Virtual Reality Therapy to Treat Phobias

We are in the 21st century, so high-tech gadgets would, of course, present themselves to treat phobias and fears. In actuality, virtual reality has proven to be quite effective in treating phobias – especially arachnophobia.

This is one therapy you will not be able to do on your own. You will have to find a place that offers this treatment since it requires a virtual reality setup. However, we can touch on the basics of what it can do and how it works.

Virtual Reality (VR) is a type of exposure therapy in a virtual setting that is safer, less embarrassing, and less costly than reproducing the real world situations. Besides situations can be created that are difficult to find in real life and it’s more realistic than imagining the danger.

Already some experiments have proven VR to be a useful tool in treating specific phobias such as fear of heights, fear of spiders, fear of flying and claustrophobia, as well as agoraphobia. However most research that is done on VR exposure consists of single case studies and controlled group studies are necessary to support the conclusions of case studies. Research in this area is still in its infancy, but is progressing rapidly.

The therapy consists of a few sessions with a psychologist to determine the origin of the fear. The VRT portion of the therapy begins after there is a sufficient understanding of the phobia. Using a platform and a headset, a patient is immersed in a computer-generated environment designed to reproduce a real-world setting. Real digital video is incorporated into the virtual environment to promote a sense of reality. A process known as habituation is used to help patients manage their anxiety.

Habituation occurs with exposure over time. The therapy might begin with exposure to the virtual room only. Then the stimulus (spider) is introduced far away and gradually gets closer. It’s sort of like taking baby steps. As the patient becomes more and more comfortable in the room, the body’s anxiety reaction will become less and less severe.

The headset is attached to a desktop computer and sensors pick up any head movement so when the user turns his head, he can look around. The earphones will simulate the sounds of the environment. The platform also moves to simulate the physical nature of the situation.

The process is started in a hierarchical way beginning with the less intimidating scenario and gradually making it more difficult. The patient is kept in the environment until their anxiety begins to lessen (habituation).

Overall the experience is convincing but still cartoon-like; there’s no mistaking this for the real situation. But, for most people with phobias that doesn’t matter–it’s real enough to elicit their fears. The advantages of virtual reality are becoming very evident. First, the therapist can carefully control the amount of exposure in each session. For fear of flying, for example, they can slowly take clients through the steps of a flight–from takeoff to landing–over many sessions, waiting at each step and working with them until they feel comfortable and habituated.

Also there is the convenience and confidentiality factor: One therapist explains, “I could take someone with a fear of elevators onto a real elevator, but this way they don’t have to worry about running into people and explaining who this guy with them is.”

Finally, it’s easier to get people with phobias to agree to exposure therapy when it’s begun virtually, rather than in vivo. In vivo [exposure therapy] is very effective, but you have to convince people to try it. By definition, someone with a phobia wants to avoid what they’re afraid of.

Of course, virtual reality has some disadvantages as well. First, there is the cost: A Virtually Better VR system sells for more than $6,000 and requires a monthly licensing fee. That price tag doesn’t put it out of reach for most therapists, but it is a significant investment.

For the patient, it can be expensive as well. The treatment costs between $100 and $300 an hour. Typical treatments are completed in eight one-hour sessions. Also, the therapy does not work for everyone–and it works better for some people than for others. Some studies have found, for example, that people who are more hypnotizable or more easily able to block out distraction and be absorbed in an activity like reading are also more likely to benefit from virtual reality exposure therapy. There are people who try it and it doesn’t work, but that’s not true for most people.

The goal, of course, is to eventually move all clients from the virtual to the real world.

When it comes to arachnophobia, virtual reality appears to work very, very well. On the screen, the phobic will see a 3-D virtual spider in what appears to be a normal setting like the kitchen. The subject will be encouraged to “walk” closer to the spider while their anxiety level is monitored.

Eventually, they will be asked to touch a realistic larger version of a spider while virtually touching the one in the setting. Again, habituation is used to minimize the body’s fear response and the patient will eventually become less stressed to touch the spider – both virtually and in reality.

While not everyone is able to do this, they are able to make great strides towards reducing their anxiety level and better deal with the spider in real life.

Virtual Reality Medical Education in Second Life

Increasing numbers of people are using the Internet for the provision of all sorts of health services, from prescribing, through consulting to setting up automated self-treatment programs. But what about using it for education and therapy? After all, in theory, the ultimate form of cognitive behavioral therapy should be “virtual reality therapy.” By simply wearing your wrap-around sound and vision multimedia headset you can be instantly transported to a cliff edge, soar in a plane thousands of feet above the ground or be surrounded by a gathering of thousands of spiders – depending on your phobia. And the ultimate form of online education should be fully interactive, case based and student driven, all of which I now use in my teaching in Second Life.

The phrase “virtual reality” was coined by Jaron Lanier in 1989 to describe computer simulations of physical environments. Since the mid-1990s, the video game industry and 3D graphics card manufacturers have driven forward the state of personal computer graphics, advancing it far beyond the needs of most business users. These systems range in capability from simple displays of 3D objects to entire virtual cities. Virtual reality systems are now being routinely implemented on personal computers for a variety of activities. One of the most popular virtual reality programs is Second Life, produced by Linden Lab, Inc. Second Life is a general-purpose virtual world accessible through any Internet-connected personal computer. In order to interact in Second Life, users create “avatars”, or animated characters, to represent themselves. Individuals use these avatars to maneuver through various “worlds”, complete with buildings, geographical features, and other avatars. While the system borrows heavily from video game technology, it is not a game – there are no points, no levels, no missions, and nothing to win. It is simply a platform by which people can create virtual communities, model geological, meteorological, or behavioral phenomena, or rehearse events. I have been working in Second Life for several years now.

Users of Second Life include a variety of education organizations, from Harvard Law School to the American Cancer Society. There are currently areas of the virtual world that provide such disparate services as teaching heart sounds and auscultation technique, providing social support for individuals with Asperger’s Syndrome, and modeling the effects of tsunami on coastal towns. The system has over 10 million account holders from all over the world, most of them with free basic accounts. Approximately 800,000 of those users are active, with over 80,000 of them connected to the system at any time. Virtual reality programs such as Second Life are increasingly being used for educational purposes in a variety of fields, including medical training and disaster preparedness. Linden Lab currently operates the Second Life Education Wiki which functions as a source of information for educators and trainers in a variety of fields who wish to use Second Life for distance learning or large-scale training purposes. A number of government agencies, including the Department of Homeland Security, the Centers for Disease Control, the National Institutes of Health, and the National Science Foundation, have begun using Second Life to hold meetings, conduct training sessions, and explore ways to make access to information more readily available around the world. A recent comprehensive survey intended to gather information on the activities, attitudes, and interests of educators active in Second Life conducted by New Media Consortium reported that the majority used it for educational purposes such as teaching and taking classes as well as for faculty training and development.

I have been using Second Life as a teaching and learning environment for several years now. With colleagues I have created a “virtual hallucinations” environment, which demonstrates the lived experience of psychosis and allows participants who travel through the environment to experience both visual and auditory hallucinations; visions and voices. We used this environment to teach this experience to our medical and psychology students. With the California Department of Health and other colleagues I have created a virtual bioterrorism crisis clinic to train health workers, and more recently, as part of our Health Informatics Certificate Program, with University of California Davis Extension, we have taught informatics students in a virtual conference center on our own private island; Davis Island. Students find the environment straightforward to learn to navigate, and within a week of our informatics students being introduced to the environment they were able to travel and tour around Second Life with the rest of us with ease.

Second Life and similar multi-user environments offer enormous possibilities in the medical educational world, where such applications are now called “serious games” rather than social or fun software. Students of the future will adapt to them very easily, and it is clear that applications such as Second Life have a great educational future before them. I look forward to continuing to teach classes of medical and graduate students “inworld”.

virtual reality therapy

Virtual-reality therapy I was a form of systematic systematic desensitization, which employs feature theory as it relates to Geon and templates.

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