When EmotionTech Causes Harm: The Case of Therapeutic XR

Paper Title

When EmotionTech Causes Harm: The Case of Therapeutic XR

Publication Info

• Topic area: Emotional harm in therapeutic extended reality (XR) and its implications for EmotionTech design.
• Keywords: EmotionTech, therapeutic XR, emotional harm, emotional discomfort, HCI, design responsibility, emotional safety, epistemic justice, affective interaction, user experience.

Background and Problem

• Problem / challenge: Emotional harm and discomfort in therapeutic XR applications are underexplored, with existing research prioritizing clinical and functional outcomes over affective experiences. Current tools and frameworks fail to adequately capture or address subtle, ambiguous, or negative emotional responses.
• Significance: Emotional harm can undermine the therapeutic value of XR, particularly in sensitive healthcare settings, and risks being overlooked due to a lack of shared language, tools, and frameworks for addressing emotional experiences.
• Motivation and related work: While XR research has focused on issues like motion sickness, accessibility, and physical safety, emotional dimensions remain secondary. Prior work highlights the need for frameworks that account for emotional plurality and the risks of privileging positive or measurable emotional states. This paper builds on these gaps by framing therapeutic XR as part of the broader EmotionTech category.

Solution

• Proposed approach: The paper introduces the concept of EmotionTech to frame therapeutic XR as socio-emotional artifacts and proposes Multi-Perspective EmotionTech Vignettes (MET) as a reflective tool for addressing emotional harm and discomfort.
• Novelty:
  1. Conceptualization of therapeutic XR as EmotionTech, integrating insights from affective computing and interaction.
  2. Identification of four core concerns for emotional harm in therapeutic XR: how, when, whose, and which emotions are addressed.
  3. Introduction of MET as a tool for surfacing and addressing emotional harm in research and design practices.
  4. Expansion of emotional harm definitions to include subtle and cumulative discomforts.
• Procedure and key techniques:
  • Conducted semi-structured interviews and workshops with nine researchers across 12 therapeutic XR projects.
  • Developed and iteratively refined MET based on real-world scenarios to provoke reflection and discussion.
  • Applied reflexive thematic analysis to identify concerns and actionable strategies for addressing emotional harm.

Results

• Concrete findings:
  • Emotional harm in therapeutic XR often stems from unnoticed discomfort, lack of readiness, and privileging of positive emotions.
  • Emotional harm is subtle, cumulative, and often underreported, particularly in vulnerable populations like children or older adults.
  • MET proved effective in surfacing hidden tensions and preparing researchers to address emotional discomfort.
• Advantage over baselines:
  • The proposed framework and tools address gaps in existing methods by legitimizing discomfort as evidence and supporting emotional plurality and ambiguity.
  • MET facilitates interdisciplinary collaboration and reflexivity, enabling better anticipation and response to emotional harm.
• Experiments / evaluation:
  • Data was collected through interviews and workshops with nine researchers, covering 12 therapeutic XR cases in diverse contexts (e.g., aged care, oncology, paediatrics).
  • Evaluation focused on how emotional harm was perceived, negotiated, and addressed, with MET used as a generative tool for reflection.
• Limitations and future work:
  • The study is qualitative and context-specific, with findings based on a small but diverse group of researchers.
  • Future work could expand MET to other EmotionTech modalities, test its applicability in broader contexts, and explore its pedagogical potential.

Summary

This paper examines emotional harm in therapeutic XR, framing it as part of the broader EmotionTech category. Through interviews and workshops with researchers, it identifies four key concerns: how, when, whose, and which emotions are addressed. The study introduces Multi-Perspective EmotionTech Vignettes (MET) as a tool for reflecting on and addressing emotional harm, emphasizing the need to legitimize discomfort as evidence and support emotional plurality. Findings highlight the importance of interdisciplinary collaboration, caregiver involvement, and reflexive practices in EmotionTech design. The proposed framework and tools offer actionable strategies for minimizing harm and fostering emotional accountability in therapeutic XR and beyond.