Using avatar based interventions within the therapeutic relationship
: what therapists find helpful and unhelpful

  • Melanie Baker

Student thesis: PsychD


Newer forms of technology bring the potential for new ways to deliver psychotherapy. As technology has progressed, therapists have offered new forms of therapy including distance and online therapies. The newest platforms introduce avatars and virtual worlds into the therapy room. Platforms such as ProReal enable therapists to use avatar-based interventions (ABIs) both face to face with clients and remotely. Other ABIs include Virtual Reality Therapy and the Audio Visual Assisted Therapy Aid for Refractory auditory hallucinations (AVATAR) protocol.
The aim of this research was to ascertain how professional psychotherapists experienced the impact of virtual worlds/avatars on how they related to clients, and whether or not this was helpful. Semi-structured interviews took place with 11 professional therapists and the transcripts were analysed using interpretative phenomenological analysis to find superordinate and subordinate themes. Superordinate themes that emerged from analysis included 1. client led therapy when using ABIs; 2. using ABIs to make the unseen seen allows clients to have psychological distance; 3. building blocks of the therapeutic relationship; 4. avatars acting as mediators in the therapeutic relationship; 5. ABIs affect therapeutic use of time; and 6. ABIs as new delivery methods for traditional interventions. Implications of these superordinate themes are then discussed in light of counselling psychology’s focus on intersubjectivity and diversity in the therapeutic relationship, Winnicott’s theories of the transitional area and transitional objects, and identifying with the avatar. Beliefs regarding what is helpful or unhelpful were found to be flexible dependant on the intersubjective interplay between therapists and clients and reliant on the client’s individual characteristics, desires, and choices. What was found to be helpful for one client might not be helpful for another client and what was helpful during one session might not be helpful the next session. Findings also suggested that the virtual world could be seen as a transitional area and the avatars as transitional objects that allowed clients to feel safer to explore their difficulties within the therapeutic relationship. Furthermore, by identifying with the avatar and projecting their difficulties into it to objectively observe them, clients were able to gain new insight or awareness regarding solutions to their difficulties. Limitations of research and future recommendations are then discussed.
Date of Award14 Nov 2018
Original languageEnglish
Awarding Institution
  • University of Roehampton
SupervisorGella Richards (Supervisor) & Rachel Darnley-Smith (Supervisor)

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