Introduction
head nodding
Automated virtual reality (VR) therapy is likely to prove a key approach to scale up the delivery of efficacious psychological treatment for mental health difficultiesTherapeutic alliance, a positive relationship between patient and therapist, is a reliable predictor of better mental health treatment outcomesA growing body of research has focused on the experience of virtual humans in coaching and therapies within non-immersive modalities. For example, an early test from Bickmore and PicardOther studies have looked at virtual humans in mental health digital interventions. DeVault et al.In studies of virtual humans in VR, research has suggested that characters’ behavioural realism and positive non-verbal communication can enhance their social impactThe current study tested the impact of a VR coach’s positive non-verbal behaviours (warmth of facial expression, head nodding) on therapeutic alliance and treatment credibility and expectancy for an acrophobia treatment. Additionally, we tested whether a participant’s level of mistrust may moderate the relationship with a virtual coach. Our primary hypotheses were that the addition of warm facial expressions and affirmative nods would independently enhance the therapeutic alliance and treatment credibility and expectancy. Further, we hypothesised that the combined use of warm facial expressions and affirmative nods would have the strongest positive effect (i.e. there would be a significant interaction).