Freely Available Virtual Reality Experiences as Tools to Support Mental Health Therapy: a Systematic Scoping Review and Consensus Based Interdisciplinary Analysis

Abstract

The primary purpose of this article is to review the potential therapeutic value of freely available VR content as an addition to the practitioners ‘toolkit’. Research has shown that virtual reality (VR) may be useful to extend existing guided imagery-based practices found in traditional mental health therapy. However, the use of VR technology within routine mental health practice remains low, despite recent reductions in equipment costs. A systematic scoping review and interdisciplinary analysis of freely available VR experiences was performed across two popular online databases (SteamVR and Oculus.com). A total of 1785 experiences were retrieved and screened for relevance with 46 meeting the inclusion criteria. VR content was then reviewed for potential therapeutic value by an interdisciplinary panel with experience across a number of therapeutic interventions including cognitive behavioural therapy, Rogerian counselling, mindfulness-based therapies. and family therapy. Eleven (22%) of the 50 freely available VR experiences were reported to have therapeutic potential as tools to support routine mental health therapy. These included support with the following mental health issues—low mood, social anxiety, stress reduction and fear of heights. Guidance of a qualified mental health practitioner was recommended in all cases to maximise the benefit of the VR experiences retrieved. While the quality is variable, freely available VR experiences may contain valuable content that could support mental health therapy. This includes as a homework activity or as an initial setting for case formulation and behavioural experiments.

Are Australian Mental Health Services Ready for Therapeutic Virtual Reality? An Investigation of Knowledge, Attitudes, Implementation Barriers and Enablers

“…It is important to note that while commercially available products (see Table 2) are developed with evidence-based principles in mind, most have not undergone, or are in the process of being tested for efficacy in randomized controlled trials (29). Similarly, freely available VR experiences are often marketed as having a mental health focus on open application marketplaces (e.g., SteamVR, Oculus), without verification of clinical utility or safety (63). Thus, there is a risk of unvalidated VR programs being marketed for both therapist-assisted or selfdirected therapy, with potential to cause harm to users and diminish the credibility of validated programs (9).…”

The Symbiosis of Virtual Reality Exposure Therapy and Telemental Health: A Review

“…Social VR games can facilitate casual intimacy (Maloney and Freeman, 2020), which may provide opportunity for patients to engage with social phobias in low-stake settings. While most mental health VR apps have been rated unlikely to support patient care (Best et al, 2021), there is a growing abundance of other VR apps that may be useful in phobia and anxiety treatment protocols (Lindner et al, 2017). These commercial hardware, video games, and smartphone apps were not made for health purposes but there is ample opportunity to incorporate them into therapy today (Tuerk et al, 2019).…”

“…This can make VR-based therapy feel disorienting, as people who provide and receive mental health care may not have extensive gaming experience (Tuena et al, 2020;Pimentel et al, 2021). A systematic review found 1,785 VR apps for mental health, but only 11 were rated as potentially beneficial for therapy due to poor functionality (Best et al, 2021). In addition to unintuitive design or lack of therapeutic customization, VR-related motion sickness (often called cybersickness or simulator sickness) remains an issue (Timothy .…”

Appraising Virtual Technologies’ Impact on Older Citizens’ Mental Health—A Comparative between 360° Video and Virtual Reality

“…The questionnaire addressed the participant’s demographic profile and a series of Likert-scale statements using a seven-level scale (−3 = Strongly disagree or displeased to +3 = Strongly agree or pleased, and 0 = neutral). This approach was guided by Best et al’s (2021) [ 61 ] study, which used a similar questionnaire to collect data about how participants react to immersive experiences. The questionnaire also incorporated an open-ended question that allowed participants to express thoughts and justify answers.…”

“…The ability to explore a virtual space and interact with objects within VR experiences has been shown to increase the level of immersion for users [ 38 , 39 , 61 ]. Mol (2019) [ 39 ] reported that older users were able to enjoy VR experiences more when they were able to independently explore the virtual environment by themselves instead of following predefined routes.…”