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July 23, 2018
by Tina Arnoldi

Can Virtual Reality Avatars Replace Therapists?

July 23, 2018 10:15 by Tina Arnoldi  [About the Author]

Are we too quick to overlook technology as a solution for mental health treatment? Negative press cites research about the influence of social media on mental health struggles, such as depression. And there are legitimate concerns around privacy, stirred on by controversy with Facebook and Alexa. But is technology something we need to be more open to in the treatment of mental health?

People are connected to technology today in a way they were not 10 or 20 years ago, which is clear from the rise of mental health startups. Technology is the tool of choice to connect with people where they are. 

But is it possible to take the therapist out of the equation when it comes to mental health treatment? Professionals obviously would say no since that is their career. They rightly emphasize the nature of the empathetic relationship with a client.  The ebb and flow of a conversation that happens in a therapy room cannot be easily replicated even with the best artificial intelligence (AI). Carl Rogers would argue that the empathy alone could be enough for positive change.

Without negating the role of the therapist, these advances do not rule out having a in-person counselor while leaving the door open to other treatment possibilities. Is it possible to program the type of behaviors that are needed to build this trust? Could people select the right therapist for themselves based on programmed characteristics?

One role of therapists today is to walk clients through some of the challenging situations they are dealing with and guide clients in how to better cope. Since not all clinicians do this type of work, one way to meet this need could be through a virtual reality (VR) environment. Clients experience a simulation of an issue they need to address, such as fear of heights, and can do so safely. With the capabilities of technology, a more engaging experience can be created than what might be done through imagination alone.

The Lancet Psychiatry published a recent study by Daniel Freeman and colleagues where they examined an automated VR treatment for exposure therapy. Rather than working with in-person therapist, clients worked with an avatar who took them through a program to address their fear of heights.

One hundred adults were split into two groups with half wearing a headset for half an hour; two or three times a week. During the session, the avatar had them choose a floor of a virtual building and perform activities from that height to ferret out what was behind their fear.

An assessment done a couple weeks after the study and then again two weeks later showed that those who were in the VR group had an improvement in their phobia symptoms with little change experienced by those who did not experience VR. “It is better than what you would expect if you saw a therapist face to face,” Freeman said of the results.Their study found that a VR counselor or coach working with a client can result in clinical benefits.

Limbix, a start-up that previously worked on VR projects for both Google and Facebook, has a slightly different approach. Rather than replacing therapists, they present their solution as a tool that therapists can use to “gradually expose patients to phobias or sources of distress to increase a patient's anxiety tolerance to distressing situations.” In addition to exposure mentioned above, it also has interesting implications for treating addictions.

By putting the client in a bar scene through VR, a therapist can gain insight about whether simply being present in a bar setting is what triggers a client or if there is something else happening in that environment that triggers them. (And this is perhaps a better solution than actually taking a client into a real bar.)

In-person therapists will likely - or hopefully - always be needed. If anything, they are a valuable resource to have behind the development of these applications since they have the clinical training to know how to work appropriately with clients in crises.  And since the treatment of mental health is an ongoing issue in our culture, any research backed solution that is available to the masses is worth exploring.


About the Author

Tina Arnoldi

Tina Arnoldi, MA is a marketing consultant and freelance writer in Charleston SC. Learn more about her and connect at

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