CounselAR: Exploring How AR Filters Facilitate Online Psychotherapy In the Wild With South Korean Young Adults

Research Background and Issues

• What problems or challenges did the authors identify?
  Mental health issues are prevalent globally, yet treatment participation rates remain low. In South Korea, cultural stigma and feelings of shame significantly hinder young people from seeking mental health support. Additionally, online psychotherapy faces challenges such as promoting self-disclosure and building trust.

• Why is this issue important?
  Mental health problems among South Korean young adults aged 20-30 are particularly severe, with the country having the highest suicide rate among developed nations. Only about 10% of young people seek psychotherapy, as societal and structural barriers limit access to support. Discussing and adopting innovative solutions, such as leveraging technology to reduce barriers to psychotherapy, is crucial for improving the accessibility of mental health support.

• Research Motivation and Related Work
  With AR technology entering the mental health domain, studies suggest that AR filters can enhance comfort and self-disclosure during online counseling. However, there is limited research on the application of AR in psychotherapy, especially regarding its long-term psychological support effects in real-world scenarios.

Solution

• What methods or solutions did the authors propose?
  The authors proposed a system called "CounselAR," which uses augmented reality (AR) filters to support one-on-one synchronous online psychotherapy. CounselAR provides video anonymity and offers users a variety of AR filters to choose from, aiming to lower barriers to accessing psychotherapy.

• What is innovative about this solution?
  CounselAR introduces AR filters into psychotherapy for the first time, offering a hybrid anonymity solution. Unlike complete video-off anonymity, this approach retains some non-verbal cues while providing psychological safety.

• What are the implementation steps and key technologies used?

  1. Design and Development - Key features were identified through collaborative user design workshops, including adjustable displays, filter selection and modification, and anonymous data storage.
  2. Technical Implementation - DeepAR filters were used, offering three levels of anonymity: full anonymity, partial anonymity, and accessories.
  3. Preliminary Testing and Field Deployment - During a six-week field trial, therapists and clients freely chose to use filters to observe their impact on interaction and therapeutic dynamics.

Research Outcomes

• What specific outcomes were achieved?

  1. CounselAR enhanced psychological safety and anonymity, encouraging participants to disclose personal information earlier. Some clients who previously avoided sensitive topics shared them early on using AR filters.
  2. AR filters created a more customized therapeutic environment for clients, giving them greater control over self-presentation and reducing the burden of self-consciousness tied to social norms.
  3. Filters reduced visual response distractions for therapists, allowing them to focus more on verbal content while alleviating clients' concerns about cultural biases.

• What advantages does it have compared to existing solutions?
  Compared to traditional in-person or video therapy, AR filters offer a transitional solution that addresses anonymity concerns while retaining some non-verbal cues. Additionally, CounselAR demonstrated significant effectiveness in supporting psychotherapy for sensitive topics.

• What were the experimental or evaluation results?
  Nine clients completed all sessions within six weeks, showing strong therapeutic engagement. Anxiety (GAD-7) and depression (PHQ-9) scores decreased for all clients, while therapeutic alliance (WAI-SR) and therapist self-efficacy scores improved. The choice of specific AR filters varied based on participants' needs and preferences.

• Limitations and Future Directions

  1. The sample size was small, with only 9 clients and 4 therapists, limiting statistical validation.
  2. The study focused on young adults in South Korea, without exploring applicability across other age groups or cultural contexts.
  3. The effectiveness of CounselAR was not tested in long-term interventions or controlled experiments. Future research could expand to broader user groups and evaluate the impact of AR filters in extended psychotherapy.

This study demonstrates the contribution of AR filters to the psychotherapy environment, paving the way for an innovative approach to providing mental health support while emphasizing the importance of further technological optimization and cultural adaptation research.