Virtual Reality – A New Tool For Psychologists

Virtual Reality – A New Tool For Psychologists

Virtual Reality (VR) is a technology that allows the user to interact with a computer-generated environment. Large companies such as Google or Samsung were among the first ones to invade the market with head-mounted displays and interactive clothing. Thus, users are no longer passive spectators in front of their screen but active participants in a virtual 3D world.

VR is particularly interesting when applied to medicine, and more precisely, psychology. Indeed, several behaviour disorders can be solved by what professionals call cue expose therapy. CET consists in controlled and repeated exposure to a cue that usually triggers the pathological behaviour. The objective is to teach the patient how to correctly react to the signals.

1. Smoking Relapse Prevention

Although there have been many successful initiatives to help smokers quit, relapse prevention, however, did not encounter the same success.Indeed, studies have shown that after smoking cessation programs, 40% to 70% of the patients relapse. When we know that tobacco is among the first causes of preventable mortality and that it leads to billions of dollars in health expenditure, we easily understand that preventing relapse is a major economical and public health challenge.

A study is being run in a hospital in Marseille, France, with the objective of evaluating the interest of using virtual reality to help patients permanently stop smoking. The use of this technology results from various studies that showed that relapse is often induced by environmental stimuli such as having lunch next to smokers. Thus, it is important that smoking cessation programs include this approach and that therapists teach their patients how to cope with real-life scenarios. However, it is hard to set up a consultation at a party or at a terrace surrounded by smokers. Therefore, virtual reality appears like a good compromise between a classical consultation and the possibility of experiencing and working around environmental stimuli.

In this study, patients face different scenarios that could potentially lead them to start smoking again. Here are a few examples:

Virtual reality cue exposure for the relapse prevention of tobacco consumption: a study protocol for a randomized controlled trial – Camille Giovancarli et al.

2. Phobias

One of the main advantages of VR in clinical psychology is that it allows the therapist to control the environment the patient is exposed to and go from low anxiety situations to very high ones. Thus, the programs are very flexible and can adapt to the patient’s progression. The therapist can not only control the stimuli and their intensity but he or she can also analyse and correct the patient’s behaviour immediately. Moreover, studies reported that with VR, patients don’t feel as threatened by their environment as they do in real-life, allowing them to act more freely and therefore accelerate their progression and prepare them for the real world. This characteristic is particularly interesting when dealing with phobias.

C2Care, a French VR company, develops virtual scenarios to treat a wide range of psychological disorders such as phobias, addictions, eating disorders, etc. In their website, they state:

“According to the National Institute of Mental Health (NIMH), approximately 10% of people in the United States suffer from phobias. And, in fact, phobias are the most common mental disorder in the U.S. They can now confront the object of their anxiety in a gentle and progressive way, safe in the office of their therapists. Phobias, eating disorders, addictions, C2Care virtual environments allow the treatment of several mental pathologies.”

For each phobia, several exposure steps are available. For example, for a claustrophobic, C2Care offers an elevator simulation with 6 levels of exposure going from simply pressing the button to call the elevator to being inside a failing lift.

3. Post-Traumatic Stress Disorder (PTSD)

When we think about PTSD we often think about veterans. But post-traumatic stress disorder can affect anyone that went through a traumatic experience in his or her life, like a terrorist attack or a natural disaster. In the United States, prevalence is around 8.7%.

VR has the potential to influence a patient’s actions and thoughts by confronting him/her to various stimuli while keeping him/her in a secure environment. For patients suffering from PTSD, VR allows them to visually and aurally embed themselves into the traumatic situation without requiring imagination efforts to relive the experience. This characteristic is very helpful since patients are usually unwilling or unable to do this.

Oculus Rift

Studies describe two types of VR environments: the first one uses precise and realistic situations whereas the second one uses symbols to represents a traumatic event. The advantage of using symbols such as pictures, music or sounds is that it can easily adapt to any type of patient and can help him/her relive any traumatic event.

Bravemind is VR exposure therapy developed at the University of Southern California used to treat PTSD in soldiers coming back from the war.

“Bravemind not only provides a tool for clinicians in the treatment of PTSD patients but also allows them to measure, document, and learn from the results in order to better understand the brain and biological factors that serve to inform the prevention, assessment and treatment of PTSD.”  Bravemind

But researchers did not stop at using VR to treat PTSD, they also used this technology to prevent it. Strive is a new form of VR that trains future soldiers and teaches them how to cope with highly traumatic situations, reducing the risk of developing PTSD. Thus, the program provides advice and techniques to handle the stress before the soldiers experience it on the field.

3. Phantom Limb Pain

There are nearly 2 million people living with limb loss in the United States. Most of them are caused by diabetes, trauma or cancer. Although pain is common during the healing process, some people experience chronic pain in the part of the limb that is missing. It is call the phantom limb pain. One of the techniques to treat this pain is to use a mirror. This technique makes the patient’s brain think that the missing limb is still there. The mirror therapy is very effective but new technologies such as Augmented Reality or VR have proven to me equally or more efficient. Indeed, these technologies can allow the patient to see, move and feel the missing limb on a screen or through VR glasses.

A recent study compared the pain levels of patient with upper extremity amputation before and after virtually grasping and releasing an apple. In five of the seven patients included in the trial, the pain levels were significantly lower. There is more evidence of this in the following video.

These are only a few of the applications of virtual reality in treating psychological disorders. VR could also be used as a relaxation technique or for patients suffering from eating disorders. Several companies such as C2Care already offer such scenarios.