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SCI."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>In mental health care, fear of social stigma can prevent people from seeking therapy. Video-based remote therapy can lower this barrier, but for highly stigmatized or legally sensitive conditions, additional privacy protection may be required. Our prior work used a landmark \u201cmask\u201d representation for emotion-preserving facial anonymization; in this extension, we introduce humanoid avatarization and directly compare both approaches. In an online user study (N = 33), participants performed open-set human re-identification and human emotion recognition on anonymized videos and reported preferences in an A\/B comparison. Participants rated the avatar as more natural and expressive, while rating the mask as more anonymous and private. In contrast, objective re-identification accuracy was lower for the avatar than for the mask (13.46% vs. 20.20%), indicating stronger privacy protection by avatarization despite lower perceived anonymity. Emotion recognition was generally higher with the avatar method, consistent with participants\u2019 utility-oriented preferences.<\/jats:p>","DOI":"10.1007\/s42979-026-05042-0","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T11:35:46Z","timestamp":1779276946000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Avatar-Based Anonymization in Remote Therapy: Balancing Privacy and Emotional Expressivity"],"prefix":"10.1007","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2910-8202","authenticated-orcid":false,"given":"Jan","family":"Marquenie","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1188-7861","authenticated-orcid":false,"given":"Carlos","family":"Franzreb","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Brunstein","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7447-7141","authenticated-orcid":false,"given":"Ingo","family":"Siegert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,5,20]]},"reference":[{"issue":"6","key":"5042_CR1","doi-asserted-by":"publisher","first-page":"857","DOI":"10.1177\/0011000012459365","volume":"41","author":"J Owen","year":"2013","unstructured":"Owen J, Thomas L, Rodolfa E. 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All procedures involving human participants were performed in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. This article does not contain any studies involving animals.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Research Involving Humans and\/or Animals"}},{"value":"Informed consent was obtained from all participants included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed Consent"}}],"article-number":"460"}}