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Virtual Reality: Expanding Use in Mental Health Treatment

     

You may be familiar with virtual reality technology from the VR goggles that are increasingly popular for entertainment and games — a headset display, stereo sound and head motion tracking provide an immersive virtual reality experience.

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Virtual reality technology is also used in simulators for training and it is increasingly being used to help people with mental illness. While it has been used for some time treating people with phobias, advances in technology and greater availability are facilitating expanded use in mental health treatment.

Exposure therapy is a type of behavior therapy used to treat anxiety and other disorders. It involves exposing a person to the feared object or situation in a safe environment in order to overcome their anxiety and/or distress. This can involve directly facing the feared object or situation, vividly imagining it or experiencing through virtual reality technology.

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Virtual reality therapy has been used to help people with variety of fears and phobias.1 The Duke University Virtual Reality Treatment Program offers therapy for anxiety disorders related to fear of heights, elevators, thunderstorms, public speaking and flying. Participants are placed in a computer-generated three-dimensional world that gives them a sense of presence in the virtual environment. The experience is guided by a therapist who can interact with them throughout the therapy. Treatment typically involves six to 12 sessions.

Virtual reality therapy has several advantages over recreating experiences in real life, including the ability to control the environment, to schedule treatment, to repeat scenarios and to adjust scenarios to improve treatment. Also, it may have insurance benefits as some insurance will not cover the extended time needed for exposure therapy in person — virtual reality therapy often requires much less time.

Research supports the effectiveness of virtual reality exposure therapy and it is generally accepted by patients.2 A meta-analysis conducted in 2015 concluded that the benefits carry over to real life, and that virtual reality therapy leads to significant behavior change in real-life situations.3

Virtual reality exposure therapy is also being used to help treat people with posttraumatic stress disorder (PTSD), particularly people who have experienced combat trauma. Virtual reality allows a person to experience the scenario again in a safe and controlled way using interactive computer-generated environments that can be modified to look like aspects of the trauma memory. The virtual exposure helps the person activate the memory so that it can be revisited and emotionally processed leading to reduced anxiety and related symptoms.

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The University of Southern California Institute for Creative Technologies has built upon technology originally developed for the X-Box game to create a series of virtual military scenarios, such as a Middle-Eastern themed city and desert road environments. The simulation uses a head mounted display and can include 3D audio, vibrations and smells. The presentation is controlled by the clinician who is in audio contact with the patient.

According to the Defense Health Agency, this type of therapy may help improve access to care for service members who might otherwise avoid treatment due to stigma.

Researchers are also using virtual reality in job interview training for people with severe mental illness and people with autism. These groups of people have very low employment rates and the job interview often presents a major barrier to competitive employment. Research so far is promising. One study of individuals with severe mental illness found that virtual reality job interview training lead to increased job offers and less time searching for employment.4 A study of individuals with high-functioning autism found that those completing virtual reality job interview training were significantly more likely to have a job offer for a competitive position compared to those without the training.5

Resources

See a PBS video of Marine combat cameraman recounting his struggle with PTSD and how virtual reality therapy helped.

References

  1. Valmagia, LR, et al. Virtual reality in the psychological treatment for mental health problems: A systematic review of recent evidence. Psychiatry Research, 2016. See a short video about using virtual reality treatment, https://vimeo.com/145992521, password ‘cure.’
  2. Botella, C., et al. Virtual reality exposure-based therapy for the treatment of post-traumatic stress disorder: a review of its efficacy, the adequacy of the treatment protocol, and its acceptability. Neuropsychiatr Dis Treat. 2015; 11: 2533–2545.
  3. Morina N, Ijntema H, Meyerbröker K, Emmelkamp PM. Can virtual reality exposure therapy gains be generalized to real-life? A meta-analysis of studies applying behavioral assessments. Behav Res Ther. 2015 Nov;74:18-24.
  4. Smith, MJ, et al. Job Offers to Individuals with Severe Mental Illness After Participation in Virtual Reality Job Interview Training. Psychiatric Services. 2015, Nov:66(11):1173-9. www.jobinterviewtraining.net/Research
  5. Smith, MH. et al. Brief Report: Vocational Outcomes for Young Adults with Autism Spectrum Disorders at Six Months After Virtual Reality Job Interview Training. J Autism Dev Disord. 2015, October; 45(10):3364-69.

     

AnxietyDissociative DisordersADHDBipolar DisordersIntellectual DisabilityDepressionAutismPatients and FamiliesHoarding DisorderOCDPersonality DisordersGambling DisorderSpecific Learning DisorderSomatic Symptom DisorderSchizophreniaAddictionPTSD

 

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