Could Avatar Therapy Enhance Mental Health in Chronic Patients? A Systematic Review

Abstract

The use of avatars in the psychological treatment of some chronic diseases is in their infancy, and it represents a growing field of research with many possibilities for innovation. However, there is a lack of studies seeking to determine if avatar-based therapies could improve mental health in chronic care settings. In fact, to the best of our knowledge, this is the first systematic review addressing this research topic. The objectives of this study were to review the scientific literature on those studies involving avatar-based therapies for chronic patients, as well as different ways to develop them and their efficacy on mental health outcomes. Two main questions were addressed: (1) Are avatar-based strategies useful to improve mental health in chronic patients? (2) Which is the best way to develop avatar-based strategies regarding chronic diseases? A systematic review of the peer-reviewed literature was conducted in March 2021. The results were, not only useful for establishing suitable ways to develop avatar-based strategies to improve mental health in chronic care, but also for providing an ad hoc taxonomy regarding this research topic. Five modalities were established according to technological complexity and avatar presentation. Most of the studies were effective (61.1%) in enhancing mental health in chronic care.

Changes in Quality of Life in Treatment-Resistant Schizophrenia Patients Undergoing Avatar Therapy: A Content Analysis

“…It is indeed plausible that ATp does both, as this therapy is not only experiential and emotion-inducing, but the beliefs and self-perceptions of the patient are also questioned by the Avatar; therefore, cognitive processes are also an important focus of therapy [ 30 ]. Since everything occurs in a safe space, under the control and supervision of a therapist, these techniques allow patients to incorporate new information and change their relationships with their voices, thereby reducing anxiety and increasing self-confidence [ 30 , 33 ]. Another factor accounting for ATp efficacy could be the use of Avatars.…”

Avatar-Based Strategies for Breast Cancer Patients: A Systematic Review

“…Avatars are customized by users, and generally, such customization represents aspects of their personality, self, and physical appearance that could be analyzed in the context of psychological assessment [ 33 , 35 , 36 ]. In this regard, avatars are digital representations of the self that are used in the context of the Inter-net within digital environments, encouraging not only social interactions and interaction in a virtual environment among users, but also the adoption of adaptive or healthy behaviors [ 37 , 38 ].…”

“…In addition, other positive aspects are related to the diversity of their application in a heterogeneity of pathologies [ 40 ], their ability to train emotions in patients with schizophrenia or related disorders [ 38 ]; as well as in major depressive disorder [ 41 ]; in anxiety disorders [ 42 ]; or in autism spectrum disorder [ 43 ], among others.…”

“…Likewise, in chronic diseases such as cancer, variables such as knowledge, self-care behaviors, and improved QoL have been favored, demonstrating promising results in terms of effectiveness for patient education (improving knowledge and self-care behaviors in cancer patients) [ 46 ]. Avatar-based strategies have been also mentioned as an effective tool to improve patients’ mental health and chronic care [ 38 ].…”

“…When patients were asked about their user experience, they reported a high level of user satisfaction after using avatar-based tools [ 38 ]. Similarly, when BC patients were questioned about their attitudes toward internet-based psychotherapy, including avatar therapy, the results showed a positive attitude towards this new technological tool [ 1 ].…”