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Role of Technology in the field of Clinical Psychology

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 Indian Journal of Behavioral Research & Therapy
2022, Volume 3, Number 1 & 2 An Official Research Journal of Indian Institute of Psychology

Role of Technology in the field of

Clinical Psychology
—Titiksha Paul*

ABSTRACT
Since the past, psychological therapies and assessments have been used to deal with the issues related to human behavior.
However, certain factors like physical presence of both therapist and client at clinic, and treatment’s cost may reduce the
effectiveness or easy access of psychological services to the client. Therefore, these hindering factors gave impetus to the
use of technology in the application of psychotherapy. The review paper aims to explain the significance of technology based
therapeutic tools, various modes of technology such as audio/video counseling, self-directed and computer-based therapeutic
tools, web-based text communication, Virtual Reality and Artificial Intelligence. It will also examine the legal and ethical
issues that are considered during e-therapy and mention some of the current research related to the field of clinical psychology.
Various search engines such as “Wiley Library ‘’, ‘’JSTOR ``,’’PubMed `` have been used to find out various studies related
to how computer technology plays an important role in providing psychological services. After reviewing different articles
related to psychology and technology, it has been found that technology plays a very important role in psychology. It is quite
effective in the treatment of various disorders such as anxiety, depression, phobias, PTSD and so on. Integrating technology
into mental health practices has the potential to dramatically shift the traditional format of mental health services. It has
made transformative changes in prevention, promotion, and treatment of mental health problems through flexible, immediate,
on-demand, personal and individually paced and stigma free services.
Keywords: Technology, psychological services, E-therapy, virtual reality

Introduction market in the world after China (Keelery, 2020). Thus, it is

Technology has a very powerful impact and has changed
the field of psychology. It has given a new perspective by
introducing new ways of providing psychological services,
conducting research as well as treatment (Broudy, n.d.). The
use of computer technology is universal in many developed/
developing countries. It can be categorized as cyberpsychology
which refers to the field of study of how individuals interact
with computers or any digital devices (Caponnetto & Milazzo,
2019). Some of the digital platforms and resources are email,
smartphone/tablet applications (apps), online forums, web
sites, DVDs, CD-ROMs, blogs, computer software, online
social networks, telephone and televideo communication, and
mobile devices (Substance Abuse and Mental Health Services
Administration, 2015). According to (Statista, 2021), 4.66
billion people use the internet worldwide, which encompasses
59% of the global population and 91% of people use mobile
internet. In India, over 560 million people used the internet,
while securing a place of providing the second largest online
*M.Phil. Clinical Psychology Trainee, Department of Psychology and Mental Health, Gautam Buddha University
important to understand the role of how new technologies
secure a place within the therapeutic practice (Caponnetto &
Milazzo, 2019).
Before examining the objectives of the study, let’s
understand the history of online cyberpsychology as well as
e-psychotherapy. The history of cyberpsychology can be traced
back from two decades. According to John Suler, the word
‘Cyberpsychology’ surfaced in the mid 1990’s which refers
to studying online behavior of individuals. “Cyberpsychology
& Behavior” was the first journal to use this term, which was
launched in 1998 (Widman, 2018). Another journal originated
in CzechRepublic in 2007 named, Cyberpsychology &
Behavior (Widman, 2018).
Historians have different starting times while tracing
the history of online psychotherapy. Some historians believe
that there was a small demonstration of online therapy in
1972 during International Conference on Computers, where
it did not meet the correct requisite of psychotherapy sessions

110
 Indian Journal of Behavioral Research & Therapy
2022, Volume 3, Number 1 & 2
with trained or licensed therapists (Rauch, 2018). Telephonic
psychotherapy has been dated to the early 1960’s, however
it was discontinued due to the breach of confidentiality
issue. However, many historians believe that the first online
psychotherapy service in terms of dealing with mental health
issues was conducted in Cornell University in 1986, as a form
of online forum named “Dear Uncle Ezra, where students
and people ask questions and get answers anonymously
(Müller, 2018). Still there was no direct contact between the
therapist and the client. In 1966 and onwards few computer
software programmes were developed to ensure a dialogue or
conversation with the client like “ELIZA” and “PARRY” but it
lacked forming a bond between the software (acting a therapist)
and client, which is the most crucial part of psychotherapeutic
relationship (Green, 2013).
The first online therapy which led to proper conversation
between the therapist and the client and confidentiality was
created by Dr. David Sommers in 1995. His approach used
emails and real time chats to provide therapy to clients
anywhere around the world with a private fee. Cyberpsych
counselling was also launched by therapist Ed Needham in
1995, which charged 15$ for an hour session (Rauch, 2018).
Then, Talkspace was launched by Oren and Roni Frank in
2012, which provided online therapy at a much higher scale
with unlimited messaging therapy features. The app could be
used on smartphones allowing individuals to send a video or
voice message (Raunch, 2018). Therefore, the concept of online
therapy became more popular and widespread.
Importance Of Technology Based
Therapeutic Tools
Technology assessment plays a vital role in the dynamic
process of improving the healthcare system. Many clinicians
turn to technology based assessment in order to provide better
information, which helps in accurate decision making and to
set national health policy (Sox & Donaldson, 1992). There
are a variety of ways in which technology-based assessments
and interventions can be used, which provides meaning to
the wide range of mental health services including screening,
assessments, treatment, prevention, recovery, management
and continuing care (Center for Substance Abuse Treatment
(US), 2015). With the help of technology, there has been
standardization of the assessment tools used for screening
the patients and access of all relevant information without
the help of a clinician, which saves time as well resulting in a
more global outcome (Macqueen, P. 2012). Some of the other
benefits are increased efficiency, security of the test materials
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An Official Research Journal of Indian Institute of Psychology
and scoring protocols and flexibility in terms of different norms
and languages. Therefore, online assessment tools provide
better and cheaper outcomes at a faster rate (Macqueen, P.
2012). The e-tools also provide clinicians to work with a large
number of clients for a longer period (for example, online
counselling offers relapse prevention after intensive treatment).
Another important benefit of technology assisted care is time
flexibility, which allows clients to receive treatment according
to their convenience and new information can be incorporated
easily and exported quickly suggesting e-assessments are
in accordance with latest scientific advances (Center for
Substance Abuse Treatment (US), 2015). Further, with the help
of technology, clients can join online recovery support groups,
which is also known as virtual support groups. As a result of
this, clients can learn to take care of themselves resulting in
monitoring their own health and recovery process (Center for
Substance Abuse Treatment (US), 2015).
There are some disadvantages of using technology to
provide mental health support. For example – if a client uses
an online anonymous support group to take help from the
clinicians and address sensitive topics such as substance use or
engaged in other risky and harmful behaviors. Then anonymity
can create ethical and legal issues because the clinicians
or counsellors cannot verify the client in case of suicidal
attempt or having dangers to others (Center for Substance
Abuse Treatment (US), 2015). Although standardization is an
advantage for conducting online assessments in terms of test
materials and flow of the test, it is considered a disadvantage
in terms of the environment in which the client is performing
the test, sustainability and quality of the device display and
technology in general (Macqueen, P. 2012).
Modes of Technology
There are rapid advances in the field of technology
and therefore, clinicians should be vigilant while selecting a
particular tool for the benefit of clinical work. Clinical benefits
and needs should drive the use of technology and not vice
versa (Center for Substance Abuse Treatment (US), 2015).
According to the World Health Organization (2019) ‘Telehealth’
is defined as the delivery of health care services with the help
of technology such as video-conferencing, mobile apps and
electronic transmission, where the client and doctor/therapist
are separated by distance. Some of the services delivered by
telehealth in the field of clinical psychology are assessment,
psychoeducation, training, supervision and consultation
(Backhaus et al., 2012). Let’s understand the technologies in
greater depth.
 Indian Journal of Behavioral Research & Therapy
2022, Volume 3, Number 1 & 2
Video/web-conferencing tools.
Video conferencing psychotherapy is one of the subtypes
of telehealth. In a study conducted by Bouchard et al. (2020),
it was found that video conferencing psychotherapy requires
using the right software with password so as to confirm
the identity of the client and thereby, providing powerful
encryption of the therapy sessions and on the user’s computer.
This process helps to maintain the confidentiality issue which
is an integral part of psychotherapy. While having a web
based psychotherapy, it is essential to set some ground rules
(psychotherapeutic contract) to maintain a steady growth and
professionalism. Some of them are –
• Setting rules regarding the environment of the session.
Example – there should be no disturbance from both
the sides and privacy should be maintained
• Interpersonal interactions – such as no phones call will
be addressed during the session on both the sides and
maximize face to face interaction
• Management distractors – No email or any other
important alerts
• Communication strategies – non-verbal cues such
as nodding and connecting a few minutes before the
session time so that the client settles down completely
while being in a waiting room.
• Contingency management plan – informing prior in
advance regarding the cancellation or rescheduling of
the session (Bouchard et al., 2020).
In another study conducted by Backhaus et al. (2012), it
was concluded that video based psychotherapy is constructive
and most users are satisfied with online sessions. Video-based
psychotherapy is extremely useful for clients living in remote
areas or geographically isolated areas (Johnsson et al., 2019).
In a very interesting study conducted on Japanese adults, it
was revealed that there was an improvement in the client’s
compliance with tasks and goals after delivering online CBT,
thereby resulting in better prognosis (Matsumoto et al., 2019).
Self-directed, web-based and desktop computer based
therapeutic tools.
Many times it has been observed that people do not prefer
to seek help from mental health professionals due to stigma, but
often engage in self-help techniques, which are available online.
Due to advancement in technology, many programmes have
heuristic techniques, which enables them to produce a natural
response to client entered information (Luo, 2005). Most
programs are coded according to cognitive mode of treatment
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An Official Research Journal of Indian Institute of Psychology
(i.e. cognitive behavioural therapy), which represents many
significant concepts such as relationship between automatic
thoughts and feelings, thereby highlighting techniques to
control these thoughts (Luo, 2005).
Another intriguing device which is being incorporated in
the field of clinical psychology in the form of psychotherapeutic
intervention, assessment as well as rehabilitation is the use of
Virtual Reality. The term ‘Virtual Reality’ was developed by
Jaron Lamier in 1986 to describe a set of technology generated
by computers to produce a 3-D effect rather than a simple 2-D
display. Virtual reality stimulates visual, auditory, tactile as
well olfactory sensations providing the users to experience the
world in a real way (Brahnam & Jain, 2011). Virtual reality
has contributed immensely in the field of mental health. With
the help of this technology, clients can overcome their phobias
(excessive fears), get rid of flashbacks with reminders of past
trauma in PTSD and of persecutory delusional beliefs and is
helpful in resisting the urge to take another drink in case of
alcohol based disorders (Freeman et al., 2017). Supervision of
skilled therapists is greatly reduced and can be eradicated as
well for most of the disorders. Therefore, in the near future,
Virtual Reality is one of the methods of psychological treatment
– “out with the couch, on with the headset” (Freeman et al.,
2017).
Web-based text communication (email, chat rooms
and forums).
Chat rooms refers to a platform where the clients can join
and leave according to their own convenience and could talk
to any participants in that chat room. These are moderated by
clinicians which have a set of guidelines for the participation
(Center for Substance Abuse Treatment (US), 2015). It
works more on the principles of focus group discussions.
Since privacy is not maintained it is not a beneficial tool for
psychotherapeutic intervention. However, few topics could
be discussed using this technology. Online support forums
are arranged in a bulletin board format, which allow users
to post anonymously involving a text based communication.
Nowadays, there are various forums or online support groups
where people are connected with each other, which helps them
to share their experience with others and grow individually.
Forums also works on promoting mental health care and
well-being and working towards helping clients with mental
disorders. Some of the prominent names of forums are ‘Beyond
Blue’ in Australia, ‘Patients like me’ in Cambridge, United
Kingdoms and ‘Something Fishy’ is working towards people
dealing with eating disorders in the USA.
 Indian Journal of Behavioral Research & Therapy
2022, Volume 3, Number 1 & 2
Legal And Ethical Issues of E-Therapy
Confidentiality, privacy and security.
The use of technology based therapeutic tools involves
many factors/issues which evolves around confidentiality,
privacy and security of online psychotherapeutic sessions
(Center for Substance Abuse Treatment (US), 2015). The
breach of confidentiality can occur from the therapist’s end,
client’s end, during transmission of records or from where the
online data is being stored. Therefore, it is very necessary to
evaluate the software and the security of the websites as well
as computers because there are chances of hackers hacking the
computer and then misusing personal information (Childress,
2000). Therefore, it is essential to use firewalls, passwords
and backup data storage systems to increase the security of
the online therapeutic sessions (Cherry, 2020). Some of the
software to increase the confidentiality are Secure Socket
Layers (SSL) and encryptions technologies for email and
IRC. Encryption provides protection of the date by converting
plain text into cipher text and is recommended for all therapy
using email. The SSL is most used in areas of virtual reality
environments or where conversation is being held and stored
(Midkiff & Wyatt, 2008).
Informed consent
It is very important to discuss the potential risks of online
treatment and the theoretical foundation of the treatment
on which it is based. It could be discussed verbally through
online videoconferencing and later an email can be sent as a
document record (Childress, 2000). In an informed consent, all
the relevant points must be mentioned and discussed with the
clients to have a better understanding. According to American
Psychological Association (2020), some of the important points
of the informed consent are as follows –
• Therapeutic benefits and risks
• Confidentiality
• Agreement on using videoconferencing for
psychotherapy treatment and explain the process
• Quiet and polite environment, free from distractions
• Secure internet connection rather than free or public
Wi-Fi
• Punctuality should be maintained and cancellation or
rescheduling of appointment must be informed in prior
advance
• In case of technical difficulties, there should be a
back-up plan such as scheduling it for the next time or
solving the issue to restart again
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An Official Research Journal of Indian Institute of Psychology
• An emergency number of a person to contact during
times of crisis
• If a person is a minor, permission from parents or local
guardians for them to participate in e-therapy sessions.
Boundary issues
Boundaries are an integral part of psychotherapeutic
intervention and many factors contribute to the making of
boundaries between the client and the therapist. The two
important factors responsible for increasing the likelihood
of harmful boundary crossing and violation in the field of
telepsychology are issues related to time and aspects related
to settings (Drum & Littleton, 2014).
Time is a very important aspect in psychotherapy as
it helps in providing a structure to the therapy sessions.
Some of the issues that occur during tele-therapy are the
mode in which the therapy is being conducted (example
– videoconferencing, email therapy, online interventions),
structured work environment and the perception of convenience
for both parties. Mostly these issues arise during asynchronous
communication (i.e. use of technological tools like email, pre-
recorded sessions or online interventions)since there is no set
time for the client and therapist to interact with each other,
therefore, the time boundary can be crossed frequently. Another
important point in time boundaries is that there is no set speed
or frequency of interaction, therefore there are higher chances
of unintentional favouritism with few clients by interacting
more frequently and quickly whereas delaying the interactions
with others (Drum & Littleton, 2014).
Another boundary issue is settings of the environment
from where the therapy sessions are being held. Although
online psychotherapy provides flexibility in terms of distance
or travelling, a proper environment is essential and mandatory.
Therapy sessions cannot be held in public places (such as coffee
shops etc.) as it involves many legal and ethical consequences
and also a risk to the confidentiality aspect. The clinician should
not frequently change the background as it stimulates boundary
related challenges. The clinicians should not accept any request
from the client on any social networking sites as it loosens the
formal relationship bond between the therapist and the client
(Drum & Littleton, 2014).
Practising beyond the boundaries of competence.
According to American Psychological Association
(2013), there are certain guidelines regarding the competence
of the psychologist to practise teletherapy.
 Indian Journal of Behavioral Research & Therapy
2022, Volume 3, Number 1 & 2
• The clinicians must pursue additional qualifications
and training regarding telecommunication, attend
conferences and be an integral part of continuing
education.
• Psychologists are also expected to examine whether
specific telecommunication is suitable for the client
based on practical guidance and current literature
reviews. They should be aware about the effectiveness
of a particular technology being used for teletherapy.
• Psychologists should also take into consideration the
role of linguistic, cultural, socioeconomic and other
specific individual characteristics (example – personal
preferences, medical and psychiatric history)
• Psychologists should be able to handle emergency
situations via telecommunications (i.e. having an
emergency contact number, local resources for referral
and so on) and make reasonable efforts to discuss with
clients and provide written instructions as to what to
do in case of emergency situations.
• They should also make an arrangement of discharge
plans when teletherapy is not necessary.
• For supervision, psychologists could consult others
who are aware of the uses of telecommunication
and be proficient in the professional services being
offered.
Crisis intervention planning.
Online psychotherapists must be prepared for addressing
the crisis via telecommunication such as suicidal ideations,
sexual abuse and harm to others. They should have a full-
fledged plan in case of emergency situations and all the
immediate resources for contact. Many psychologists discuss
crisis plans with their clients before starting the therapy sessions
and obtain relevant information such as verified street details
and emergency contact number (Childress, 2000).
Method
Search Strategy
A systematic research was conducted using various
keywords such as “Technology and e-therapy”, “Virtual reality
and psychotherapy”, “Online psychotherapy” and “Artificial
Intelligence and Psychology”. Studies have been taken from the
last one decade and theoretical concepts have been explained
by exploring and examining the articles in greater depth. The
articles have been obtained from various online databases such
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An Official Research Journal of Indian Institute of Psychology
as JSTOR, EBSCO, ProQuest Research Library and Google
Scholar. A total of 19 studies have been reviewed.
Eligibility Criteria
No restrictions were placed on the diagnoses or any
clinical or demographic characteristics of the eligible sample.
Studies using active or inactive control groups were eligible
for inclusion. Inactive control groups were those in which
participants received no intervention during the trial period
(or were placed on a waiting list). Active control groups were
those that used apps, face-to-face interventions, or other forms
of patient contact to control for the time/attention given to those
in the intervention condition.
Types of Studies
The articles have been published in reputed journals to
evaluate the effectiveness of technology in the field of clinical
psychology. Various studies have been taken with RCT’s and
non-RT’s and were included if the full report was accessible
in English.
Types of Interventions
The review included studies with psychological and
non-psychological interventions (e.g., psychoeducation, self-
management programs, physical and mental exercises). Studies
were included regardless of treatment intensity or duration.
Results and Discussion
Digital technology has become an integral part of every
day’s life, which serves many purposes and functions. It
includes a wide range of electronic devices, hardware, software
and internet based services. The results of the studies reviewed
are as follows:
Technology and E-therapy
It involves digit intervention, videoconferencing
psychotherapy, self-help interventions and asynchronous
communication. Digital interventions are fully automatic and
its underlying algorithm feeds the delivery of information,
support and advice in a personally tailored manner. A total of
5 studies have been reviewed under this category and it has
found to be quite effective in the treatment of insomnia and
depression (Cheng et al., 2019; Espie et al., 2012, 2019; Wilks
et al., 2018, Sweet et al, 2021), as mentioned in Table 1. Various
psychotherapies algorithm such as Cognitive Behavioural
therapy (CBT), Dialectical Behavioural therapy (DBT) or
Behavioural activation and Approach balance training have
 Indian Journal of Behavioral Research & Therapy
2022, Volume 3, Number 1 & 2
been developed for digital use, where there is no or little use
of psychotherapist. When web-based therapies are designed,
it is noted that while mirroring the face to face counterpart, it
should not hinder the advantages of technology and preludes
a level of effectiveness comparable to in-person treatment
(Schuurmans, n.d.).
Videoconferencing technology allows both audio as
well as video information to be shared concurrently across
geographical distances (Fernández-Álvarez, 2021) and is a
growing practice in the field of mental health (Muir et al.,
2020). The studies reviewed treated Obsessive Compulsion
disorder and Panic disorder and Agoraphobia and it was
found that this mode of treatment is moderately effective
(Bouchard et al., 2020; Kyrios et al., 2018) as indicated in
Table 1. Videoconferencing psychotherapy did not show that
it is better than other modes of treatment such as face to face
psychotherapy. The integration of digitally delivered treatment
options into health systems and policies is of paramount
importance in the development and management of mental
health challenges of communities.
Self-help intervention is defined as a psychological
treatment which involves standardized psychological treatment
protocols and the individual works through it more or less
independently (Schuurmans & Cuijpers, n.d.). Asynchronous
communication is when there are two (or more) people who
can communicate without being actually present at that
current moment (Thomas, 2018). These studies did not show
any compromising results and proved to be ineffective in the
treatment of the disorder (Hodgins et al., 2019; Jonas et al.,
2018) as manifested in Table 1.
Virtual Reality and Psychotherapy
Virtual reality is one of the most powerful tools that is
emerging in the near future. It is referred to as a 3-D virtual
environment that is generated by computers, which stimulates
visual, auditory and tactile sensations providing the individuals
to experience the world in a real way (Foreman, n.d.). It is quite
effective in the treatment of wide spectrum of psychological
disorders ranging from eating disorders, psychotic disorders,
mild cognitive impairment, social anxiety disorder and post-
traumatic stress disorder (Anderson et al., 2013; Beidel et al.,
2019; Liao et al., 2020; Matsangidou et al., 2020; Pot-Kolder et
al., 2018), as mentioned in Table 2. For psychotherapy, virtual
reality programmes have been developed by taking principles
from Cognitive behavioural therapy (CBT), Exposure therapy
and Acceptance and Commitment therapy (ACT). In most of
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An Official Research Journal of Indian Institute of Psychology
the studies of Virtual Reality, there was small sample size and
lack of comparison group. Overall, it is helpful in providing
and promoting better treatment as well as resulting in cost-
effectiveness.
Artificial Intelligence and Psychology
Artificial Intelligence refers to a machine’s ability to
perform functions, which can be performed by an individual
such as reasoning, problem-solving, learning, control,
adaptation and perception (Mello & Souza, 2019). A total
of five studies have been reviewed and robots were used
for the treatment which were compared to non-robot based
therapy. It has been found that robots are effective in reducing
psychological symptoms such as anxiety and stress, reinforces
facial engagement and emotional cognition among children
population (Marino et al., 2020; Petersen et al., 2016; So et al.,
2020; Voss et al., 2019; Yun et al., 2017) as indicated in Table
3. One of the most common limitations among the articles
reviewed were of small sample size, therefore, resulting in no
generalizability of the results.
Conclusion
Integrating technology into mental health practices has
the potential to dramatically shift the traditional format of
mental health services and has made transformative changes
in prevention, promotion, and treatment of mental health
problems through flexible, immediate, on-demand, personal,
individually paces and stigma free services. Robots can help in
a number of ways such as to assist individuals with cognitive
issues (e.g.- reminding and playing memory games), health
management (e.g.- monitoring blood pressure and encouraging
exercise) and psychosocial issues (e.g.- providing compassion
and entertainment) to cure loneliness especially with elderly
people. Robots are also used to help children with Autism
spectrum disorders who have difficulty in communicating and
understanding other people. An excellent example of artificial
intelligence is Sophia – a socio-humanoid robot developed by
Hong Kong based company named Hanson robotics. In 2017,
she received citizenship of Saudi Arabia. Sophia has the ability
to understand emotions but cannot feel it, conducted few guided
meditations and participated in autism treatment.
Another intriguing aspect is that Japan is one of the most
technologically advanced country in the world and recently
‘Ministry of Loneliness’ was formed to tackle suicide rates
(Awasthi, 2021).
Indian Journal of Behavioral Research & Therapy
2022, Volume 3, Number 1 & 2 An Official Research Journal of Indian Institute of Psychology

Table 1: Summary of studies depicting Technology and E-therapy

Study Design Participants Intervention Comparison Outcome

Use of dCBT is effective in improving

Adults diagnosed Digital CBT using Sleep Hygiene
Espie el functional health, psychological well-being,
RCT with Insomnia Sleepio Program Education
at. (2019) and sleep-related quality of life in people
(DSM-5 Criteria) (N=853) (N=858)
reporting insomnia symptoms
Adults diagnosed Digital CBT using dCBT-I effectively targets both insomnia and
Cheng et Online sleep
RT with Insomnia Sleepio Program comorbid depression across a wide spectrum
al. (2019) education (N=300)
(DSM-5 Criteria) (N=358) of the population.
Participants with Internet delivered iDBT-ST may be a viable resource for the high-
Wilks et suicidal individuals DBT skills training Waitlist control risk and underserved group represented in this
RCT
al. (2018) who engage in heavy intervention (iDBT- (for 8 weeks) study, and pathways for future development
episodic drinking ST) are suggested.
Online image CBT delivered using a media-rich web
Participants
relief therapy application with automated support and a
Espie et diagnosed with
RCT Online CBT (N=55) (IRT) (N=55) + community forum is effective in improving the
al. (2012) Insomnia disorder
Treatment as usual sleep and associated daytime functioning of
(DSM-5)
(N=54) adults with insomnia disorder.
Computerized Computerized
Brief, computerized behavioral activation plus
Participants with behavioral behavioral
Sweet et approach/avoidance training (BA + AAT) may
RT diagnosis of MDD activation + activation +
al. (2021) be acceptable and beneficial for some patients
(DSM-5) Approach Positive Approach Balance
with moderate-to-severe major depression.
Training Training
Internet-based
Participants with Internet based CBT standard Large magnitude effect of a therapist-assisted
Kyrios et
RCT diagnosis of OCD (therapist assisted) progressive iCBT for OCD and iPRT was moderately
al (2018)
(DSM-IV-TR) (N=89) relaxation training efficacious
(iPRT) (N=90)
Bouchard Adults with CBT through
Non- CBT through face Mental health professionals can use VCP to
et al. Panic Disorder & videoconferencing
RT to face (FF) provide services to patients with PDA.
(2020) Agoraphobia (VCP)
Hodgins Control group The self-help online intervention was not
Adults with gambling Self-change tools
et al. RCT – Check your associated with better outcomes than the brief
problems (SCTs)
(2019) Gambling Check Your Gambling intervention.
“Quit the Shit” – The reduction of program length and the
No chat-based
Jonas et Participants with Chat-based waiver of synchronous communication have
RFT counselling for 50
al. (2018) cannabis dependance counselling for 50 no meaningful impact on the effectiveness of
and 28 days
days and 28 days QTS.

Table 2: Summary of studies showing Virtual Reality and Psychotherapy

Study Design Participants Intervention Comparison Outcome

Multi-
VR - ACT, Play MUVR is a powerful predictor for
Matsangidou user High risk of developing
& Exposure individuals at high risk of developing eating
et al. (2020) Virtual eating disorders
therapy disorders
Reality

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Indian Journal of Behavioral Research & Therapy
2022, Volume 3, Number 1 & 2 An Official Research Journal of Indian Institute of Psychology

Virtual Reality
VR-CBT can reduce paranoid ideation
Single Participants diagnosed – Cognitive
Pot-Kodler Waitlist and momentary anxiety in patients with a
blind with psychotic disorder Behavioral
et al. (2018) control group psychotic disorder as compared to standard
RCT (DSM-IV) Therapy (VR-
treatment
CBT)
VR-based Combined
Single VR-based physical and cognitive training
Liao et al. Older adults with mild Physical and Physical and
blind improves cognitive function, IADL and
(2019) cognitive impairment Cognitive training Cognitive
RCT neural efficiency in older adults with MCI.
group training
Exposure
Participants with VR exposure therapy is effective for
group
Anderson et diagnosis of social anxiety Virtual Reality treating social fears, and improvement is
RT therapy +
al. (2013) disorder with primary fear Environment maintained for 1 year. It is equally effective
Waitlist
of public speaking as exposure group therapy
group
Trauma Exposure
Beidel et al. VRET is an efficacious intervention for
RCT Participants with PTSD Management Therapy
(2017) combat-related PTSD
Therapy (VRET) (VRET)

Table 3: Summary of studies indicating Artificial Intelligence and Psychology

Study Design Participants Intervention Comparison Outcome

Children (age 2 to 7 Human assisted

Yun et al. Therapeutic robot Robots are useful mediators of social
RCT years) diagnosed with treatment
(2017) intervention skills training for children with ASD.
ASD (DSM-5) intervention

Robot-based play- drama intervention

Children diagnosed
So et al. Robot based Wait -list control can enhance the joint attention and
RT with ASD (age 18 to 48
(2019) intervention (N=12) (N=11) play behaviours of children with
months) (DSM-5)
ASD.

Partially controlled assistive

Children diagnosed robots can be used as an effective
Mariano el Robot assisted group Non-robot REBT
RCT with ASD (age 4 to 8 augmentative mediator in CBT
al. (2019) REBT therapy therapy
years) (DSM-5) protocols on children with autism
spectrum.

PARO robots decreased stress and

Standard of care
Participants diagnosed anxiety and reductions in the use of
Peterson et – music, physical
RBD with mild to moderate PARO robot pet psychoactive medications and pain
al. (2017) activity & mental
dementia medications in elderly clients with
stimulation
dementia.

It reinforces facial engagement and

Superpower glass Applied Behavioral
Voss et al. Families with children emotion recognition and could be the
RCT intervention + ABA Analysis Therapy
(2019) with ASD potential of digital home therapy to
therapy (ABA)
augment the standard of care.

Therefore, three supreme questions that we need to find answers in the imminent future are as follows:
1. Can there be a correlation between technological advancement and increased psychological distress?
2. Can robots ever be able to replace a real human connection?
3. Can technology replace man-power or human interaction to cure mental illness alone?

117
 Indian Journal of Behavioral Research & Therapy
2022, Volume 3, Number 1 & 2
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