{"id":{"repo_id":"middlesex","oai_identifier":"oai:repository.mdx.ac.uk:2x154x"},"canonical_url":"https://search.dev.ndltd.org/etd/middlesex/oai:repository.mdx.ac.uk:2x154x","repository":{"repo_id":"middlesex","name":"Middlesex University","base_url":"https://repository.mdx.ac.uk/oai2"},"display":{"title":"A case study in the use of avatar-based therapy utilising the externalisation of problems with an adult on the autistic spectrum","abstract":"The aim was to investigate the use of a novel therapeutic intervention utilising narrative therapy combined with the use of avatars within a virtual world. The basis of this approach was the idea that this environment could help facilitate the externalisation phase of narrative therapy, to help produce more positive narratives about the client’s lived experience. It is qualitative research using a theory building case study methodology with a single participant who is an adult with a diagnosis of autism who presented with a history of emotional dysregulation. The research design involves undertaking the therapy remotely via video over 8 sessions of approximately 60 minutes. The therapist-researcher and client each observed the virtual scene provided by the ProReal Ltd virtual reality system. The client could create, modify and interact with avatars whilst they conversed. The data gathered consists of a verbal transcript of the therapy sessions and a video recording of the virtual world. Reflective thematic analysis was used to create a number of themes and sub-themes from the data. The outcomes developed were three primary themes, Ableism & distress, Externalising lived experience and Overcoming difficulties. The first being associated with the sub-themes, Emotional overwhelm and its responses and Shame and the causes of distress. The third theme was associated with sub-themes Acceptance through relationship, Self-acceptance and Awareness of influences on distress and learning from the therapy. These themes could be related through the central idea of Living in a neuro-normative world. In the conclusions, the issues raised are critically reviewed and the possible applications and limitations are then discussed.","abstract_html":"The aim was to investigate the use of a novel therapeutic intervention utilising narrative therapy combined with the use of avatars within a virtual world. The basis of this approach was the idea that this environment could help facilitate the externalisation phase of narrative therapy, to help produce more positive narratives about the client’s lived experience. It is qualitative research using a theory building case study methodology with a single participant who is an adult with a diagnosis of autism who presented with a history of emotional dysregulation. The research design involves undertaking the therapy remotely via video over 8 sessions of approximately 60 minutes. The therapist-researcher and client each observed the virtual scene provided by the ProReal Ltd virtual reality system. The client could create, modify and interact with avatars whilst they conversed. The data gathered consists of a verbal transcript of the therapy sessions and a video recording of the virtual world. Reflective thematic analysis was used to create a number of themes and sub-themes from the data. The outcomes developed were three primary themes, Ableism & distress, Externalising lived experience and Overcoming difficulties. The first being associated with the sub-themes, Emotional overwhelm and its responses and Shame and the causes of distress. The third theme was associated with sub-themes Acceptance through relationship, Self-acceptance and Awareness of influences on distress and learning from the therapy. These themes could be related through the central idea of Living in a neuro-normative world. In the conclusions, the issues raised are critically reviewed and the possible applications and limitations are then discussed.","abstract_has_math":false,"creators":["Short, T.E.G."],"institution":"Middlesex University / Metanoia Institute","degree_name":"DCPsych","degree_level":"DCPsych thesis","degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2025,"date_issued":"2025","date_published":"2025","updated_at":"2026-07-24T03:03:17Z","subjects":[],"languages":[],"rights":[],"rights_urls":[],"identifier_entries":[{"key":"dc:identifier","label":"Identifier","values":["oai:repository.mdx.ac.uk:2x154x"],"render_values":[{"text":"oai:repository.mdx.ac.uk:2x154x","href":null,"code":true}]}]},"links":{"outbound_url":null,"outbound_label":null,"outbound_source":null},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:creator","label":"Author","values":["Short, T.E.G."]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date","label":"Dc Date","values":["2025"]},{"key":"dc:date.issued","label":"Date","values":["2025"]},{"key":"dc:publisher","label":"Institution","values":["Middlesex University Research Repository"]},{"key":"dc:publisher.department","label":"Dc Publisher Department","values":["Psychology","Science and Technology"]},{"key":"dc:publisher.institution","label":"Dc Publisher Institution","values":["Middlesex University / Metanoia Institute"]},{"key":"dc:relation","label":"Dc Relation","values":["https://repository.mdx.ac.uk/item/2x154x"]},{"key":"dc:relation.isreferencedby","label":"Dc Relation Isreferencedby","values":["https://repository.mdx.ac.uk/item/2x154x"]},{"key":"dc:type","label":"Dc Type","values":["Thesis or dissertation"]},{"key":"dc:type.qualificationlevel","label":"Dc Type Qualificationlevel","values":["DCPsych thesis"]},{"key":"dc:type.qualificationname","label":"Dc Type Qualificationname","values":["DCPsych"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["oai:repository.mdx.ac.uk:2x154x"]},{"key":"dc:identifier.uri","label":"Identifier URI","values":["https://repository.mdx.ac.uk/download/b80c37b87bc14c936e48e1ea37b98c5b3d3e52cf3f1cf80f60d5c920223085d4/5399039/TEGShort%20thesis.pdf"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["The aim was to investigate the use of a novel therapeutic intervention utilising narrative therapy combined with the use of avatars within a virtual world. 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The outcomes developed were three primary themes, Ableism & distress, Externalising lived experience and Overcoming difficulties. The first being associated with the sub-themes, Emotional overwhelm and its responses and Shame and the causes of distress. The third theme was associated with sub-themes Acceptance through relationship, Self-acceptance and Awareness of influences on distress and learning from the therapy. These themes could be related through the central idea of Living in a neuro-normative world. In the conclusions, the issues raised are critically reviewed and the possible applications and limitations are then discussed."]},{"key":"dc:description.abstract","label":"Abstract","values":["The aim was to investigate the use of a novel therapeutic intervention utilising narrative therapy combined with the use of avatars within a virtual world. The basis of this approach was the idea that this environment could help facilitate the externalisation phase of narrative therapy, to help produce more positive narratives about the client’s lived experience. It is qualitative research using a theory building case study methodology with a single participant who is an adult with a diagnosis of autism who presented with a history of emotional dysregulation. The research design involves undertaking the therapy remotely via video over 8 sessions of approximately 60 minutes. The therapist-researcher and client each observed the virtual scene provided by the ProReal Ltd virtual reality system. The client could create, modify and interact with avatars whilst they conversed. The data gathered consists of a verbal transcript of the therapy sessions and a video recording of the virtual world. Reflective thematic analysis was used to create a number of themes and sub-themes from the data. The outcomes developed were three primary themes, Ableism & distress, Externalising lived experience and Overcoming difficulties. The first being associated with the sub-themes, Emotional overwhelm and its responses and Shame and the causes of distress. The third theme was associated with sub-themes Acceptance through relationship, Self-acceptance and Awareness of influences on distress and learning from the therapy. These themes could be related through the central idea of Living in a neuro-normative world. 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