Participatory Design of VR Scenarios for Exposure Therapy
EivindFlobak JoD.Wake∗ JoakimVindenes†
SmitiKahlon TineNordgreen‡ [email protected]
FrodeGuribye§
[email protected] DepartmentofInformation [email protected] [email protected] ScienceandMediaStudies [email protected] PsychiatricDivison UniversityofBergen
[email protected] HaukelandUniversityHospital Bergen,Norway DepartmentofInformation Bergen,Norway
ScienceandMediaStudies UniversityofBergen
Bergen,Norway ABSTRACT
Virtualreality(VR)applicationsforexposuretherapypredom- inantlyusecomputer-generatedimagerytocreatecontrolled environmentsinwhichuserscanbeexposedtotheirfears.
Creating3Danimations,however,isdemandingandtime- consuming.Thispaperpresentsaparticipatoryapproach forprototypingVRscenariosthatareenabledby360°video andgroundedinlivedexperiences.Weorganizedaparticipa- toryworkshopwithadolescentstoprototypesuchscenarios, consistingofiterativephasesofideation,storyboarding,live- actionplaysrecordedbya360°camera,andgroupevaluation.
Throughananalysisoftheparticipants’interactions,weout- linehowtheyworkedtodesignprototypesthatdepictsitua- tionsrelevanttothosewithafearofpublicspeaking.Ouranal- ysisalsoexploreshowparticipantsusedtheirexperiencesand refectionsasresourcesfordesign.Sixclinicalpsychologists evaluatedtheprototypesfromtheworkshopandconcluded theywereviabletherapeutictools,emphasizingtheimmer- sive,realisticexperiencetheypresented.Wearguethatour approachmakesthedesignofVRscenariosmoreaccessible.
∗AlsowithNORCE.
†AlsowithSLATE–CentrefortheScienceofLearning&Technology.
‡AlsowithDepartmentofClinicalPsychology,UniversityofBergen.
§AlsowithPsychiatricDivison,HaukelandUniversityHospital.
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CHI 2019, May 4–9, 2019, Glasgow, Scotland UK
©2019Copyrightheldbytheowner/author(s).Publicationrightslicensed toACM.
ACMISBN978-1-4503-5970-2/19/05...$15.00 https://doi.org/10.1145/3290605.3300799
CCS CONCEPTS
•Human-centeredcomputing→Participatorydesign;
HCI design and evaluation methods.
KEYWORDS
virtualreality;participatorydesign;exposuretherapy;work- shop
ACM Reference Format:
Eivind Flobak, Jo D. Wake, Joakim Vindenes, Smiti Kahlon, Tine Nordgreen, and Frode Guribye. 2019. Participatory Design of VR ScenariosforExposureTherapy.In CHI Conference on Human Fac- tors in Computing Systems Proceedings (CHI 2019), May 4–9, 2019, Glasgow, Scotland UK. ACM,NewYork,NY,USA,12pages.https:
//doi.org/10.1145/3290605.3300799
1 INTRODUCTION
Sweatypalms,ashakyvoice,andtremblinghands—mostof ushaveexperiencedthesesensationswhilegivingapublic speech.Fearofpublicspeakingisprevalentinone-fourth toone-thirdofthegeneralpopulation[15,40]andusually beginsinadolescence[47].Whenthesymptomsofthisfear persevereandbecomehabitual,theymayleadtounfortunate consequencessuchassocialanxiety,depression,academic failure,andmorelimitedemploymentopportunities[2].
Virtualreality(VR)isusedasatoolintherapyforexposing patientswithperformance-typeanxietydisordertotheirfear ofpublicspeaking[21,22].ExposuretherapyscenariosinVR areordinarilydesignedusingcomputer-generatedimagery (CGI),whichrequirescareful3Dmodelingandanimationthat canbetime-consumingandcostlytocreate.Furthermore, suchdesignscommonlyfeaturegenericenvironmentsand scenariosthattakea“one-size-fts-all”approachtotargeting speakinganxiety.
Theemergenceofafordableandreadilyavailable360°ste- reoscopicvideocamerashasopenedupanewdesignspace.
ThistechnologyallowsrealisticVRscenariostobecreated
basedonrecordingsofrealpeople[16,24].These360°cam- erashaverecentlybeenusedinVRexposuretherapy[41], andaccordingtoSeoletal.[35],theyprovideatoolwith“eas- iermeansforcreatingmanydiferentscenes/situationsand customizingfortheparticularneedsofthepatient”[35,p.2].
Giventhatfearofpublicspeakingusuallybeginsinado- lescence[47],wearguethatthereisaneedtotailorexposure therapydesignstothisagegroup.Sincewearetargetingthe exercisetoolatadolescents,wehaveusedaparticipatory approach[14]tocreatedesignsthatarebasedonthelived experiencesofadolescentsaged15-17years.
Toaddresstheneedforincorporatingadolescents’lived experiencesindesign,wedevisedaworkshopinspiredby experienceprototypingtechniques[9,46]inthedesignofVR scenarios.Overtwodays,ffteenadolescents–withthehelp offvefacilitators–producedfourscenariosthatdepictsitu- ationsinwhichonemightexperiencefearofpublicspeaking.
Theparticipantsplayedouttheirscenariosaslive-actionper- formances,whichwerecapturedbya360°stereoscopicvideo camera.Aftersomestitchingandediting,thesevideosbecame VRprototypesaimedatexposingtheusertopublicspeaking.
Wereviewedandtranscribedvideorecordingsofthepar- ticipants’workprocesstoanalyzetheirapproachandidentify analyticalthemes[6,7].Inthisanalysis,weidentifedthemes relatingtohowtheadolescentsusedtheirlivedexperiencesto designVRscenarios,envisionedandcomposedvirtualenvi- ronments,andmadesenseofthesubjectmatter.AftertheVR prototypeswerecompleted,sixclinicalpsychologistsevalu- atedtheVRscenariosbyviewingthemwithahead-mounted display(HMD)andassessedeachscenario’sfeasibilityforuse intherapeuticcontexts.Theevaluatorsemphasizedthesce- narios’authenticityandrealism,statingthattheyconsidered theprototypesviableforuseinexposuretherapy.
Ourresultsshowthat360°videoisaviabletoolfordesign- ingVRscenariosandiswell-suitedforconstructingrealistic anddetailedvirtualenvironments.Theprimarycontribution ofthispaperisthecompositionoftoolsandmethodswe presentfordesigningsuchscenariosandincludingpartici- pantsinthedesignprocess.
2 RELATED WORK
Thissectionintroducespreviousresearchonfearofpublic speaking,exposuretherapy,andvirtualreality.
Fear of public speaking
Fearofpublicspeaking,asubtypeofsocialanxietydisorder, ischaracterizedbyanintensefearofhumiliationandembar- rassmentbeforeandduringpublicandsocialspeakingperfor- mances.Thefearexperiencedistypicallydisproportionateto theactualthreatposedbythesocialsituation.Furthermore, avoidance-typebehaviorisoftendisplayedbytheindividual inthesepublicandsocialperformancesituations[2].
Thisphenomenonisprevalent,withone-thirdoftheUS populationreportingexcessivefearofpublicspeaking[40,47].
Socialanxietydisorders,suchasthisfear,mayleadtoother anxietydisorders,majordepressivedisorder,andsubstance usedisorders.Further,itisassociatedwithreducedopportu- nitiesinacademicstudiesandprofessionalcareers,aswellas alowerqualityoflifeduetosocialisolationandwithdrawal [2].Socialanxiety,ingeneral,isaseriouspublichealthcon- cernthatoftengoesuntreated[27].Giventhatfearofpublic speakingusuallyhasitsonsetinadolescence,itisimportant tointerveneearlytopreventtheconditionfromworsening.
Exposure therapy
Exposuretherapy,atreatmenttechniquewithincognitivebe- havioraltherapy,aimstocombatpatients’fearofcatastrophic outcomesbyplacingtheminsituationsthatelicittheirfear responses.Withrepeatedexposuretothefearedsituations, patients’establishedfearsarechallengedandeventuallyin- hibitedandoverriddenbytheirnewexperiences,aprocess referredtoasinhibitorylearning[10]. In vivo exposurether- apy(treatmentinnaturalisticsettings)isefective[1,43],but logisticallycomplicatedtoimplement,forpatientswithafear ofpublicspeaking.Inpublicspeakingperformancescenarios inparticular,itisdifcultforatherapisttocontrolthestimuli andexposurewhileinsession[22].
Virtual reality for exposure therapy
Theuseofimmersivevirtualreality(VR)inexposuretherapy totreatanxietydisorderssuchasfearofpublicspeakingdates backtothe1990s[22,26].Withthistechnique,anHMDthat showstwoslightlydiferentsegmentsofanimageisemployed topresenttheuserwithastereoscopicvirtualenvironment.
TheHMDisequippedwithmotionsensors,whichallowfor constantcomputationofnewimagestosustainthepresented environmentandhelpcreateanimmersiveexperienceforthe viewer[37].
LevacandGalvinviewsuchapplicationsasatoolinVR- basedtherapy,inthattheyrequireatherapistto“identify specifcgoals,determinetherapytasks,gradeandprogress theactivitytoprovideappropriatechallenge,monitorper- formance,evaluateoutcomes,andenablepatientstolinkthe tasksoractivitiesbeingpracticedintherapytotheirreal- worldcontext”[20,p.795].UseofVRalonedoesnotconstitute therapy.However,whenviewedasatool,VRcanbeunder- stoodasatherapeuticelementthatcanenhancetherapyand amplifyitspositiveoutcomes.
UsingVRasatoolforexposuretherapymay,depending onimplementation,allowtherapiststotakecontroloftheex- posurelevel,stimuli,setting,anddesignoffeaturespresented tothepatient.SystematicreviewsofVRforexposuretherapy showthattheefcacyoftheseinterventionsissimilartothat of in vivo interventions[23,29,30].
HMDsforexperiencingVRcontenthaverecentlybecome availableontheconsumermarket.Duetoimprovementsin graphicalresolution,feldofview,andrefreshrates,these HMDscannowprovideimmersiveexperiencesatlowercosts.
Therefore,consumer-gradeHMDsareexpectedtochangethe designanduseofVRforpsychologicaltreatment[22,31].
Anaudienceisanecessaryingredientinavirtualenviron- mentthatpresentsexposuretopublicspeaking.Designingan- imatedavatarsthatdepicthumanaudiences,however,comes withthepitfallsoftheuncannyvalleyefect[25,34]andsub- sequenttrade-ofsindesignbetweenrealisticandcartoonish human-likeavatars[36].Hence,designersofthesetreatments oftenoptforsemi-realisticavatarstorepresenthumans,along withsimplifedanimationofsocialinteractions[22].
Whilesomeefortshavebeenmadetoinclude360°videoin exposuretherapy[41],thesefeaturegenericsettings–such asanauditorium–thatarealsocommonlyseenincomputer- animatedVRenvironmentsforexposuretherapy.Weargue, inlinewithHodgeetal.[17]andSeoletal.[35],thatthereis aneedtoexploretailoringoftreatmentsandwaystorapidly createnewVRscenarios.ThedebatesonrealisminVR[37,38]
areoftenfocusedonpixelsandsensoryfdelity,butweargue thatthereisalsoaneedtogobeyondthisandfocusonwhatis realandauthenticintermsofsocialscenarios,especiallywhen conductingexposuretherapyforfearofpublicspeaking.
3 METHODS
ToaddresshowtocreateVRscenariosbasedonthelivedexpe- riencesofthetargetaudience,weorganizedourresearchinto threephases.First,weplannedaparticipatoryworkshopwith adolescents,evaluatinghow360°camerascanbeusedtopro- totypeVRscenarios.Second,followingtheimplementationof theworkshop,weconductedadetailedanalysisofhowthepar- ticipantsinterpretedandorganizedtheirworkinmakingthe VRscenarios.Finally,wehadsixclinicalpsychologistsevalu- atethefourscenariosthatresultedfromtheworkshop,assess theirrealism,anddiscusshowtheworkshopapproachcould beusedtomaketailoredVRscenariosforexposuretherapy.
Participatory workshop
Weengagedadolescentsagedffteentoseventeeninapro- cessofparticipatorydesign[5,13,14,42,45],goingbeyond traditionaluserconsultationandtestingbyseekingactive contributionsintheformofdesignproposalsandalternatives.
Theprimarymotivationforinvolvingadolescentswastohave themnotonlyengagecreativelyinthedesignprocess,butalso producescenariosthataregroundedintheirlivedexperiences andlife-world.InlinewithDourish[12]weunderstandlife- worldas“theintersubjective,mundaneworldofbackground understandingsandexperiencesoftheworld.Itistheworld ofnaturalattitudeandofeverydayexperience”[12,p.106].
Thus,weweremainlyinterestedinadolescents’knowl- edgeofandexperiencewithsituationsthatrequirethemto speakpublicly.Byinvolvingthemdirectlyinthedesignpro- cess,weaimedtobuildonlivedexperiencesthatwewould notordinarilyhaveaccesstoandthusachieverelevantand sociallyrealisticprototypes.Thespecifcwaytheadolescents participatedinthedesignprocesswastocollaborateingroups oniterativedesignphasesformakinga360°videopotentially treatingfearofpublicspeaking.Theyalsogavefeedbackon othergroups’workthroughouttheprocess.Theresearchers andfacilitators,ontheotherhand,defnedthegoalsand stepsintheworkprocess,providedguidanceandbackground knowledgeoncentraltopics(i.e. VR,creativeworkprocesses, andfearofpublicspeaking),occasionallyoferedencourage- mentandadviceonthecollaborationprocess,andassistedin theuseoftechnicalhardwareandsoftware.
Werecruitedparticipantsfromtwopublicschoolsbydis- tributinganinformationalfyer.Weaskedforparticipants thatwerebetween15-17yearsoldandhadeitheraninterestin designingtechnologyorfrst- orsecond-handexperienceof fearofpublicspeaking.Participantswererecruitedfromsec- ondaryschools,astheseeducationalinstitutionsaresettings inwhichsocialphobiascommonlybegin[47].
Fifteenparticipantssignedupfortheworkshop,fourof whomwerefemale.Theboardofethics–TheDataProtection Ofcialforresearch,assessedandapprovedthestudy.Par- ticipantsagedsixteenandolderwereallowedtopersonally signtheinformedconsentform.Threeffteen-year-oldpartic- ipantshadtheirconsentformssignedbyparents,asrequired byNorwegianprivacylaw.
Participantsreceivedcertifcatesofparticipationandcom- pensationintheformof$120ingiftcertifcates.
Theworkshopwasorganizedasatwo-dayeventovera weekend.Theparticipantsformedgroupsontheirownbased ontheirprioracquaintanceasclassmates.Intotal,therewere fourgroups:threegroupswithfourparticipants,andone groupwithparticipants.Thegoaloftheworkshopwasto producefourdistinctprototypes.
Data collection and analysis
Weflmedtheparticipantsandfacilitatorsthroughoutthe workshop.Usingfourcameras,wewereabletocaptureallpar- ticipants’collaborationontheirscenarios.Thevideorecord- ingsprovideadetailedviewoftheadolescents’workprocess, includinghowtheymadesenseoftheirgiventaskandhow theyunderstood360°videoandVRenvironments.
Tenhoursofvideorecordingsweretranscribedverbatim.
AlltranscribeddatawasenteredintoNVivoforqualitative analysis.Weusedthematicanalysis[6,7]tosearchforthe- maticpatternsthroughoutthedatacorpus.Thefollowing questionguidedtheanalysis:“Howdotheparticipantsmake
senseoftheirdesigntaskandhowdotheyworkwhende- signingVRscenarios?”Theanalysiswasperformedusing abottom-up,inductiveapproach,meaningthatinteresting dataexcerptswerecodedforwhattheyrepresentedinthe situationalcontext,nothowtheyftintoourpreconceptions offearofpublicspeaking,design,andparticipation.
Thefrstauthorconductedinitialcodingofthedata,us- ingcodessuchas“realism,”“taskunderstanding,”“story- telling,”and“sharinganexperience.”Then,thecodeswere readthroughandorganizedintopossiblethemes.Eachtheme wasthenmappedoutinaconceptualmodelofthedatacor- pus,withtheauthorensuringtheextractedcodesmadesense withintheirthemes.Lastly,thethemeswererefnedtoavoid overlapandrefecttheresearchquestion.
Evaluation
ViewingtheprototypesinlightofLevacandGalvin’sperspec- tiveonVRasatoolfortherapy[20],weperformedanexpert evaluationwithsixclinicalpsychologists.Evaluatorswerere- cruitedamongacquaintancesandcolleagues.Threeoftheex- pertshadpriorknowledgeofandexperiencewithVRforexpo- suretherapy.Onehadpracticalandclinicalexperienceusing VRintherapeuticpracticetoaddressfearofpublicspeaking.
Thepsychologistsviewedthefourprototypesusingan HTCViveProHMDandwereinterviewedbeforeandafter theviewingbasedonthefollowingstructure:(1)theirpre- viousexperiencewithVRandknowledgeandpracticeof exposuretherapy;(2)theirgeneralimpressionoftheproto- types,assessingperceivedrealismandhowimprovements maybemade;and(3)thefeasibilityofusingtheprototypes asatherapeutictool.
Thegoalsofthisevaluationweretoexplorebothhowthe VRscenariosmaybeperceivedandexperiencedbypatients [18]andhowtheycouldbeusedasatoolintherapy[20].While wehavenotdoneanevaluationwithpatients,wefollowDo- hertyetal.[11],whoproposethattherapistscanbeusedas proxiesforpatientsinevaluationbyprovidinganunderstand- ingofhowatoolmaybeperceivedandexperiencedbythem.
4 PARTICIPATORY DESIGN OF VR SCENARIOS Inthispartofthepaper,weprovideanaccountofourmethod fordesigningVRscenariosandhowweapplieditinapartic- ipatorytwo-dayworkshopwithffteenadolescents.
Process for creating VR scenarios
Ascenarioisaconstructionwiththeclearpurposeofpresent- ingandsituatingsolutionstoaproblem[3].Whenbuildinga VRscenario,weunderstandtheprocesstoalignwithBødker’s viewofcreatingascenariofordesign[3],butalsounderstand ittoincludeadramaticcompositionthatcanbeactedout,
capturedbyastereoscopic360°camera,andrenderedintoa videothatcanbeexperiencedinVR.
ToprototypeVRscenarioswithparticipants,wedevised thefollowingiterativeprocessfordesign:(1)ideation,(2)sto- ryboarding,(3)live-actionplaysrecordedbya360°camera, and(4)experience-basedevaluation.
Ideation. WhendesigningaVRscenario,itisnecessarytocon- structanenvironmentwhereintheeventstakeplace.Aphase ofidea-generation[48]isnecessarytoselecttheelementsthat makeupthescenario’splotandenvironment.Thisideation isperformedbydiscussionandbuildingonco-participants’
ideas.Theoutcomeofthisphaseisaconceptualizationofthe selectedideasforthenextphaseofstoryboarding.
Storyboarding. Storyboardingisatechniqueforintegrating theconceptualizedcomponentsofascenarioasacohesive script[44].Tocomposethescript,onecandrawcomicstrips onasheetofpaper.Afurthermethodtosupportstoryboard- ingistheuseofacircularpieceofpaperthatillustratesthe 360°environmentofVR.Anoverlayingcircularsheetwith 100°ofthecirclecutoutcanbeattachedtothis360°story- boardtoillustratetheuser’sfeldofview.Thiscircularoverlay canthenberotatedtoshoweverypotentialviewpointofthe plannedscene.
Live-action plays. Thereisatraditionforusingrole-playasa techniquetosupportthedesignofinteractiveexperiencesin HCI[4,9,19,39,42,46].TocreateaVRscenario,onecanuse actorsandpropstoenactthestoryboardasalive-actionplay, whichcanbecapturedviaa360°videocamera.Therecording canthenbestitchedandrenderedasa360°videothatafords animmersiveexperiencewhenviewedthroughanHMD.The confgurationoftherole-playthatiscaptured,stitched,and renderedtoa360°videoconstitutesaprototype,whichcan beexperienced,assessed,andreviewedbythedesignersand otherinterestedparties.
Experience-based evaluation. TheVRscenariomaybeviewed throughanHMDforanimmersiveVRexperience.Thisview- ingcanbeorganizedasanexperience-basedevaluation[9]
inwhichonecritiquesthedesignandhighlightshowthesce- nariomaybeimproved.ByexperiencingtheirVRscenarios frst-hand,participantscangaininsightintohowothersmay perceivetheprototype.
Technical equipment for VR prototyping
Astereoscopic360°videocamera,Vuze+,wasusedforcap- turingtheparticipants’scenarios.Thecamerarecordsstereo- scopicalvideoin4Kresolutionat30framespersecond.We usedtheaccompanyingHumaneyesVRStudiosoftwarefor stitchingvideo,minorvideoediting,andrenderingtoH264- encoded360°videofles.ForviewingthescenariosasVR experiences,weemployedSamsungGearVRHMDdevices
withSamsungGalaxyS8smartphonesandheadphonesfor achievingspatialaudio.
Workshop implementation
Theworkshopstartedwithafewpresentationsaimedaten- couragingcollaboration,inspiringcreativethought,andfamil- iarizingparticipantswiththetopicoffearofpublicspeaking.
Theparticipantswerethenledthroughaseriesoficebreaker gamesandreceivedahands-onpresentationonfearofpublic speakingbyaclinicalpsychologist,demonstrationsofhow VRworks,andanoverviewofhowtoiterativelyprototype VRexperienceswithastereoscopic360°videocamera.We concludedthissessionbysettingthegoaloftheworkshop:
“Createasituationwhereapersonmayexperiencefearof speakingpublicly.”
Participantsworkedtogetheringroupsfor45minutesto ideate,discusspossibledirectionsfortheirscenarios,andcom- posestoryboards.Halfwaythroughthisideationphase,afacil- itatorvisitedeachgrouptocheckonprogress.Themembers ofonegroup,forexample,statedtheyhadplannedtheirsce- nariosaroundtheintentto“createanintenseexperiencethat wouldbealmostintolerable.”Here,thefacilitatorintervened toreiterateakeypointfromthepresentationonfearofpublic speaking:usually,forapersonwhohastroublespeakingin frontofothers,thetaskofperformingisdifcultenough.
Followingthefrstideationandstoryboardingphase,the groupsofparticipantspresentedtwoideasforVRscenarios toco-participantsandfacilitators,whooferedfeedbackin aninformalevaluation.Inthissession,eachgroupchoseone scenariotocontinuedeveloping.Thefrstdayendedwith taking360°videorecordingsofthechosenscenarios,inwhich theparticipantshelpedeachotherbyservingasactors.Four VRprototypesresultedafterstitchingandrendering.The post-processingof360°videowasdonebythefacilitatorsto savetimeandtoprioritizetheparticipants’creativeprocess.
Thesecondandlastdayoftheparticipatorydesignwork- shopbeganwithoneofthefacilitators,aclinicalpsychology student,reiteratingthecriticalpointsofthepreviousday’spre- sentationonfearofpublicspeaking.Theparticipantgroups thencontinuedtheirworkbyexperiencingandevaluatingtwo scenarioseach(theirownandonecreatedbyanothergroup) withanHMDdeviceforafullyimmersiveVRexperience.One facilitatorjoinedeachgrouptoassisttheparticipantswithnav- igatingtheinterfaceoftheVRheadsetandelicitconstructive, criticalrefectionsontheirexperiencesviewingthescenarios.
Afterthisforty-fve-minuteevaluationperiod,ajointview- ingsessionofallVRscenarioswasconducted,witheachgroup summarizingitsevaluationsasfeedback.Participantsgave eachotherfrankandconstructivecommentary.Forexample, oneindividualsaid,“[Thescenario]wasrealistic,andthatis good,butyoucouldworkontheactorsmessingaround.Itis easiertobedrawninifitfeelstruer.”Followingthefeedback
session,eachgroupreconvenedtoreviseitsscenariobasedon thereview.Participantsdrewmodifedstoryboards,drafted newspeakinglines,andrehearsedtheirscenarioswherenec- essary.Themajorityofthisdaywasspentcapturingthere- visedscenarioswiththe360°camera.Eachgroupdidthree tofourtakesofitsscenarios,evaluatingtheperformances betweentakes,andusedco-participantsandfacilitatorsas actors.
The“besttake”ofeachgroupwerestitchedandrendered into360°videos,showninafnaljointviewingsessionwithall participants.BeforewedetailtheresultingVRscenarios,we turntoananalysisofthecollaborationbetweenparticipants inthisworkshop.
5 ANALYSIS
Thissectionpresentsathematicanalysisoftheadolescents’
designprocess,focusingonhowtheyusedtheirexperiences asinputfordesign,howtheyenvisionedtheirscenarios,and howtheymadesenseofthetaskathand.
Designing from lived experiences
Theparticipantsverballysharedlivedexperiencestoform commongroundthroughwhichtoexplorethedesignchal- lengeandgeneraterefectionsonhowtheirscenariosmay playoutforaviewer.Weidentifytwowaysinwhichthepartic- ipantssharedexperiencesandstoriesthatshapedthedesign:
(1)sharingamemoryofasituationinwhichoneexperienced fearofpublicspeakingtospurdiscussioninthedesignprocess and(2)sharinganexperienceofwitnessingsomeone’sfear ofpublicspeakingtoguidespecifcelementsofthedesign.
First,welookathowparticipantsusedtheirlivedexperi- encestoopendiscussioninthedesignspace:
Lars: Every time I am presenting for my class I end up acting like a fool. Everyone thinks it is hysterical [in a good way], and then I am like, “Fuck me, every time I try to act seriously...” And then it is like,
“Damn, what was I saying again?” I just crack up.
Earlyoninthedesignprocess,Larssharedthisexperience withhisgroupandthusmadetheproblemathandavailableto discussion.Anotherparticipant,Anna,sharedanexperience ofhowanaudiencecanmakeheranxiouswhensheisgiving apresentation:
Anna: When I present in class, I do not care for chatter among the participants. It makes me feel uninteresting and makes me anxious.
WhileLarssharedanexperienceofhowhecandisappoint himselfinpublicspeakingsituations,Annadescribedanexpe- rienceofhowaudiencebehaviorafectsherduringapresen- tation.Theformerestablishesspeakinginfrontofothersasa theme,whilethelatterhastheextendedutilityofcontributing aparticularvariabletothedesignofthescenarios.
Participantsalsosharedstoriesofobservingotherpeople’s fearsandusedthemasadesignelement.
Intheexamplebelow,Ivartellsastoryofhowsomeone heworkedwithinclasswasovercomewithpressurefrom performingamundanetask:
Ivar: So, like, the first time we got any insight to who she was, well, it was one other person and me, right, and she was merely translating
“smart” to Norwegian [from English; the word is the same in Norwegian].
She could not do it. So she, like, broke down because it was too much pressure. From two other people.
Thisstorytellingwasusedbyparticipantstosociallyex- plorethephenomenonoffearofpublicspeakingasastepin theirdesignprocess,whichintheaboveexampleledtoan earlyideathatwaslaterabandoned.Here,theyobservedthat itispossibletoexperiencefearofpublicspeakingwithout beingexplicitlyaskedtospeakinfrontoftheclass.Theway stressfulsituationsmayoccurfrommundaneconversations.
Envisioning and composing the virtual experience Todesignascenario,theparticipantshadtocomposeavirtual environmentinwhichitcouldtakeplace.Creatingthisvirtual environmententailedtheuseofdesigntools,aswellasthe proposalofadramaticcomposition.Intheconversationexam- plebelow,theparticipantsareusingthecircularstoryboards describedinsection4tonegotiatedecisionsabouttheirdesign.
Thecircularstoryboardsdrawnupfortheirscenariofunction asareferencepointtodiscusstheplacementofactorsand sequencingofdialogue.Employingthestoryboards,thepar- ticipantsarenegotiatinghowtoincorporateelementssuchas audienceattentiontotheuserintotheirvirtualenvironment.
Ivar: You are in the middle of the classroom, and then you get up to explain stuff?
Karsten: Yes, or your teacher is here [pointing at storyboard], and then she asks, like, a random student, like, “Yes, and you? Please tell.”
And then that student, maybe one of us, right, as an actor, “Yes, I am this and that, born in China,” or whatever. And then, “Yes, how about you?” and she is then pointing at the student sitting there.
Here,Karstenisusingthestoryboardandhissurroundings toexplainhowheenvisionsthescenario.Thestoryboardis usedtosituatetheuser,whomhereferstoasthe“student sittingthere,”withinthevirtualspace.
Thefollowingexampleillustrateshowtheparticipantsen- visiontheroleplaybasedontheirconceptionofwhatwill triggerfearofpublicspeaking.Inthisgroup’scase,itisthe actionofsomeoneturningaroundtolookdirectlyattheuser.
Furthermore,thespecifcchoicetheymakehereincorporates anelementofsurpriseinthattheteacherisseeminglyran- domlyaskingpeopletorespond.
Ivar: And then everyone turns around.
Karsten: So he can see that everyone is staring at him, or not everyone, but some, so he must tell them something.
Lars: So it is going to be very on the spot. You are not given anything before that.
Thisdemonstrateshowtheparticipantsusethedesigntools tocomposethevirtualspaceanditscomponentsofactorsand dialogue.Italsoexemplifeshowchoicesrelatedtothecon- structionofdialogueanddramaticcompositionarebasedon theadolescents’conceptionsofwhatitmeanstoexperience fearofpublicspeaking.
Making sense of exposure therapy
Partoftheparticipants’designprocessinvolvedbuildingan understandingofthesubjectmatter,namelyfearofpublic speakingandexposuretherapy.
Initially,participantswereunsureofwhatthegoaloftheir scenariosshouldbe,askingquestionslike,“Whatlevelof socialanxietyarewedealingwith?”Byrefningtheirsce- narios,theywereabletoimprovetheirunderstandingofthe subjectmatter.Thebelowtranscript,takenfromanevalu- ationofagroup’sfrstprototype,refectshowparticipants’
understandinghaddevelopedsincetheworkshopbegan.
Anna: I just realized something regarding our video. The fact that our reaction is so negative will only make the patient or person watching that has these anxieties feel even worse.
Daniel: Yes, I thought the same.
Anna: While all the others are saying something about themselves we are laughing.
Cedric: But the goal here is to make a bad ending? Because that was everyone’s focus yesterday. That it should be . . .
Bendik: And that is good, right? That people get to practice?
Anna: No, it is supposed to be therapy. You are supposed to get used to talking in front of people. The point is not to make anyone feel worse.
Thetranscriptsillustratethejointconstructionofideas abouttheconditionofhavingafearofpublicspeakingand whatexperiencethescenarioshouldofertheviewer,based onareviewofthefrstprototype.Annamakessenseofwhat thegroup’sprototypeisbyplacingitwithinherconception of“therapy.”Sheidentifesthenegativeconsequencesthe scenariotheyhavecreatedmayhaveforsomeonewithpublic speakinganxiety.Thissparksadiscussionwithinthegroup, inwhichtheparticipantscollectivelycometounderstandthe purposetheyaredesigningthescenariosfor:tocreateavirtual environmentthatcanhelpimproveusers’publicspeaking abilities.Itisthenunderstoodbythegroupmembersthatthey shouldreworkthetoneandfeeloftheirscenario.
6 VR SCENARIOS FOR FEAR OF PUBLIC SPEAKING Followingtheanalysisoftheparticipants’collaborationto createVRscenarios,wepresentdescriptionsofeachgroup’s fnalprototypefromtheparticipatoryworkshop.Aperson viewingthescenariosinVRmayexperiencefearofpublic speakingandpracticehisorherpublicspeakingskills.
Figure 1: An equirectangular snapshot from The introduction round. This snapshot is cropped vertically for appearances.
The introduction round
Withtheviewerplacedamongacircleofhighschoolstudents, thisscenariostartswithapersonintroducinghimselfasthe teacheroftheclass,welcomingeveryonetothefrstdayof secondaryschool(Figure1).Theteachershareshisnameand ahobbyheenjoys.Eachstudentthenfollowsinturn,per- formingthesameintroduction.Oneofthestudentsstarts talkingaboutsomethingunrelatedonhisturn,leadingthe teachertointerruptthestudentandcuethecircletocontinue.
Thelaststudentbeforetheviewertellsajokeabouthisskills inperformingpush-ups,whichpromptsallstudentsinthe circletoburstintolaughter.Asthecollectivelaugheases,the teacheraskstheviewertointroducehimorherself.Twenty secondsofsilencefollow,withthestudentsindiferentmodes ofattentionandsuggestivepostures.Theteacherproceeds bythankingtheviewerandtheroundcontinuesuntilevery- onehasintroducedhimorherself.Theteacherconcludesby thankingeveryonefortheirparticipation.
Interruptions in the classroom
Theviewerisplacedatadeskinthemiddleofaclassroom withstudentssittingattheirdesks.Totheleft,afellowstudent isintroducinghimselftotheclass.Infrontofallthedesks, apersoneasilyidentifedastheteacherthanksthestudent andinstructstheviewertopresentaself-introduction.Si- lencefollowsfortenseconds,withthestudentsinfrontofthe viewerturningtowardhimorherintheirchairs.Suddenly, thedooropens,andapersonwalkshalfwayintotheroom.
“Doesanyoneknowwherethebigauditoriumis?”theperson asks.“Yes,downthehallandthelastdooronyourleft,”a studentontheviewer’srightresponds.Thepersonleavesand closesthedoor.Mildlaughterfollows,withtheteacherbreak- ingthroughthelaughtertosay,“Pleasecontinue.”Afterfve secondsofsilence,studentsontheviewer’srightbecomeinat- tentive.Theteacherquicklydisciplinesthem,saying,“Please payattention.”Thirtysecondsofsilencefollow,givingthe vieweranopportunitytospeaktotheclass.
Reminiscing about the weekend during recess Theviewerisplacedwithinagroupof friendssittingon couches,casuallydiscussingtheirweekendduringrecess.Sev- eralconversationsareoccurringatthesametimewhilemusic isheardfromaphone,makingitdifculttofollowanyonedis- cussion.Thesubjectamongthefriendsisapartytheyattended thepreviousweekend.“Everyonewasattheparty,right?”one persondistinctlyaskstheothersinthegroup.Apersonto theleftoftheviewerconfrmsthis.Themusicgoessilent.
“Yes,everyonewasattheparty,”declaresagirlinfrontofthe viewer.Immediatesilencefollows.Theboynexttoherasks theviewer,“Wereyouthere?Icannotrememberseeingyou attheparty.”Silencefollowsfortenseconds,whilethegroup offriendspayssomeattentiontotheviewer.Thefocusthen divertsfromhimorherandtheconversationpicksupagain.
Presenting a field trip in class
Theviewerissituatedbehindsixstudentssittingattheirdesks, withthreestudentsbehinddeskstotheright.Atthefrontof theroom,therearelargesheetsofpaper,onwhicharewritten keywordsaboutafeldtrip.Aseeminglydisgruntledteacher mentionssomethingaboutthefeldtripandaskstheviewer tocomeforwardtosummarizeitfortheclass.Afade-to-black sequencefollowsandtheviewerfndshimorherselfinfront oftheclasswiththetaskofpresentingasummaryofthetrip.
Theteacherpromptstheviewerbysaying,“Yes,pleasebegin.”
Facingthestudents,theviewermustimproviseasummary ofthefeldtripbasedonthekeywords,whicharenolonger visible.Thestudentslookinattentive.Afterffteenseconds ofsilence,onestudentexclaims,“Pleasespeaklouder!”Some studentsstartgigglingandtheteacherquicklyreprimands them.Twentysecondsofsilencepass.Suddenly,thesound ofaschoolbellisheard,promptingthestudentstogetupand leavetheroomforrecess.
Havingpresentedeachgroup’sfnalprototypes,wenow turntotheexpertevaluationbysixclinicalpsychologiststhat wascarriedoutaftertheparticipatoryworkshop.
7 EXPERT EVALUATION
Thepsychologists’feedbackiscategorizedaccordingtothe followingthemes:(1)presenceandrealismand(2)theirfea- sibilityasatoolintherapy.
Presence and realism
InVR,presencereferstothesubjectivesenseofbeingpresent inthevirtualenvironment[38].Describingtheexperience ofthe’introductionround’scenario(Figure1),oneevaluator said, “It felt like I was there, physically, in the group. It felt like it usually does in real life. It’s not like I’ve just had VR glasses on. It was quite convincing.”
Anotherevaluatorappreciatedtheanticipatoryefectof waitingforone’sturninthesamescenario,saying, “You can feel it coming. One step closer, one step closer. I could feel it in my body that there was an activation.”
TheevaluatorwithpreviousexperienceusingVRforther- apyhighlightedthemorenuancedcontentthat360°videois capableofcapturingcomparedtoCGI.Hesaid, “Although this is similar to my prior experiences with VR, where you are present- ing, this is so much more . . . realistic, down-to-earth. . . . Because you have the adolescents, with their body language, which I think people with fear of public speaking will fnd quite disconcerting.”
Theevaluatorsreportedbeingimpressedbytherealismof theprototypes,notingtheactors’naturalisticperformances.
Oneevaluatorsaid, “If these people [in the scenarios] were actors, then they did a really good job.” Afterseeing“Theintro- ductionround,”anotherevaluatorasked, “Is this real? Or are they actors?” Theevaluatorsrespondedtothesituationsde- pictedinthescenariosasexperiencesthattheywerefamiliar withfromtheirownmemoriesofschool.
Oneevaluatorsuggestedthateachscenariocouldfrstbe introducedfromabird’s-eyeviewperspectiveorthattherole oftheviewercouldfrstbeasaninvisiblebystander,say- ing, “I was thinking about how to introduce this more mildly. I would have one [scenario] where I was outside the situation and just observed the group. Then you would know what’s about to happen.” Thispsychologisthadpriorexperienceindoing in vivo exposuretherapyandwasfamiliarwiththemethod’s progressive,hierarchicalframework[28].
Althoughstereoscopic360°videosprovidedepthoffeld whenviewedviaHMD,fnerdetailsoffeatures(suchasfacial expressions)maybeblurredinthecaseofactorswhoare situatedfarfromthecamera.Notingthislackoffnedetailsin distantactors,oneevaluatorremarked, “There was a certain
’flter’ that made their faces harder to see. It is important that facial expressions are visible to make the experience as realistic as possible.” Otherevaluatorsalsonotedthesamevisibility issue.However,theresolutionwasstillhighenoughtosustain theperceivedrealismofthescenarios.
Feasibility as a therapeutic tool
Overall,theevaluatorswerepositiveaboutthepotentialofus- ingVRscenarioslikethoseprototypedthroughthisstudyin exposuretherapy.Mostarguedthattheywouldnotbeuseful asstand-alonetools,buthadthepotentialtoenhancetherapy ifcombinedwithpsychoeducationandspecifcpracticetasks.
Oneofthepotentialadvantagesof360°videosliesinthe readilyavailable,realisticrecreationofchallengingsituations.
Inthewordsof oneevaluator, “In a therapy situation, we often play [roleplaying] games where, as a therapist, I play out situations and practice a little with the patient. But this [prototype] is much more varied. It could somehow cause anxiety [more easily]. It is closer to the situation. It is more real than what a therapist can do with exercises and plays. I think the anxiety will go up. And that’s good; that’s what we want. [It’s good] [t]hat we get the patient activated in the therapeutic room, that they get the anxiety activated, that they can get into that situation.”
Anotherevaluatorsaidthattheprototypesintheircurrent formcouldbeverychallengingforpatients,butstilluseful asatherapeutictool,explaining,“Ifyouhavebeenbulliedin school,Ithinkthiscanbereallyuncomfortableandevokeun- pleasantmemories.”Thereisanupsidetothisefect,however, aspainfulmemoriesandfeelingsmaybedifculttoevoke andexamineinconversationalone.Patientsoftenhavedif- fcultyrememberingandarticulatingexactlywhatcausesthe experienceoffearinaparticularsituationandtheprototypes canmakefear-producingsituationsimmediatelyavailable.
Theuseof360°videoinVRwasregardedasahands-on,direct approachthatcouldbeusefulintherapy.
Theabsenceof controlwithinthevirtualenvironment raisedaconcernwithoneofthepsychologists.Ifthescenario becomestoouncomfortableforthepersonusingtheHMD, thereisnooptionwithintheinterfacetoregaincontrolby adjustingthestimuli.
8 DISCUSSION
OurmethodforparticipatorydesignofVRscenariospresents bothopportunitiesandchallengesfordesigningVRexposure therapywithadolescents.Inthissection,wediscusseach phaseoftheiterativedesignprocessandpresentrefections onusing360°videoinexposuretherapyforthisagegroup.
Participatory design of VR scenarios
Asexplainedinsection4,ascenarioisaconstructionthat presentsandsituatesasolutiontoaproblem[3].Torealisti- callyconstructandsituateasolutioninaVRscenario,there isaneedforacleardescriptionoftheenvironment(including potentialactorsandprops),astoryline,andanunderstanding ofhowtheenvironmentandstorylinecanbeintegratedas alive-actionplay.Thescenariocanthenbedevelopedinto
anexperienceprototype[9]whencapturedwith360°camera andsubsequentlyviewedthroughanHMD.
Ideation. Thegoalofthefrstphase,ideation,wastogenerate ideasofsituationsinwhichonecouldexperiencefearofpub- licspeaking.Usingtheirlivedexperiencesasaresourcefor developingideas,theparticipantscreatedpotentialscenarios thatincludedsurprisingelements.
Inthisphase,itisessentialtoensurethattheparticipants stayfocusedonthetaskathand.Inparticipatorydesign,there isatrade-ofinfacilitatorintervention:steeringtheprocess towardsthedesiredgoaloftheworkshopversuslettingthe participantscreativityroamfreely.SvanæsandSeland[42]
discussthistrade-ofandask,“Towhatextentdothescenarios andideasoriginatefromtheusers,andnotfromthefacili- tatorsordevelopers?”[42,p.485].Theappropriatebalance canbeachievedby:(1)clearlystatingtheintendedgoalofthe workshop,(2)providingtheparticipantswiththenecessary informationtocarryouttheirwork,and(3)directlyinter- veninginthecreativeprocessifparticipantslosetrackofthe workshopgoals.Whilethismayberelevantforallphases, itisparticularlyimportanttokeepparticipantsfocusedon theoverallgoalintheideationphase.Facilitatorsshoulden- suretheyguideparticipantsinconceptualizingandchoosing betweenideasforfurtherdevelopment.
Storyboarding. Intheircollaborativeprocess,theparticipants usedstoryboards,asdetailedinsection4,tonegotiatethecom- positionandstorylineoftheirscenarios.Ourthematicanal- ysisaddresseshowthestoryboardcanfunctionasashared referenceparticipantscanemploytosituatetheirideasand envisiontheirscenariosinavirtualenvironment.Thecir- cularstoryboardshaveacertainpedagogicalvalueinthat theyaidparticipantsinunderstandinghowscenesneedtobe arrangedtobeflmedin360°video.Thecameraissituatedat thecenterofthecircleandtheoverlaysonlyallowvisibilityof 100°atatime,helpingillustratehowaviewermightnavigate thevirtualenvironment.Somegroupsinourstudy,however, hadamoredialogue-basedstoryboardfocusedongenerating thespeakinglinesfortheactors.Themainoutcomeofthis phaseisadetailedscriptofhowthestorylinewillbeacted out,whichcanberepresentedindiferentwaysthroughthe useofcomicstrips,circularcards,orwrittenlines[44].
Live-action plays. Live-actionplays,role-playing,anddesign theaterhavebeenusedtoexploredesignconcepts[9],gener- ateconceptsfordesign[19],andembodyandactoutdesign ideas[42].Inourprocess,however,theplaysalsoserveda moreconcretepurposeinproducingavirtualenvironment.
Theiterativeprocesshelpedrefnetheseplaysandthepar- ticipantsneededseveralroundsofrehearsalanduptofour takestogettheresultstheywanted.
Havingtheadolescentparticipantsperformasactorsin theirscenariosaddedtotheauthenticityandrealisticqualities oftheprototypes.Althoughtheparticipantswerenotprofes- sionalactors,theyplayedrolesthatwerefamiliartothem.
Experience-based evaluation. Theexperience-basedevalua- tionsession,inwhichtheparticipantsexperiencedtheirsce- nariosfrst-handwithanHMD,providedanopportunityfor theadolescentstoseehowtheirideasandactingplayedout inVR.Asshowninsection5,thispromptedAnnatoconsider howthescenarioshouldbedesignedtohelptheviewer“get usedtotalkinginfrontofpeople.”Thisdemonstratesthe valueoftheseevaluationsessionsinimprovingemphathyfor viewersandassessingtowhatextenttheprototypeconforms withtheultimategoal.
Inassessingthequalityofoutcomesofaworkshopfordevel- opingscenarios,SvanæsandSeland[42]askapertinentques- tion:“Arethescenariosaccurateintheirdescriptionofthe situationsbeingstudied?”[42,p.485].Thisquestionrefersto theproducedscenario’struthfulrelationtotherealworld[42].
Experience-basedevaluationasincorporatedinourmethodis onewayofassessingthisquality,asitallowstheparticipants toevaluatetherealismofwhattheyhavedesigned.
Beyond pixels and sensory fidelity in VR scenarios Theparticipatoryprocesswascrucialtocreatingscenarios thatappearedtobeauthenticsocialsituations.Intheanal- ysisoftheparticipants’workprocess,wecanseehowthey concretelydiscussedtheirownlivedexperiencesandgave accountsofothers’experiencesfromtheirdailylife,andhow theyusedthisasaresourceinthedesignoftheirrespective scenarios.
WhenmakingVRscenariosusingCGI,amajorchallengeis virtualcharacterdesign[34]andavoidingtheuncannyvalley efect.InthecaseofVRscenariosgeneratedusing360°video, however,themainchallengesaretiedtowhetherthesitua- tionthatisportrayedineachscenarioseemsbelievableand sociallyrealistic,alongwithhowwellthescriptandstoryline areactedout.
Whilethescenariosfeaturerealpeopledisplayingrealistic bodylanguageascharacters,theyarestilllimitedbythefact thattheinteractionisscripted.Thishighlightsanadditional challengewithscenariosthathaveasomewhatcomplicated storylineandcompositionofactions.Inparticular,thedif- fcultyrelatestohowtheparticipantsinthescenariocan addresstheviewerandhowthescriptcanbetimedtoftwhat theviewersaysandwhenheorshespeaks.
Thewayturn-takingisaccomplishedinsocialinteraction [33]dependsonmicro-pausesandthetimingofdetailssuch asgazesandgestures.Thisischallengingtoaccomplishin aVRscenario,sincetheactionsoftheviewerareunknown.
Whileanactorinthescenariocanaddressthecameraasa
proxyfortheviewer,itisdifcultto,inarealisticway,signal whentheviewerissupposedtostoptalking.Thetechnique ofaddressingthecamerawasusedinallourscenarios.Fur- therresearchintohowtoovercomethechallengeofhavinga realisticinteractiveexperienceinVRscenariosbasedon360°
videoisneeded.Inthecontextofexposuretherapyrelated topublicspeaking,severalpossibletechniquescouldbeex- plored.Forexample,onemightincludeagraphicaloverlay withaprogressbarindicatingthespeakingtimetheviewer hasavailableor,alternatively,displayascriptofspeakinglines fortheviewerintheformofsubtitlesinthevirtualenviron- ment[8,32].AkeypointwhendesigningVRscenariosisto makethestorylineclearintermsofwhentheuserissupposed tosaysomethingorwhenaparticularactionisexpected.
Tailoring VR scenarios for exposure therapy
Oneofthethemesidentifedintheanalysiswasthatthe participantshadtomakesenseoftheconceptofexposure therapy.Therearechallengestiedtoincludingadolescents intheprocessofcreatingcontentfortherapeutictools.It wasnotstraightforwardfortheparticipantstocreatesce- nariosthatalignedwiththetherapeuticmakeupofexposure therapy–neitherweretheyexpectedtoortaskedwithde- signing therapy.Thefacilitatorsintervenedtoguidesomeof thegroups’processesawayfromcreatingsituationsthatelicit asmuchfearaspossibletoinsteaddesignscenariosinwhich theviewercouldexperienceconditionedfearresponsesina realisticsituation.
Theexpertevaluatorsfoundthescenariosconvincingin portrayingsituationsthatarewell-suitedtoreproducerele- vantfearedstimuliforadolescentswithafearofpublicspeak- ing.Theevaluatorshighlightedthesocialnuancesandbody languageoftheactorsaskeyfeaturesformakingthesce- nariosrealisticandauthentic.Theyfurthersawthevaluein usingthescenariosasacomponentofexposuretherapy.Still, havingrealisticscenarios,withfamiliarscenes,isnotneces- sarilyenoughtomakeexposuretherapysuccessful.Theidea ofusingVRasatool inexposuretherapy[20]meansthinking oftheVRscenarioasonlyoneofthenecessaryelementsof treatment.TouseVRscenariosintherapywould,forexample, requireatherapisttocomposeaccompanyingtasksforthe patient.Then,thetherapistcanmonitorperformanceand evaluateoutcomesofthetherapy.
Furthermore,therapistscould,followingourmethod,even tailor360°videocontentforspecifcsocialphobiasthatmatch thepatient’scondition.Thistailoringwouldenablethethera- pisttoprovideappropriatechallengesandspecifcgoalsbased ontheneedsofthespecifcpatient,butwouldrequireaccess toequipmentandsomeonetoactouttheplays.
Inthisstudy,wehaveseenthatadolescentsarecapable ofparticipatinginadesignprocessandthattheproduced scenarioshavethequalitiesofbeingrealisticandportraying
scenesfromafamiliarsocialandculturalcontext.Thus,they arerecognizableforthetargetgroup.Themainstrengthof themethodisthatitcanhelpcapturethosequalities.The goaloftheoutlinedprocessisnotnecessarilytomakeready scenariosforuseintherapy,buttoprototypeandmaterialize ideasandsuggestionsthataregroundedinthelivedexperi- encesofthetargetgroup—inthiscase,adolescents.Inthis sense,thescenarioscanfunctionasprototypesthatcapture ideasandexperiencesthatcanbeusedinacontinuingde- signprocess.Moreover,theparticipatorydesignprocesscan beusedtotailortreatmentsfordiferenttargetgroupsand toprovidescenariosportrayingrelevantexperiences.This canhelpframedesignsolutionsspecifctoparticularcultural contexts,socialsituations,andtherapeuticneeds.
9 CONCLUSION
Thispaperhaspresentedaparticipatoryapproachtoprototyp- ingvirtualrealityscenariosforexposuretherapytoaddress fearofpublicspeaking.Inourstudy,wedemonstratehowado- lescentscanbeinvolvedinthedesignofVRscenariosenabled by360°videorecording.Wealsoshowhowtheparticipants drawontheirlivedexperienceswhencreatingthesescenarios.
Thepaperillustratesthat360°videoisaviabletoolformaking thedesignofimmersiveVRexperiencesmoreaccessible,asit requiresfarlessadvancedtechnicalskillsthancreationofCGI- basedenvironmentsandislesstime-consuming.Further,the expertevaluationphaseinourstudyhighlightedtheauthen- ticityandrealismofthescenarios,whichwereseenasbeing potentiallyusefulinatherapeuticcontext.Thisapproachto designingVRscenarioswith360°videoofersthepotential totailorVRexperiencestomanydiferentsituationsandto specifcfears.Ourparticipatorymethoddemonstrateshowit ispossibletodesignVRscenariosrelativelyrapidlyandweex- pectthattherapistscouldbuildonourapproachtodesignsuch scenariosandpotentiallyincludepatientsintheprocessof tailoringVRenvironmentstohelpaddresstheirspecifcfears.
ACKNOWLEDGMENTS
Wethankalltheparticipantsforcontributingtothisstudy andgivespecialthankstoSynnøveOlsetofHelseVestIKT forco-organizingtheworkshop.Furthermore,wewouldlike tothankthereviewersandcolleaguesOleAmundsen,Daniel A.JensenandOskarJuhlinfortheirvaluablefeedbackonthe writingofthispaper.ThispublicationispartoftheINTRO- ducingMentalhealththroughAdaptiveTechnology(INTRO- MAT)project,fundedbyTheResearchCouncilofNorway underGrantNo.:259293/o70.
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