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Case Study: How a 14 Year Old Boy with ASD used ProReal to Build ‘Meaning Bridges’

22 May 2017

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In January 2015 ProReal Ltd began a major research project supported by NHS England’s Small Business Research Initiative Healthcare (SBRI Healthcare) to evaluate the use of its virtual-world software with young people in school counselling. As part of this research ProReal commissioned two case studies to examine the use of its platform – these were drawn from an initial evaluation that the software may be particularly useful with a range of clients, in particular boys, and those who may find verbal expression difficult.

The case study team consisted of Biljana van Rijn (Metanoia Institute), Caroline Falconer (University of Nottingham, NIHR MindTech HTC), Evi Chryssafidou (Metanoia Institute), Mick Cooper (University of Roehampton) and William B.Stiles (Miami University and Appalachian State University).

The first case study (recently completed) examines how Richard (a pseudonym) – a 14-year-old boy who had been diagnosed with high functioning Autism Spectrum Disorder (ASD) and seen in school counselling for anxiety and behavioural problems – used the software over a sequence of 9 sessions.  Findings show that the digital imagery (of the software) provided a non-verbal, creative medium for expression and facilitated the therapeutic relationship, providing meaning bridges between the counsellor and the client. If you would like a copy of the case study, please email us at

The case study team will be presenting papers at the following events in 2017:

British Association of Counselling & Psychology (BACP) Research Conference, Chester UK 19-20th May: On 20th May, Evi Chrysaffidou will present the evaluation of Avatar Based Counselling for Young People. This will be followed by a presentation of the case-study ‘Richard’ by Biljana van Rijn.

Society for Psychotherapy Research (SPR) 48th International Annual Meeting, Toronto Canada 21-24th June 2017. Bill Styles will present his paper ‘Digital images as therapeutic meaning bridges: Use of avatars by a 14-year-old boy in school counselling’.

World Conference of Transactional Analysis, Berlin Germany 27-30th July 2017 Biljana van Rijn will present an abstract from the ‘Avatar Based Counselling with an Autistic Adolescent. Case Study’.

SPR UK & European Chapters 3rd joint conference, Oxford UK 20-22nd September 2017. Biljana van Rijn, Bill Stiles and Evi Chrysaffidou will present a paper as part of the ‘New directions in assimilation model research: Theory-building case studies on setbacks, dementia, bereavement, and digital imagery’ panel.

A second case study involving a young female is nearing completion with findings expected to be shared in Summer 2017.

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