{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T19:36:42Z","timestamp":1785526602080,"version":"3.56.0"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:00:00Z","timestamp":1759881600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>The gestalt empty-chair technique facilitates dialog between clients and an imagined person or aspect of themselves to explore and resolve emotions or conflicts. Although it has proven to be therapeutic, middle-aged South Korean men may find its traditional format uncomfortable because of cultural norms and traditional gender roles that discourage emotional expression. This study explored the perceptions of a virtual reality (VR)-based adaptation of the empty-chair technique.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fourteen middle-aged South Korean men (aged 40\u201359\u202fyears) participated in sessions involving interaction with a virtual representation of their younger selves in a VR environment, followed by in-depth interviews. Data were analyzed using Smith\u2019s Interpretative Phenomenological Analysis to reveal participants\u2019 lived experiences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Three positive experience domains emerged: \u201cemotional reactions from meeting my childhood self,\u201d \u201cshifting attitudes toward the self,\u201d and the \u201cadvantages of using VR.\u201d Conversely, three negative experience domains were identified: \u201cdifficulty revisiting childhood without constraints,\u201d \u201celements that disrupted immersion,\u201d and \u201careas for improvement.\u201d<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The findings highlight the potential of the VR-based empty-chair technique as a counseling tool for middle-aged men, offering innovative ways to overcome the limitations of the traditional approach.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyg.2025.1559171","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T06:47:25Z","timestamp":1759906045000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Qualitative study on the virtual reality-based empty-chair technique in middle-aged South Korean men"],"prefix":"10.3389","volume":"16","author":[{"given":"Kieun","family":"Yoo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eunha","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,8]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1002\/jclp.21830","article-title":"Collaboration in experiential therapy","volume":"68","author":"Berdondini","year":"2012","journal-title":"J. Clin. Psychol."},{"key":"ref2","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1007\/978-3-319-07233-3_26","article-title":"HCI prototyping and modeling of future psychotherapy technologies in second life","volume-title":"Human-computer interaction. Theories, methods, and tools: 16th international conference, HCI international 2014, Heraklion, Crete, Greece, June 22\u201327 2014, Proceedings, Part I 16","author":"Brahnam","year":"2014"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1016\/j.janxdis.2018.08.003","article-title":"Virtual reality exposure therapy for anxiety and related disorders: a meta-analysis of randomized controlled trials","volume":"61","author":"Carl","year":"2019","journal-title":"J. Anxiety Disord."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1685","DOI":"10.1007\/s11126-021-09935-6","article-title":"Virtual reality exposure treatment in phobias: a systematic review","volume":"92","author":"Freitas","year":"2021","journal-title":"Psychiatry Q."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"664687","DOI":"10.3389\/fpsyg.2021.664687","article-title":"Looking back from the future: perspective taking in virtual reality increases future self-continuity","volume":"12","author":"Ganschow","year":"2021","journal-title":"Front. Psychol."},{"key":"ref6","volume-title":"The descriptive phenomenological method in psychology: A modified Husserlian approach","author":"Giorgi","year":"2009"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"406","DOI":"10.1037\/0022-006X.70.2.406","article-title":"Resolving unfinished business: relating process to outcome","volume":"70","author":"Greenberg","year":"2002","journal-title":"J. Consult. Clin. Psychol."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1037\/0022-0167.55.2.185","article-title":"Differential effects of emotion-focused therapy and psychoeducation in facilitating forgiveness and letting go of emotional injuries","volume":"55","author":"Greenberg","year":"2008","journal-title":"J. Couns. Psychol."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1111\/j.1468-2850.2011.01253.x","article-title":"Culturally competent treatments for Asian Americans: the relevance of mindfulness and acceptance-based psychotherapies","volume":"18","author":"Hall","year":"2011","journal-title":"Clin. Psychol. Sci. Pract."},{"key":"ref10","year":"2022"},{"key":"ref11","first-page":"219","article-title":"Challenges and tasks of technology-based counseling practice","volume":"21","author":"Hwang","year":"2020","journal-title":"Korean J. Couns."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1472780","DOI":"10.3389\/fpsyg.2024.1472780","article-title":"Virtual reality vs. imagery: comparing approaches in guided meditation","volume":"15","author":"Jo","year":"2024","journal-title":"Front. Psychol."},{"key":"ref13","doi-asserted-by":"crossref","first-page":"189","DOI":"10.23844\/kjcp.2021.02.33.1.189","article-title":"Development and effects of group counseling program on discovering meaning of life for psychological crisis overcoming of middle-aged men","volume":"33","author":"Jung","year":"2021","journal-title":"Korean J. Couns. Psychother."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1891","DOI":"10.9728\/dcs.2022.23.10.1891","article-title":"The concept and necessity of escape from immersion in virtual reality content: focusing on digital content cases","volume":"23","author":"Kim","year":"2022","journal-title":"J. Dig. Contents Soc."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"466","DOI":"10.5762\/KAIS.2023.24.12.466","article-title":"Utilizing virtual reality technology in psychological testing and psychotherapy: a review of international research","volume":"24","author":"Kim","year":"2023","journal-title":"J. Korea Acad. Ind. Coop. Soc."},{"key":"ref16","first-page":"45","article-title":"The effects of counseling effectiveness according to the client\u2019s level of self-concealment and the counselor\u2019s verbal response types","volume":"1","author":"Kim","year":"2002","journal-title":"J. Commun. Counsel."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"e39966","DOI":"10.2196\/39966","article-title":"Immersive virtual reality avatars for embodiment illusions in people with mild to borderline intellectual disability: user-centered development and feasibility study","volume":"10","author":"Langener","year":"2022","journal-title":"JMIR Serious Games"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"265","DOI":"10.15703\/kjc.14.1.201302.265","article-title":"The curative factors that client\u2019s perceive as having changed during effective empty-chair dialogues in gestalt therapy","volume":"14","author":"Lee","year":"2013","journal-title":"Korean J. Counsel."},{"key":"ref19","first-page":"515","article-title":"Validation of the barriers to help seeking scale for Korean middle-aged men","volume":"36","author":"Lee","year":"2024","journal-title":"Korean J. Couns. Psychother."},{"key":"ref20","doi-asserted-by":"crossref","first-page":"543","DOI":"10.23844\/kjcp.2015.08.27.3.543","article-title":"An exploratory study on the possibilities and limitations online psychotherapy","volume":"27","author":"Lee","year":"2015","journal-title":"Korean J. Couns. Psychother."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1016\/j.explore.2022.08.001","article-title":"The effectiveness of immersive virtual reality (VR) based mindfulness training on improvement mental-health in adults: a narrative systematic review","volume":"19","author":"Ma","year":"2023","journal-title":"Explore"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"554","DOI":"10.1007\/s13311-017-0534-y","article-title":"Virtual reality-enhanced extinction of phobias and post-traumatic stress","volume":"14","author":"Maples-Keller","year":"2017","journal-title":"Neurotherapeutics"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"173","DOI":"10.3389\/fnhum.2019.00279","article-title":"Immersive virtual reality and virtual embodiment for the treatment of severe post-traumatic stress disorder","volume":"13","author":"Matamala-Gomez","year":"2019","journal-title":"Front. Hum. Neurosci."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1111\/acem.13308","article-title":"Using virtual reality simulation environments to assess competence for emergency medicine learners","volume":"25","author":"McGrath","year":"2018","journal-title":"Acad. Emerg. Med."},{"key":"ref26","first-page":"85","article-title":"User experience in virtual reality games: the effects of presence on enjoyment","volume":"24","author":"Nam","year":"2017","journal-title":"Korean Telecommun. Policy Rev."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1037\/0022-006X.63.3.419","article-title":"Resolving\" unfinished business\": efficacy of experiential therapy using empty-chair dialogue","volume":"63","author":"Paivio","year":"1995","journal-title":"J. Consult. Clin. Psychol."},{"key":"ref9001","volume-title":"Gestalt therapy","author":"Perls","year":"1951"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"956","DOI":"10.3389\/fpsyg.2020.00956","article-title":"Virtual reality body exposure therapy for anorexia nervosa. A case report with follow-up results","volume":"11","author":"Porras-Garcia","year":"2020","journal-title":"Front. Psychol."},{"key":"ref29","first-page":"1","article-title":"Motivational chair work: an experiential approach to resolving ambivalence","volume":"2","author":"Pugh","year":"2018","journal-title":"Eur. J. Couns. Theory Res. Pract."},{"key":"ref30","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1007\/s41042-020-00046-4","article-title":"Positive psychotherapy with a pulse: achieving depth through dialogue","volume":"6","author":"Pugh","year":"2021","journal-title":"Int. J. Appl. Posit. Psychol."},{"key":"ref31","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1002\/cpp.2622","article-title":"Virtual reality in the treatment of eating disorders","volume":"28","author":"Riva","year":"2021","journal-title":"Clin. Psychol. Psychother."},{"key":"ref9003","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1177\/1069397114528292","article-title":"Parental power and prestige moderate the effects of perceived acceptance on offspring\u2019s psychological adjustment","volume":"48","author":"Rohner","year":"2014","journal-title":"Cross-Cultural Research"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"617","DOI":"10.4088\/JCP.v62n0808","article-title":"Virtual reality exposure therapy for Vietnam veterans with post-traumatic stress disorder","volume":"62","author":"Rothbaum","year":"2001","journal-title":"J. Clin. Psychiatry"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1026\/\/1617-6383.15.2.69","article-title":"The sense of presence in virtual environments: a three-component scale measuring spatial presence, involvement, and realness","volume":"15","author":"Schubert","year":"2003","journal-title":"Z. Medienpsychol."},{"key":"ref34","first-page":"1359","article-title":"Development and effectiveness of self-compassion based exposure therapy for public speaking anxiety using virtual reality","volume":"34","author":"Seo","year":"2022","journal-title":"Korean J. Counsel. Psychother."},{"key":"ref35","doi-asserted-by":"publisher","first-page":"124","DOI":"10.3389\/fnhum.2020.00124","article-title":"Alcohol craving in heavy and occasional alcohol drinkers after cue exposure in a virtual environment: the role of the sense of presence","volume":"14","author":"Simon","year":"2020","journal-title":"Front. Hum. Neurosci."},{"key":"ref36","volume-title":"Interpretative phenomenological analysis: theory, method and research","author":"Smith","year":"2009"},{"key":"ref37","volume-title":"Der leere Stuhl [the empty chair]","author":"Staemmler","year":"1995"},{"key":"ref38","year":"2023"},{"key":"ref39","doi-asserted-by":"crossref","first-page":"547","DOI":"10.15753\/aje.2019.06.20.2.547","article-title":"The relationships between patriarchal family environment and men\u2019s depression: the mediating effects of sexism and men\u2019s gender role conflict","volume":"20","author":"Sung","year":"2019","journal-title":"Asian J. Educ."},{"key":"ref40","doi-asserted-by":"publisher","first-page":"550165","DOI":"10.3389\/fpsyt.2020.550165","article-title":"A virtual reality game to assess OCD symptoms","volume":"11","author":"Van Bennekom","year":"2021","journal-title":"Front. Psych."},{"key":"ref41","doi-asserted-by":"publisher","first-page":"1758","DOI":"10.3389\/fpsyg.2019.01758","article-title":"Inferiority or even superiority of virtual reality exposure therapy in phobias?: a systematic review and quantitative meta-analysis on randomized controlled trials specifically comparing the efficacy of virtual reality exposure to gold standard in vivo exposure in agoraphobia, specific phobia, and social phobia","volume":"10","author":"Wechsler","year":"2019","journal-title":"Front. Psychol."}],"container-title":["Frontiers in Psychology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2025.1559171\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T06:47:29Z","timestamp":1759906049000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2025.1559171\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,8]]},"references-count":42,"alternative-id":["10.3389\/fpsyg.2025.1559171"],"URL":"https:\/\/doi.org\/10.3389\/fpsyg.2025.1559171","relation":{},"ISSN":["1664-1078"],"issn-type":[{"value":"1664-1078","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,8]]},"article-number":"1559171"}}