Chapter 42.

Introduction

Student Video Activities for Abnormal Psychology
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Avatar Therapy for Agoraphobia

Authors: Ronald J. Comer, Princeton University and Jonathan S. Comer, Florida International University

Photo Credit: narvikk/E+/Getty Images

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42.1 Avatar Therapy for Agoraphobia

This video demonstrates avatar therapy, in which clients interact with digital avatars to improve social skills and interactions in a comfortable, safe setting. The video presents the case of Lisa, a woman with severe agoraphobia who undergoes avatar therapy. The video shows her having sessions with an avatar, both in an office and at home, and she discusses her optimism that this type of therapy can prove very helpful for her disorder. The video also shows clinicians discussing how they created the avatar therapy program and discussing their expectations about its future.

Avatar Therapy for Agoraphobia

[MUSIC PLAYING]

ELLIE: Hi, I'm Ellie. Thanks for coming in today.

[MUSIC PLAYING]

SKIP RIZZO: The idea of building a virtual human that can sense your state, just like a real person would, that's a challenging idea. And it sounds simple at first. But as you start to dig into it, it is pretty complex and sometimes scary.

LOUIS-PHILIPPE MORENCY: Skip came with this idea of taking virtual human, and tried to push the envelope, try to go further than what we had. And I was like, this is a big project, but I want to do it. This is a project, that if we can do, just having just one baby step in the right direction, I think it can help a lot of people.

[MUSIC PLAYING]

LISA QUILLMAN: I've spent probably 85% of my life in my bedroom. Agoraphobia is when you can't leave your home. You get me near a door, and I literally would get physically ill.

This has happened to me three times. It was a five year episode. I had a two year period, then I had a three year period. It's debilitating, it's not fair. You're a prisoner in your own body.

LOUIS-PHILIPPE MORENCY: This was a large scale project, 35 plus people working on it for three years. We recorded more than 450 participant. We were building all this technology. Analyzing all these interaction. And finally, we created a virtual human.

SKIP RIZZO: We were looking for creating a character that would be open, and appealing, and non-threatening. We tried a couple of different things. You know we try different types of characters. For some reason, everybody liked Ellie.

ELLIE: Hi, I'm Ellie. Thanks for coming in today. I was created to talk to people in a safe and secure environment.

SKIP RIZZO: There's something about Ellie being created to be somewhat ambiguous in terms of her ethnicity. The manner of her being was just soothing, or comforting.

ELLIE: What's one of your most memorable experiences?

LISA QUILLMAN: Going to Alaska.

ELLIE: Tell me more about that.

LISA QUILLMAN: That's probably one of the best times of my life. It's just beautiful. I couldn't believe it was our world.

LOUIS-PHILIPPE MORENCY: The analysis of participant behaviors is all done through a software called MultiSense. And MultiSense looks first at the facial expression, 68 points on the face. We look at frowning, we looked at smile, and, in general, also negative and positive facial expression.

The second one is motion. You have the eye gaze, and you have the head gaze. And in this case, we expect people who are depressed to show less amplitude. Like, so, they will move, but move a little bit less.

We also looked at fidgeting, body gestures, and finally, the word I say, which is probably the most obvious of all of them. So their voice, their facial expression and the body all together, that's what we analyze in real time as the person is talking.

LISA QUILLMAN: I just figured nobody cared about me, my future, my decisions, or anything.

SKIP RIZZO: We know that when people interact with virtual humans, and there's no real human in the loop, that people reveal more. Sometimes it doesn't come out in a way that's apparent to a clinician. But it may come out when somebody feels this comfort that they feel, talking to an artificially intelligent character.

LOUIS-PHILIPPE MORENCY: Really good clinicians, when they interact with the patient, they will automatically take into consideration the gesture, facial expression, and voice patterns, and include them in their diagnosis. But they didn't have tools to really objectify it.

What's exciting with SimSensei, is that now we can quantify. Let me give you a concrete example, smile. We taught that smile will be correlated with depression. But it turned out the number of smile was not different between depressed and non-depressed. They were smiling as often, but their smile were shorter and less amplitude.

This is something that you need a computer to really accurately quantify the dynamic of the smile. Otherwise, if you just count them, they're the same.

[MUSIC PLAYING]

ELLIE: Right now I'm doing well, as far as I can actually go to the grocery store right now. But when it's full blown symptoms, there is no trying. You can't get me down the stairs. You can't, nothing. If you can open up your computer, and do this virtual therapy, I think that that's a great idea.

I really think that it could be something pretty amazing.

ELLIE: So, how are you doing today?

LOUIS-PHILIPPE MORENCY: This technology is always gonna be an assistive technology. I don't see it as any time replacing the human. That has never been our goal. Look at virtual human as a way to standardize the process of gathering and analyzing information.

This is a first step. It's a small first step. But we can see a clear vision where this technology can eventually help clinicians and patients, in their treatment and in their diagnosis.

SKIP RIZZO: I think there's a bright future ahead for technology and mental health. I think we can begin to provide care and provide support in ways that were undreamed of back in the bygone days of the 20th century.

I think the mission for our group here, really, is to drag psychology, kicking and screaming, into the 21st century in order to be able to promote mental health in a way that is more accessible, less stigmatizing. And maybe by using these technological aids, maybe more effective.

[MUSIC PLAYING]

42.2 Check Your Understanding

Question 42.1

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Correct!
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Question 42.2

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Question 42.3

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Correct!
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Question 42.4

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Correct!
Incorrect.

42.3 Activity Completed!

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