibility (group difference = 1.76 [0.34, 3.11], p = 0.015, $${eta}_{p}^{2}$$ eta p 2 = 0.05) and expectancy (group difference = 2.28 [0.45, 4.12], p = 0.015, $${eta}_{p}^{2}$$ eta p 2 = 0.05) but warm facial expressions did not increase treatment credibility (group difference = 0.64 [− 0.75, 2.02], p = 0.363, $${eta}_{p}^{2}$$ eta p 2 = 0.01) or expectancy (group difference = 0.36 [− 1.48, 2.20], p = 0.700, $${eta}_{p}^{2}$$ eta p 2 = 0.001). There were no significant interactions between head nods and facial expressions in the occurrence of therapeutic alliance (p = 0.403, $${eta}_{p}^{2}$$ eta p 2 = 0.01), credibility (p = 0.072, $${eta}_{p}^{2}$$ eta p 2 = 0.03), or expectancy (p = 0.275, $${eta}_{p}^{2}$$ eta p 2 = 0.01). Our results demonstrate that in the development of automated VR therapies there is likely to be therapeutic value in detailed consideration of the animations of virtual coaches.

Comparison of data from six psychotherapy research measures obtained through MTurk versus traditional clinics

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Developing psychological treatments for psychosis

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The influence of Survivor stories and a virtual reality representation of a residential school on reconciliation in Canada

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