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Measuring Alliance Toward Embodied Virtual Therapists in the Era of Automated Treatments With the Virtual Therapist Alliance Scale (VTAS): Development and Psychometric Evaluation.
Stockholm University, Stockholm, Sweden.
Stockholm University, Stockholm, Sweden.
Mimerse AB, Stockholm, Sweden.
Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Stockholm, Sweden. (Internet, health and clinical psychology research group)ORCID iD: 0000-0003-4753-6745
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2020 (English)In: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 22, no 3, article id e16660Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Automated virtual reality exposure therapies (VRETs) are self-help treatments conducted by oneself and supported by a virtual therapist embodied visually and/or with audio feedback. This simulates many of the nonspecific relational elements and common factors present in face-to-face therapy and may be a means of improving adherence to and efficacy of self-guided treatments. However, little is known about alliance toward the virtual therapist, despite alliance being an important predictor of treatment outcome.

OBJECTIVE: In this study, we aimed to evaluate the first alliance instrument developed for use with embodied virtual therapists in an automated treatment format-the Virtual Therapist Alliance Scale (VTAS)-by (1) assessing its psychometric properties, (2) verifying the dimensionality of the scale, and (3) determining the predictive ability of the scale with treatment outcome.

METHODS: A psychometric evaluation and exploratory factor analysis of the VTAS was conducted using data from two samples of spider-fearful patients treated with VRET and the help of an embodied, voice-based virtual therapist (n=70). Multiple regression models and bivariate correlations were used to assess the VTAS relationship with treatment outcome, according to self-reported fear and convergence with presence and user-friendliness process measures.

RESULTS: The VTAS showed a sound two-factor solution composed of a primary factor covering task, goal, and copresence; adequate internal consistency; and good convergent validity, including moderate correlation (r=.310, P=.01) with outcomes over follow-up.

CONCLUSIONS: These preliminary results suggest that alliance toward a virtual therapist is a significant predictor of treatment outcome, favors the importance of a task-goal over bond-factor, and should be explored in studies with larger sample sizes and in additional forms of embodiment.

Place, publisher, year, edition, pages
Toronto, ON, Canada: J M I R Publications, Inc. , 2020. Vol. 22, no 3, article id e16660
Keywords [en]
alliance, automated treatment, avatar, embodiment, empathy, exposure therapy, presence, psychometric, usability, virtual coach, virtual reality, virtual therapist
National Category
Applied Psychology
Identifiers
URN: urn:nbn:se:liu:diva-164878DOI: 10.2196/16660ISI: 000521234700001PubMedID: 32207690Scopus ID: 2-s2.0-85082380039OAI: oai:DiVA.org:liu-164878DiVA, id: diva2:1417741
Available from: 2020-03-30 Created: 2020-03-30 Last updated: 2020-04-22Bibliographically approved

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Andersson, Gerhard

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