OUP UNCORRECTED PROOF – FIRSTPROOFS, Thu Jul 17 2014, NEWGEN CHAPTER Cyberpsychology and Afective 41 Computing and Abstract Key Words: Introduction clinical change (cybertherapy). On the other side, Clinical psychology has been traditionally based cyberpsychology focuses on the possible use of tech- on face-to-face interactions that involve verbal and nology for improving personal development and nonverbal language, without any technological well-being (positive technology/computing and mediation. However, emerging technologies—the smart health). Internet, mobile devices, virtual reality (VR), and Both aspects of cyberpsychology are related to the like—are modifying these traditional settings and involve a variety of afective processes. Te (Castelnuovo, Gaggioli, Mantovani, & Riva, 2003; discipline’s overlap with afective computing and Preziosa, Grassi, Gaggioli, & Riva, 2009; Riva & human–computer interaction (HCI) in general Mantovani, 2012). As the availability of these tech- are signifcant, yet its psychological origins mean nologies expands the ways in which treatment can that the research communities have somewhat dif- be provided, psychologists are expected to incor- ferent focuses. Afective computing started as an porate these innovations into their practice and engineering discipline, driven by a motivation to research (Barak, 2008). Cyberpsychology is a recent engineer new technologies that could better under- branch of psychology that is trying to support this stand humans and be more efective for humans. process. In particular, it aims at the understanding, Cyberpsychology originated in psychology and has forecasting, and induction of the diferent processes been driven by the quest to help humans deal with of change related to the use of new technologies. their digital environments and use these environ- Within this broad focus, cyberpsychology has ments to promote well-being. Te object of study two faces. On one side, cyberpsychology tries to in cyberpsychology, as it is for many HCI research- understand how technologies can be used to induce ers, is the change introduced by the technology and 547 book.indb 547 7/18/2014 1:21:59 PM OUP UNCORRECTED PROOF – FIRSTPROOFS, Thu Jul 17 2014, NEWGEN not the technology itself. In this chapter, we review tVirtual clinics and general practice, in which these histories and discuss how afective computing a professional ofers early interventions and can (or could in the future) assist cyberpsychology treatment through the Internet in terms of both treating existing mental diseases tBlended approaches, in which a range of (e.g., anxiety disorders, depression, mood disorders, services, such as Internet and face-to-face, are personality disorders) and in terms of preventive integrated to ofer prevention and care approaches to nurture health and well-being (e.g., Tese e-therapy approaches allow the patient promoting healthy lifestyles, behavior change inter- to engage in treatment without having to accom- ventions). Many mental diseases are directly related modate to ofce appointments, often reducing the to a variety of afective processes: emotional expe- social anxiety of face-to-face treatment (Mair & rience (e.g., sadness, stress), mood disorders (e.g., Whitten, 2000). Internet-based therapies have bipolar), depression (hopelessness, helplessness), shown to be economically sound by being efec- and personality (e.g., borderline). Similarly, preven- tive at a low cost (Kadda, 2010). Tey also have tively nurturing health and well-being often involves the potential to reach people in isolated places, making life changes (e.g., toward health-promoting where mental health is often a problem (Hordern, lifestyles), which in themselves are often associated Georgiou, Whetton, & Prgomet, 2011). with a variety of fuctuating afective states (e.g., Furthermore, Internet-based applications allow hopefulness of being healthy, frustration of not for the use of interactive monitoring systems that managing to stay away from fatty foods, discourage- give the therapist instant access to clinical data dur- ment of postponing to join the gym indefnitely, joy ing therapy and gives the individual patient the of having lost 2 pounds in a week, pride in having possibility of monitoring his or her progress. Tis implemented a major lifestyle change). is in line with the “know thyself” motto of recent Afective computing—whose main focus is to HCI research (Li, Forlizzi, & Dey, 2010), which develop technologies to sense, recognize, under- posits that refecting on personal data, such as our stand, and simulate afective processes—can exercise patterns, can help us lead more healthy therefore make important contributions to the lifestyles. enhancement of existing cybertherapies and posi- A great number of studies have shown sig- tive technologies, as well as to the design and devel- nifcant results in Internet-aided psychotherapy opment of novel ones. applied to both individual therapy (Andersson, Cybertherapy and Afective Computing 2009; Bergstrom et al., 2010) and self-help sup- What Is Cybertherapy? port (Andersson et al., 2005; Carlbring, Ekselius, & Andersson, 2003). Journals such as CyberPsychology, Cybertherapy is the branch of psychology that Behavior and Social Networking, IEEE Transactions uses new technology to induce clinical change. on Biomedical Engineering, Journal of Cybertherapy Historically e-therapy—the use of the Internet and Rehabilitation, Journal of Medical Internet and related media for clinical care—has been the Research, Telemedicine and e-health are dedicated to frst area of cyberpsychology to have an impact on reporting progress in this feld. However, cyberther- psychological treatments (Manhal-Baugus, 2001). apy also involves two emerging technologies: VR It is generally agreed that innovative e-therapy and mobile devices. approaches are an opportunity for earlier and better Te characteristics of VR therapy, the use of VR care for the most common mental health problems for clinical care, include a high level of control of (Christensen & Hickie, 2010). Te successful mod- the interaction with the tool and the enriched expe- els of e-therapy services include diferent levels of rience provided to the patient (Riva, 2005; 2009). interactivity and support: Typically in VR, the patient learns to cope with tContent-centric systems that ofer prevention, problematic situations related to his or her problem. self-help, and self-care to users. Multiple charities For this reason, the most common application of and government-funded projects ofer support that VR in this area is the treatment of anxiety disorders follows this approach. and phobias, such as fear of heights, fear of fying, tConsumer-assisted support, in which the level and fear of public speaking (Emmelkamp, 2005; of peer interaction is ofered online through Wiederhold & Rizzo, 2005). Emerging applications volunteers with lived experience of a mental of VR in psychotherapy include eating disorders and disorder obesity (Ferrer-Garcia & Gutierrez-Maldonado, 548 Cyberpsychology and Affective Computing book.indb 548 7/18/2014 1:21:59 PM OUP UNCORRECTED PROOF – FIRSTPROOFS, Thu Jul 17 2014, NEWGEN 2012; Riva et al., 2006; Riva, Manzoni, Villani, for 15–20 minutes about traumatic or emotional Gaggioli, & Molinari, 2008), posttraumatic stress experiences. disorder (Reger & Gahm, 2008), addictions A recent meta-analysis of 146 research trials (Bordnick et al., 2008), sexual disorders (Optale, (Frattaroli, 2006) using various unstructured emo- 2003), and pain management (Hofman, 2004). tion writing methods concluded that the impact of M-health—the use of mobile devices such as this type of writing approach may have some ben- smartphones and tablets for clinical care—is also efts for some individuals, but the overall efect size an emerging area of cybertherapy (Istepanian, was very small (r-efect size = 0.075). Jovanov, & Zhang, 2004). Te wide availability One alternative method to unstructured writ- and acceptance of mobile devices—signifcantly ing is to structure how participants write during the higher than PCs—make them the perfect tools to writing task. Writing instructions could be manipu- bridge the gap between inpatient and outpatient lated to increase the likelihood that participants treatment (Preziosa et al., 2009). On one side, write in a way that is suggested to be therapeutic mobile devices ofer a nonintrusive way to moni- (e.g., write about something that you are thinking tor patients in their real-life contexts (Gaggioli, or worrying about too much, about something that Cipresso et al., 2012), thereby afording the thera- you feel is afecting your life in an unhealthy way, pist the possibility of optimizing the patient’s treat- etc.) and therefore increase the likelihood that they ment (Gaggioli, Pioggia et al., 2012; Kauer et al., obtain benefts from the task. 2012). On the other side, advanced multimedia A number of emotion writing studies have capabilities of these devices give developers the manipulated the writing condition in such a ability to create interactive applications that allow manner (King, 2001; King & Miner, 2000) but the patients to autonomously experience clinical could not demonstrate causal links between support (Cipresso et al., 2012). hypothesized theoretical processes and outcomes. Difculties have been due to the absence of clear Afective Computing in Cybertherapy operational defnitions of the processes within Afective computing ofers new interaction the writing sessions and therefore poorly