AI Insight
This experimental study with 484 healthy participants tested whether photorealistic avatar therapists could establish therapeutic alliance and improve treatment outcome expectations compared to human therapists through empathy and expectation-challenging videos. Results showed that two human therapist videos produced the highest improvements in outcome expectations and alliance ratings, but avatars shown first also generated positive effects. However, showing an avatar after a human therapist led to decreased ratings, suggesting a negative contrast effect that undermined the expected benefits.
Why it matters
The findings suggest photorealistic avatars could support psychotherapy by establishing therapeutic alliance and improving patient expectations, particularly when used strategically before human therapist interactions. This has implications for expanding mental health service accessibility and capacity, though the sequence of avatar and human contact appears critical to avoid negative contrast effects.
Understand the Science
IntroductionBecause negative treatment outcome expectations predict unfavorable treatment effects, violating these negative outcome expectations is one central goal of psychotherapy. One mediator of outcome expectations and therapy outcome is the therapeutic alliance.MethodsThis experimental online study investigated whether human vs. photorealistic avatar therapists can establish a therapeutic alliance through a first empathy video followed by an expectation violation video, challenging negative treatment expectations. Healthy participants (N = 484) were assigned to one out of four experimental groups where either a human therapist or their photorealistic avatar expressed empathy (video 1) and gave expectation-violating information (video 2).ResultsIn line with our hypothesis (two human therapists > human, then avatar therapist > avatar, then human therapist > two avatar therapists), outcome expectation improvements and alliance ratings were highest after the two videos for the sequence with two human therapists, and still considerably positive in the groups with the avatar in the first video.DiscussionContrary to our hypothesis, outcome expectations and alliance ratings declined after the second video for the group that first saw a human and then an avatar therapist: rather than potentiating the expectation violation after a human alliance, a negative contrast effect could have occurred when seeing an avatar after an initial human therapist, besides a modest, general effect of avatar-delivered content. When combining human and avatar therapist modalities in a single session, it seems important to consider the sequence of avatar and human therapist display: targeted expectation violation effects may be stronger when the human therapist follows the avatar.
Source: Photorealistic avatars can help to improve treatment outcome expectations