Painting therapy has become an important approach to the treatment of depression in adolescents. However, depressed adolescents face low self-confidence, low engagement, and self-absorption when undergoing painting therapy. Informed by need-finding investigations, We developed Realms of the Heart, a human-AI collaborative gamified complementary treatment system for depressed adolescents. Realms of the Heart includes two AI-driven strategies: the transformation of natural objects collected by teens’ exploration into brushes, and the generation of sketches corresponding to natural objects by using brushes based on ControlNet. We conducted a randomized controlled trial. Participants were randomized into an experimental group and a control group. The results showed that Realms of the Heart increased users’ motivation and significantly alleviated their level of depression. These findings not only shed light on the role of human-AI co-created painting therapy in the treatment of adolescent depression but also pave the way for more informed design strategies for art therapy.

Abstract With the expansion of extended reality (XR), virtual agents engage more with humans across fields. While the influence of anthropomorphic traits on user perceptions is studied, the combined effects of voice traits and gestures need further investigation. We explored the impact of a virtual agent's voice personality and gestures on subjective perception and visual behaviors in a hospital guidance setting. Using a 2 × 2 within-subjects design, we assessed the influence of voice traits (calm vs. lively) and gestures (with vs. without) through subjective reports and eye tracking. Results show that the impact of gestures on content comprehension ease varied depending on the voice personality traits. Specifically, a lively voice with gestures significantly increased comprehension while a calm voice with gestures did not. Additionally, a calm voice led to longer average fixation durations on body-related areas of interest (AOIs), shorter time to first fixation, and fewer fixation counts on dialog content-related AOIs. Gestures decreased fixation counts on face-related AOIs. For some eye metrics, the impact of gestures varied depending on voice personality traits, whereas for others, the influence of voice traits depended on the presence of gestures. Thus, voice traits and gestures influence user perceptions and visual attention differently.