Clinician Perceptions of Virtual Reality to Assess and Treat Returning Veterans

Kramer, Teresa L.; Pyne, Jeffrey M.; Kimbrell, Tim A.; Savary, Patricia E.; Smith, J. L.; Jegley, Susan

doi:10.1176/appi.ps.61.11.1153

Cited by 14 publications

(12 citation statements)

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“…Since VRET has thus far remained a niche research area, there has been little research on implementation in regular care and very little research on how ordinary therapists view VRET. Research from 2010–2012 suggested that although therapists had an overall positive view of VRET (pros outweighing cons), there were also concern about required training, technical difficulties in operating, financial costs in acquiring, low immersion, and low efficacy, as well as a general unfamiliarity with the technology (Kramer et al, 2010; Segal et al, 2011; Schwartzman et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Attitudes Toward and Familiarity With Virtual Reality Therapy Among Practicing Cognitive Behavior Therapists: A Cross-Sectional Survey Study in the Era of Consumer VR Platforms

et al. 2019

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Virtual reality exposure therapy (VRET) is an efficacious treatment for fear and anxiety and has the potential to solve both logistic issues for therapists and be used for scalable self-help interventions. However, VRET has yet to see large-scale implementation in clinical settings or as a consumer product, and past research suggests that while therapists may acknowledge the many advantages of VRET, they view the technology as technically inaccessible and expensive. We reasoned that after the 2016 release of several consumer virtual reality (VR) platforms and associated public acquaintance with VR, therapists’ concerns about VRET may have evolved. The present study surveyed attitudes toward and familiarity with VR and VRET among practicing cognitive behavior therapists (n = 185) attending a conference. Results showed that therapists had an overall positive attitude toward VRET (pros rated higher than cons) and viewed VR as applicable to conditions other than anxiety. Unlike in earlier research, high financial costs and technical difficulties were no longer top-rated negative aspects. Average negative attitude was a larger negative predictor of self-rated likelihood of future use than positive attitude was a positive predictor and partially mediated the positive association between VRET knowledge and likelihood of future use, suggesting that promotional efforts should focus on addressing concerns. We conclude that therapist’s attitudes toward VRET appear to have evolved in recent years, and no longer appear to constitute a major barrier to implementing the next generation of VR technology in regular clinical practice.

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Section: Introductionmentioning

confidence: 99%

Attitudes Toward and Familiarity With Virtual Reality Therapy Among Practicing Cognitive Behavior Therapists: A Cross-Sectional Survey Study in the Era of Consumer VR Platforms

et al. 2019

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“…Though the clinicians explain to participants and their families that an increase in symptoms is likely to occur at the beginning of treatment, veterans seem to see this increase in symptoms as evidence that the treatment is worsening their condition and may cause many to terminate treatment. A qualitative study of clinician perceptions of VRET found clinicians not trained in the use of VRET expressed concerns about the safety of using VRET with veterans, questioning whether the virtual environment would exacerbate the symptoms of veterans (Kramer et al, 2010). However, in their meta-analysis on the use of VRET with anxiety disorders, Powers and Emmelkamp (2008) conducted a meta-regression analysis which showed that an increase in the number of virtual reality treatment sessions yielded larger effects sizes.…”

Section: Discussionmentioning

confidence: 99%

“…There have also been high dropout rates in studies where participants are active duty service members (McLay et al, 2012), which could be attributed to difficulties in balancing treatment with military duties, the time commitment of treatment sessions (90-120 min twice weekly for 8-12 weeks), and the possibility of transfers to other military bases occurring mid-treatment. Kramer et al (2010) also note that the use of virtual reality technology as a form of treatment may cause the therapeutic alliance to suffer as a result. Therapists expressed concern that multitasking conducting therapy and controlling complex computer software would prevent the development of an effective therapeutic relationship.…”

Section: Discussionmentioning

confidence: 99%

“…This is referred to as a “sense of presence” in the virtual world, or the level to which clients actually feel the virtual environment mirrors reality. In a qualitative study of clinician perceptions about VRET (Kramer et al, 2010), clinicians expressed concern that the virtual environment would not be realistic enough in order to trigger and then reduce anxiety. However, in their evaluation study of the realism of two virtual Iraq scenarios, Reger, Gahm, Rizzo, Swanson, and Duma (2009) conducted a convenience sample study with 93 soldiers not diagnosed with PTSD to see if the soldiers, who had been deployed to Iraq one or more times, felt this sense of presence.…”

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confidence: 99%

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Is virtual reality exposure therapy effective for service members and veterans experiencing combat-related PTSD?

Nelson¹

2013

Traumatology

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Purpose: Exposure therapy has been identified as an effective treatment for anxiety disorders, including posttraumatic stress disorder (PTSD). The use of virtual reality exposure therapy (VRET) in the past decade has increased due to improvements in virtual reality technology. VRET has been used to treat active duty service members and veterans experiencing posttraumatic stress symptoms by exposing them to a virtual environment patterned after the real-world environment in which the trauma occurred. This article is a systematic review of the effectiveness of using VRET with these two populations. Method: A search of 14 databases yielded 6 studies with experimental or quasi-experimental designs where VRET was used with active duty service members or veterans diagnosed with combat-related PTSD. Results: Studies show positive results for the use of VRET in treating combat-related PTSD, though more trials are needed with both active duty service members and veterans. Conclusions: VRET is an effective treatment, however more studies including random assignment are needed in order to show whether it is more effective than other treatments. There are still many barriers that the use of VRET with military populations would need to overcome in order to be widely used, including helping veterans become accustomed to the technology; assisting veterans who have spent a longer period of time avoiding anxiety-inducing stimuli in accepting an initial increase in anxiety; clinician concerns about the technology interfering with the therapeutic alliance, and clinician biases against the use of exposure therapy in general; and high treatment dropout rates.

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“…Contrary to the fears of some counselors that it is ineffective (Kramer et al, 2010), telepsychology has already been successfully used to deliver behavioral interventions, psychological assessments, social skills train-ing, and session evaluations to rural populations, the elderly, and clients with thought disorders (Hynes et al, 2009;Reese, Slone, Soares, & Sprang, 2015;Tuerk, Yoder, Ruggiero, Gros, & Acierno, 2010). In addition, interventions implemented over the Internet have been shown to improve client outcomes for populations suffering from both depression and anxiety disorders (Glynn, Randolph, Garrick, & Lui, 2010;Hailey, Roine, & Ohinmaa, 2008) and eating disorders (Hailey et al, 2008;Shingleton, Richards, & Thompson-Brenner, 2013).…”

Section: Efficacymentioning

confidence: 99%

Efficacy, Efficiency, and Ethics in the Provision of Telepsychology Services: Emerging Applications for International Workers

Regueiro

McMartin

Schaefer

et al. 2016

Journal of Psychology and Theology

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Computers and the Internet ushered humanity into a new era in the late 1900s—information on a variety of topics became widely available to the general public, and it became suddenly possible for individuals to communicate with one another instantaneously regardless of each person's geographical location. According to some, the evolution of technology has outpaced humanity's ability to learn how to manage technology properly, and this appears particularly true in the field of psychology. Instant messaging, social media sites, and video conferencing have all influenced the ways in which counselors and clients can interact. Questions remain, however, about the use of this technology. This paper addresses some of those questions by considering whether or not telepsychology is effective when it is used to conduct therapy and the circumstances under which a counselor might use a technological medium to provide such services. A review of some ethical considerations related to the use of technology in the service of providing therapeutic services is also included, as well as a discussion regarding the specific applicability of telepsychology services to international workers, specifically missionaries, serving abroad.

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Clinician Perceptions of Virtual Reality to Assess and Treat Returning Veterans

Cited by 14 publications

References 0 publications

Attitudes Toward and Familiarity With Virtual Reality Therapy Among Practicing Cognitive Behavior Therapists: A Cross-Sectional Survey Study in the Era of Consumer VR Platforms

Attitudes Toward and Familiarity With Virtual Reality Therapy Among Practicing Cognitive Behavior Therapists: A Cross-Sectional Survey Study in the Era of Consumer VR Platforms

Is virtual reality exposure therapy effective for service members and veterans experiencing combat-related PTSD?

Efficacy, Efficiency, and Ethics in the Provision of Telepsychology Services: Emerging Applications for International Workers

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