An experimental study of a virtual reality counselling paradigm using embodied self-dialogue

May combine two claims.

For the SC group, 86% reported a change in thoughts or feelings compared to 48% in the scripted condition; the SC proportion was reached immediately after VR and maintained for the week.

“For the SC group, 86% reported a change compared to 48% in the scripted condition. In the SC group this proportion was reached immediately after the VR experience and maintained for the week.”

• AssumptionRests on an assumption: The missing data in the study do not bias the reported results.

May combine two claims.

The probability that the coefficient of Ydisc2 is less than 1 is 0.961, indicating that other things being equal discomfort was less after one week than before VR.

“The probability that the coefficient is less than 1 is 0.961 indicating that other things being equal the discomfort was less after one week than before VR.”

May combine two claims.

The first factor (Ydisc) is dominated by importance and discomfort, with correlations 0.92 and 0.89, and low correlations with help (−0.12) and significant (0.19).

“The factor loadings on the first shows that it is dominated by importance and discomfort. We subsequently refer to this factor as Ydisc (for ‘discomfort’) and the Spearman correlations between Ydisc are 0.92 and 0.89 for importance and discomfort and −0.12 for help and 0.19 for significant, respectively.”

May combine two claims.

There was a marked effect on Yhelp (help and significance) immediately after VR, maintained for the week, with no or little effect in the S condition.

“In contrast, there appears to be a marked effect on Yhelp (help and significance) immediately after the VR exposure, which was maintained for the week, with no or little effect in the S condition (Fig. 4C).”

• AssumptionRests on an assumption: The missing data in the study do not bias the reported results.

May combine two claims.

For the SC group, the greatest frequency reasons for their changes were based on seeing themselves from the outside, as another person, with a new perspective, talking to themselves, and with their own answers and solutions.

“For the SC group the greatest frequency reasons for their changes were based as seeing themselves from the outside, as another person, with a new perspective, talking to themselves, and with their own answers and solutions.”

May combine two claims.

At AfterVR, the interquartile range for help in the SC group was all equal to 4, while the S group hardly changed from PriorVR to AfterVR and After1Week.

“At the AfterVR assessment point the interquartile range for help, the middle 75% of the observations, are all equal to 4. In contrast the S group hardly changes from PriorVR to AfterVR and After1Week.”

Classified as probably not a substantial claim.

The virtual character has a strong resemblance to the person's real body.

“The virtual character has a strong resemblance to the person’s real body.”

May combine two claims.

Significance scores increased dramatically for the SC group compared to the S group at AfterVR compared to PriorVR, although this difference diminished at After1Week.

“The significance scores increase dramatically for the SC group compared to the S group AfterVR compared to PriorVR although this difference diminishes After1Week.”

May combine two claims.

Discomfort was not influenced immediately by the SC condition at AfterVR, but decreased for both conditions by the end of one week.

“Figure 4B suggests that discomfort was not influenced immediately by the SC condition as assessed at AfterVR. However, it decreased for both conditions by the end of one week.”

May combine two claims.

A principal component factor analysis of the five AfterVR problem variables yielded a first component accounting for 88% of variance, with loadings 0.91-0.95 and correlations 0.89-0.94 with original variables.

“The first principle component accounts for 88% of the total variance. The factor loadings are all between 0.91 and 0.95. The Spearman correlation coefficients with the original variables ranges between 0.89 and 0.94 (n = 58).”

May combine two claims.

For the S group, the most frequent reason given for their change was that the three sessions of the experiment had required them to think more about their problem, whereas no one in the SC group reported this.

“For the S group the most frequent reason given for their change was that the three sessions of the experiment had required them to think more about their problem, whereas no one in the SC group reported this.”

May combine two claims.

The second factor (Yhelp) is dominated by help (rho=0.87) and significant (rho=0.86), with small loadings for importance and discomfort.

“The second factor is on the contrary dominated by help (Spearman’s rho = 0.87) and significant (Spearman’s rho = 0.86). The variables important and discomfort have small factor loadings here, and have low negative correlations with the factor, which we refer to as Yhelp.”

May combine two claims.

There is no marked effect of condition on Ydisc4; the 95% credible interval for the coefficient of C is −0.5 to 0.32.

“However, there is no marked effect of condition, the 95% credible interval for the coefficient of C being −0.5 to 0.32.”

May combine two claims.

Ydisc4 at After1Week is strongly positively related to Ydisc2 at PriorVR; the 95% credible interval of the coefficient of Ydisc2 is 0.59 to 1.02.

“The statistical analysis shows that Ydisc4 at the After1Week point is strongly positively related with the values at PriorVR, since the 95% credible interval of the coefficient of Ydisc2 is well within the positive range (0.59 to 1.02).”

May combine two claims.

The expected coefficient of SC on Y is 0.89, about one standard deviation of Y (mean ± SD 0.00 ± 1.00).

“Moreover, the expected value of the coefficient of SC is 0.89, with the mean ± SD of Y: 0.00 ± 1.00, so that the expected change with SC compared to S is not far short of one standard deviation of the variable.”

• AssumptionRests on an assumption: The missing data in the study do not bias the reported results.

May combine two claims.

Participants had strong illusions of presence and body ownership.

“strong illusions of presence and body ownership”

May combine two claims.

Most of the effects found were not overwhelmingly supported in terms of probability, although the posterior probabilities were high, and the credible intervals much narrower than the priors.

“Most of the effects we found were not overwhelmingly supported in terms of probability, although the posterior probabilities were high, and the credible intervals much narrower than the priors.”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

Amongst many people who have experienced a demonstration of the system (under non-experimental conditions) very few have found themselves 'stuck' - not knowing what to say, or quickly running out of things to say, when embodied as Freud.

“amongst the many people who have experienced a demonstration of the system (under non-experimental conditions) very few have found themselves ‘stuck’ – not knowing what to say, or quickly running out of things to say, when embodied as Freud.”

May combine two claims.

One week after the VR session there was a substantial response by participants that they were thinking differently about the problem and that the method had helped.

“and one week after the VR session there was a substantial response by participants that they were thinking differently about the problem and that the method had helped (Table 2, Fig. 4).”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Eleven volunteers were excluded due to psychological issues or logistical problems, leaving 58 participants (29 SC, 29 S), with some missing data.

“Eleven volunteers were excluded because of psychological issues detected during the screening session or logistical problems in their attendance at subsequent sessions. The final sample consisted of 58 participants, 29 in the SC condition and 29 in the S condition, although there is some missing data (detailed in context).”

• AssumptionRests on an assumption: The missing data in the study do not bias the reported results.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Participants had normal or corrected-to-normal vision and were screened for contra-indications for VR.

“All participants had normal or corrected-to-normal vision and were screened for contra-indications for VR (e.g., epilepsy, recent alcohol intake, psychoactive drugs treatment).”

May combine two claims.

In the earlier study, on average participants improved mood and happiness irrespective of condition; simply talking about the problem was sufficient for some improvement.

“Although, being embodied as Freud with synchronous visuomotor feedback produced the best overall outcomes, on the average participants improved their mood and happiness with respect to their personal problem irrespective of the experimental condition: simply talking about their problem was sufficient to lead to some improvement.”

• cites [2] Osimo, S. A., Pizarro, R., Spanlang, B. & Slater, M. Conversations between self and self as Sigmund Freud – A virtual body ownership paradigm for self counselling. Scientific Reports 5, 13899, https://doi.org/10.1038/srep13899 (2015). sourceNot checked yet

  Not checked in the free run.

May combine two claims.

The second factor represents feelings that the intervention helped and was significant.

“This factor therefore is different to the first factor, representing instead feelings that the intervention helped and was significant.”

Classified as probably not a substantial claim.

Participants were screened for psychosis with a psychologist using the CIDI psychosis module.

“Participants were screened for psychosis with a psychologist using the CIDI psychosis module20.”

• cites [20] Cooper, L., Peters, L. & Andrews, G. Validity of the Composite International Diagnostic Interview (CIDI) psychosis module in a psychiatric setting. Journal of Psychiatric Research 32, 361–368 (1998). sourceNot checked yet

  Not checked in the free run.

Classified as probably not a substantial claim.

Considering a personal problem from a third-person perspective leads to wiser problem solving than considering it from a first-person perspective.

“Grossmann and Kross1 showed that when participants are instructed to consider a problem from a third person perspective (which they refer to as ‘distancing’) they are wiser in solving a personal problem than when considering it from a first person perspective.”

• cites [1] Grossmann, I. & Kross, E. Exploring Solomon’s Paradox: Self-distancing eliminates the self-other asymmetry in wise reasoning about close relationships in younger and older adults. Psychological science 25, 1571–1580 (2014). sourceNot checked yet

  Not checked in the free run.

May combine two claims.

The first factor indicates that the problem is important and causes discomfort.

“Hence this factor indicates that the problem is important and causes discomfort.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Improvement from simply talking about a problem is considered a common factor in psychotherapy.

“This phenomenon is considered as one of the common factors in psychotherapy, e.g.19.”

• cites [19] Wampold, B. E. How important are the common factors in psychotherapy? An update. World Psychiatry 14, 270–277 (2015). sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Goodness of fit of the model was examined with graphs and Pearson correlations between observed and fitted values, and good fits were achieved.

“In order to examine goodness of fit of the model the graphs and Pearson correlations between the observed and fitted values are shown in Supplementary Text S7, and good fits were achieved.”

May combine two claims.

The standardized format was applied to all participants; therefore, it did not bias the effect in favour of one or other condition.

“Moreover, it was applied to all participants; therefore, it did not bias the effect in favour of one or other condition.”

Probably not a substantial claim: may not pass S4 (based). May combine two claims.

The VR technique results in a conversation, it is dynamic, involving voice and body movements rather than only thoughts; it is not a process of reflection, but one of dialogue.

“Third, the VR technique results in a conversation, it is dynamic, involving voice and body movements rather than only thoughts. It is not a process of reflection, but one of dialogue.”

May combine two claims.

This general reduction in positive affect found in these methods contrasts with the general positive effect of the method we have used.

“This general reduction in positive affect found in these methods contrasts with the general positive effect of the method we have used.”

May combine two claims.

The embodied method forces participants into this situation - they do not have to imagine it.

“The important point is that the embodied method forces participants into this situation – they do not have to imagine it.”

May combine two claims.

When embodied in Freud, participants could perceive a representation of themselves speaking and moving from the perspective of someone else, including better understanding of the emotional issues involved.

“Moreover, when embodied in Freud, participants could perceive a representation of themselves speaking and moving (seeing the replay of what they had just said) from the perspective of someone else, including better understanding of the emotional issues involved.”

• AssumptionRests on an assumption: The virtual embodiment as Freud with a lookalike body and own voice is sufficient to produce the intended self-dialogue and distancing.

Classified as probably not a substantial claim. May combine two claims.

The standardized format chosen to define the problem can be considered as a limitation in terms of how common personal problems are expressed in their natural context, but this limitation was imposed for the sake of experimental rigor, in order to have homogeneity across individuals and between both conditions.

“This standardized format chosen to define the problem can be considered as a limitation in terms of how common personal problems are expressed in their natural context, but this limitation was imposed for the sake of experimental rigor, in order to have homogeneity across individuals and between both conditions.”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

Prior beliefs associated to the 'figure' of Sigmund Freud (including idealization) might have enabled participants in the SC to reach a more objective and rational analysis of the problem leading to the decrease of negative automatic thoughts observed in the results.

“Prior beliefs associated to the ‘figure’ of Sigmund Freud (including idealization) might have enabled participants in the SC to reach a more objective and rational analysis of the problem leading to the decrease of negative automatic thoughts we observed in the results.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

Based on our experience with this method, the framing of the problem itself is likely to be vital, and initial guidance to participants about how they might engage in the session is likely to be important at least for some.

“Based on our experience with this method, we believe that the framing of the problem itself is likely to be vital, and initial guidance to participants about how they might engage in the session is likely to be important at least for some.”

Probably not a substantial claim: may not pass S3 (load-bearing).

These results were improved if the embodied counsellor was Freud rather than another self-copy.

“(ii) these results were improved if the embodied counsellor was Freud rather than another self-copy;”

• cites [2] Osimo, S. A., Pizarro, R., Spanlang, B. & Slater, M. Conversations between self and self as Sigmund Freud – A virtual body ownership paradigm for self counselling. Scientific Reports 5, 13899, https://doi.org/10.1038/srep13899 (2015). sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S4 (based).

The conversation is via a person, in this case, known universally as the founder of a school of psychotherapy.

“Fourth, the conversation is via a person, in this case, known universally as the founder of a school of psychotherapy.”

May combine two claims.

During the SC, participants could observe the mechanisms of their own behaviour as if it were the behaviour of someone else, which would have triggered psychological distance.

“During the SC, participants could observe the mechanisms of their own behaviour as if it were the behaviour of someone else, which would have triggered psychological distance33.”

• cites [33] Moser, J. S. et al. Third-person self-talk facilitates emotion regulation without engaging cognitive control: Converging evidence from ERP and fMRI. Scientific Reports 7, 4519 (2017). sourceNot checked yet

  Not checked in the free run.

• AssumptionRests on an assumption: The virtual embodiment as Freud with a lookalike body and own voice is sufficient to produce the intended self-dialogue and distancing.

May combine two claims.

The results together with the earlier study suggest that body swapping is effective, rather than improvements only being caused by talking to a virtual counsellor.

“The results together with the earlier study suggest that the body swapping is effective, rather than improvements only being caused by talking to a virtual counsellor.”

• cites [2] Osimo, S. A., Pizarro, R., Spanlang, B. & Slater, M. Conversations between self and self as Sigmund Freud – A virtual body ownership paradigm for self counselling. Scientific Reports 5, 13899, https://doi.org/10.1038/srep13899 (2015). sourceNot checked yet

  Not checked in the free run.

• AssumptionRests on an assumption: The SC and S conditions differ only in the body-swapping component, so any difference in outcomes can be attributed to body swapping.

Classified as probably not a substantial claim. May combine two claims.

The self-distance technique compares first person perspective with a third person perspective; the VR SC allows participants to alternately experience both first person perspective and a 'second person perspective' - from the viewpoint of another person rather than from the perspective of someone completely outside of the frame.

“Second, the self-distance technique compares first person perspective (from the point of view that ‘I’ is doing or thinking something) with a third person perspective (‘he’ or ‘she’ is doing or thinking something).”

• Also stated in: § Discussion · plain

  “The VR SC allows participants to alternately experience both first person perspective and a ‘second person perspective’ - from the viewpoint of another person rather than from the perspective of someone completely outside of the frame – it is ‘you’ are doing or thinking something, rather than ‘he’.”

Probably not a substantial claim: may not pass S3 (load-bearing).

These results are well in accord with decades of research in the area of the efficacy of psychological interventions and treatments of all kinds, including clinical psychological methods that exploit VR.

“These results are well in accord with decades of research in the area of the efficacy of psychological interventions and treatments of all kinds, including clinical psychological methods that exploit VR23.”

• cites [23] Freeman, D. et al. Virtual reality in the assessment, understanding, and treatment of mental health disorders. Psychological medicine 47, 2393–2400 (2017). sourceNot checked yet

  Not checked in the free run.

Classified as probably not a substantial claim.

The previous study found that this was advantageous compared to the counsellor being another copy of the self.

“The previous study2 found that this was advantageous compared to the counsellor being another copy of the self.”

• cites [2] Osimo, S. A., Pizarro, R., Spanlang, B. & Slater, M. Conversations between self and self as Sigmund Freud – A virtual body ownership paradigm for self counselling. Scientific Reports 5, 13899, https://doi.org/10.1038/srep13899 (2015). sourceNot checked yet

  Not checked in the free run.

Classified as probably not a substantial claim. May combine two claims.

The distance from the self is made explicit through being embodied in another character and actually seeing and hearing a representation of the self; nothing is left to the imagination and the conversation is self-driven.

“The first, and most obvious is that the distance from the self is made explicit through being embodied in another character and actually seeing and hearing a representation of the self. Nothing is left to the imagination and the conversation is self-driven.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Our embodied technique is different to the method of self-distancing in several ways.

“Our embodied technique though is different to the method of self-distancing in several ways.”

Classified as probably not a substantial claim. May combine two claims.

The SC method provides one type of objectification of the distancing approach discussed in the opening paragraph, which has proven effective in dealing with personal problems or conflictual situations.

“The SC method provides one type of objectification of the distancing approach discussed in the opening paragraph, which has proven effective in dealing with personal problems or conflictual situations.”