Currently submitted to: JMIR Formative Research
Date Submitted: Jul 29, 2026
Open Peer Review Period: Aug 7, 2026 - Oct 2, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Evaluation of a therapeutic avatar platform (ProReal) to enhance engagement and social processes in remote groups for young people in clinical services: A proof-of-principle mixed methods case series
ABSTRACT
Background:
Online groups offer the opportunity to engage young people in mental health services who might not want to attend traditional in-person formats. However, they appear to lack some of the social processes’ that are beneficial in face-to-face group environments.
Objective:
To evaluate whether ProReal, an avatar software platform, used in online groups for young people in community mental health services enhanced the group experience.
Methods:
Twelve young people aged 14 to 27 were recruited from Children and Young people’s mental health services (CAMHS) and Early Intervention in Psychosis (EIP) services. Each took part in a group-based intervention. There were two therapy groups and one social group. Four sessions using Zoom video chat were compared to 4 sessions using Zoom with activities in ProReal. Measures of group belonging, social connectedness, self-stigma, and qualitative feedback were collected.
Results:
Results:
The online Zoom format was acceptable for young people but lacking in social connection. In therapy groups, ProReal added value to improve engagement, social interactions and consolidate learning.
Conclusions:
Conclusion: ProReal activities appear to enhance social connections; the visual, interactive nature helped promote self-expression and enhance engagement. More robust research is required with a larger sample and a comparison group to establish effect size estimates with confidence intervals.
Citation
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