Abstract In Human–Computer Interaction, the adaptation of the content and the way of how this content is communicated to the users in interactive sessions is a critical issue to promote the acceptability and usability of any computational system. We present a user‐adapted interactive platform to identify and provide an early intervention for symptoms of depression and suicide. In particular, we describe the work performed to assess users' system acceptability and usability. An empathic Virtual Agent is the main interface with the user, and it has been designed to generate the appropriate dialogues and emotions during the interactions according to the detected user's specific needs. This personalization is based on a dynamic user model nurtured with clinical, demographical and behavioural information. The evaluation was performed with 60 participants from the university community. The obtained results were promising, allowing the execution of a further clinical trial. The system's usability score was 75.7%, and the score of the user‐adapted content and the emotional responses of the Virtual Agent was 70.9%.

[EN] In the field of virtual reality (VR), many efforts have been made to analyze presence, the sense of being in the virtual world. However, it is only recently that functional magnetic resonance imaging (fMRI) has been used to study presence during an automatic navigation through a virtual environment. In the present work, our aim was to use fMRI to study the sense of presence during a VR-free navigation task, in comparison with visualization of photographs and videos (automatic navigations through the same environment). The main goal was to analyze the usefulness of fMRI for this purpose, evaluating whether, in this context, the interaction between the subject and the environment is performed naturally, hiding the role of technology in the experience. We monitored 14 right-handed healthy females aged between 19 and 25 years. Frontal, parietal and occipital regions showed their involvement during free virtual navigation. Moreover, activation in the dorsolateral prefrontal cortex was also shown to be negatively correlated to sense of presence and the postcentral parietal cortex and insula showed a parametric increased activation according to the condition-related sense of presence, which suggests that stimulus attention and self-awareness processes related to the insula may be linked to the sense of presence.

Positive emotions have a significant influence on mental and physical health. Their role in the elderly’s wellbeing has been established in numerous studies. It is therefore worthwhile to explore ways in which elderly people can increase the number of positive experiences in their daily lives. This paper describes two Virtual Environments (VEs) that were used as mood induction procedures (MIPs) for this population. In addition, the VEs’ efficacy at increasing joy and relaxation in elderly users is analyzed. The VEs contain exercises for generating positive-autobiographic memories, mindfulness and slow breathing rhythms. The total sample comprised 18 participants over 55 years old who used the VEs on two occasions. Twelve of them used the joy environment, while 16 used the relaxation environment. Moods before and after each session were assessed using Visual Analogical Scales. After using both VEs, results indicated significant increases in joy and relaxation and significant decreases in sadness and anxiety. The participants also indicated low levels of difficulty of use and high levels of satisfaction and sense of presence. Hence, the VEs demonstrate their usefulness at promoting positive affects and enhancing the wellbeing of elderly people.

A growing number of empirical studies evaluate the influence of Mental Health (MH) technology on the clinical effectiveness, the therapeutic relationship (i.e., therapeutic alliance), and usability issues. However, to the authors’ knowledge, no studies have yet been performed regarding the influence of technology on the therapeutic process in terms of collaboration. This study evaluates the quality of collaboration between the client and therapist in Augmented Reality Exposure Therapy (ARET) context and the traditional, In Vivo Exposure Therapy (IVET) context with the Therapeutic Collaborative Scale (TCS). Twenty participants received an intensive session of cognitive behavioral therapy in either a technology-mediated therapeutic context or in a traditional therapeutic context. The results indicate that both therapeutic conditions show high collaboration scores. However, the asymmetry of roles between the therapist and the client under both conditions were detected. Also, a greater level of distraction was observed for therapists in ARET, which affected the quality of the therapists’ involvement in the therapeutic session. The implications of these results are discussed.

Augmented reality has been used in many fields, but it has not been used to treat psychological disorders. Augmented reality presents several advantages respect to: the traditional treatment of psychological disorders and virtual reality treatments. In this paper we present the first augmented reality system for the treatment of phobia to cockroaches. Our system has been developed using ARToolkit software. It has been tested with one patient and the results have been very satisfactory. At first of the exposure session the patient was not able to approach to a real cockroach and after the exposure session using our augmented reality system, the patient was able to approach to a real cockroach, to interact with it and to kill it by herself. This first result is very encouraging and it demonstrates that augmented reality exposure is effective for the treatment of this kind of phobias.

Tactile augmentation is a simple, safe, inexpensive interaction technique for adding physical texture and force feedback cues to virtual objects. This study explored whether virtual reality (VR) exposure therapy reduces fear of spiders and whether giving patients the illusion of physically touching the virtual spider increases treatment effectiveness. Eight clinically phobic students were randomly assigned to one of 3 groups-(a) no treatment, (b) VR with no tactile cues, or (c) VR with a physically "touchable" virtual spider-as were 28 nonclinically phobic students. Participants in the 2 VR treatment groups received three 1-hr exposure therapy sessions resulting in clinically significant drops in behavioral avoidance and subjective fear ratings. The tactile augmentation group showed the greatest progress on behavioral measures. On average, participants in this group, who only approached to 5.5 ft of a live spider on the pretreatment Behavioral Avoidance Test (Garcia-Palacios, 2002), were able to approach to 6 in. of the spider after VR exposure treatment and did so with much less anxiety (see www.vrpain.com for details). Practical implications are discussed.

Flying phobia (FP) might become a very incapacitating and disturbing problem in a person's social, working, and private areas. Psychological interventions based on exposure therapy have proved to be effective, but given the particular nature of this disorder they bear important limitations. Exposure therapy for FP might be excessively costly in terms of time, money, and efforts. Virtual reality (VR) overcomes these difficulties as different significant environments might be created, where the patient can interact with what he or she fears while in a totally safe and protected environment-the therapist's consulting room. This paper intends, on one hand, to show the different scenarios designed by our team for the VR treatment of FP, and on the other, to present the first results supporting the effectiveness of this new tool for the treatment of FP in a multiple baseline study.