Avatar-based counselling for psychological distress in secondary school pupils: pilot evaluation

Selective and indicated UK school-based mental health interventions: a systematic review and narrative synthesis

BACKGROUND

Mental health disorders amongst children and young people pose a significant burden, with a growing emphasis on early intervention. A notable gap exists between the prevalence of these disorders and sufficiently early treatment, emphasising the need for effective preventive measures.

AIMS

This review aims to comprehensively assess and narratively synthesise both quantitative and qualitative literature on secondary preventative (indicated and selective) school-based mental health interventions in the UK.

METHOD

All empirical studies published since 2010, which reported on UK secondary preventative school-based interventions were eligible. Eligible studies were identified by searching the following electronic databases: PsycINFO (Ovid), MEDLINE (Ovid), Scopus (Elsevier), EMBASE (Elsevier), ERIC (EBSCO), and Web of Science (Clarivate). Database searches yielded 3269 results, with 26 articles meeting inclusion criteria. These articles covered 22 unique studies encompassing various study designs. The Mixed Method Appraisal Tool (MMAT) was used to assess study quality, and study findings were synthesised using a single narrative synthesis ('storytelling') approach.

RESULTS

Three central themes emerged: (1) Outcomes for children and young people; (2) acceptability and preferences; and (3) practical considerations. The majority of included studies demonstrated high quality. Studies revealed diverse perspectives on the strengths, limitations, barriers, and facilitators of school-based interventions.

CONCLUSIONS

School-based interventions hold promise in promoting positive mental health amongst young people, emphasising the pivotal role of educational settings in addressing these challenges. Despite encouraging outcomes, this review highlights the need for further research to better understand intervention effectiveness, implementation barriers, and cost-effectiveness; to facilitate the development of tailored and impactful strategies for supporting young people's mental health.

PRISMA/PROSPERO STATEMENT

This systematic review was conducted following Cochrane methodology PRISMA guidelines. The review was registered with PROSPERO in June 2023 (CRD42023431966).

Comparing counseling outcome for college students: Metaverse and in-person approaches

ABSTRACTObjective This study compared metaverse counseling with in-person counseling, using in-person counseling as a comparison group. To achieve this, we assessed whether metaverse counseling, a novel treatment approach, is comparable to traditional in-person counseling. Method: A total of 60 participants voluntarily participated in the study. Among the participants, 28 preferred in-person counseling, whereas 32 selected metaverse counseling as their preferred treatment option. Results and Conclusion: The findings indicated no statistically significant differences in the psychological symptom change patterns between the two counseling modalities. Both metaverse and in-person counseling demonstrated a common pattern of reduced symptom levels from pre-to post-session (Metaverse counseling Cohen's d = 1.04, In-person counseling Cohen's d = .62), which remained stable from post-session to follow-up regardless of the chosen counseling modality. Furthermore, the study revealed that the metaverse counseling group exhibited a higher level of working alliances than the in-person counseling group. Additionally, there was a slight tendency toward higher levels of counseling satisfaction in the metaverse counseling group than in the in-person counseling group. The results of this study support the use of synchronous metaverse programs to treat college students. The implications and limitations of this study are discussed. (195 words).

An Exploratory Study of the Potential of Online Counseling for University Students by a Human-Operated Avatar Counselor

Recently, the use of digital technologies, such as avatars and virtual reality, has been increasingly explored to address university students' mental health issues. However, there is limited research on the advantages and disadvantages of counselors using avatars in online video counseling. Herein, 25 university students were enrolled in a pilot online counseling session with a human counselor-controlled avatar, and asked about their emotional experiences and impressions of the avatar and to provide qualitative feedback on their communication experience. Positive emotions during the session were associated with impressions of the avatar's intelligence and likeability. The anthropomorphism, animacy, likeability, and intelligent impressions of the avatar were interrelated, indicating that the avatar's smile and the counselor's expertise in empathy and approval may have contributed to these impressions. However, no associations were observed between participant experiences and their prior communication with avatars, or between participant experiences and their gender or the perceived gender of the avatar. Accordingly, recommendations for future practice and research are provided. Accumulating practical and empirical findings on the effectiveness of human-operated avatar counselors is crucial for addressing university students' mental health issues.

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

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.