Psychedelics and virtual reality: parallels and applications

Aday, Jacob S.; Davoli, Christopher C.; Bloesch, Emily K.

doi:10.1177/2045125320948356

Cited by 26 publications

(33 citation statements)

References 78 publications

(98 reference statements)

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“…The extant literature suggests common pharmacological drugs (e.g., antidepressants, antipsychotics) have minimal influence on concurrent VR usage (30,(58)(59)(60)(61), however, higher attrition rates and PTSD symptoms relative to controls have been reported from VR interventions in conjunction with alprazolam and dexamethasone (59,62). This will be particularly relevant with the rise of psychedelic pharmacotherapy for psychiatric indications (63), as the combination could conceivably help or hinder therapeutic outcomes. Additionally, our understanding as to which patients are "good candidates" for VR therapies, the effect of combined treatment, and the optimal number and frequency of sessions is limited.…”

Section: Implications For Future Implementationmentioning

confidence: 99%

Implementation of Therapeutic Virtual Reality Into Psychiatric Care: Clinicians' and Service Managers' Perspectives

et al. 2022

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Objectives: Virtual reality (VR) has emerged as a highly promising tool for assessing and treating a range of mental illnesses. However, little is known about the perspectives of key stakeholders in mental healthcare, whose support will be critical for its successful implementation into routine clinical practise. This study aimed to explore the perspectives of staff working in the private mental health sector around the use of therapeutic VR, including potential implementation barriers and facilitators.Methods: Semi-structured qualitative interviews were conducted with cross-disciplinary clinicians (n = 14) and service managers (n = 5), aged 28–70 years working in a major private mental health hospital in Victoria, Australia. Transcripts were analysed using general inductive coding to allow themes to naturally emerge.Results: Three major themes were identified: clinical factors (four subthemes), organisational factors (five subthemes), and professional factors (three subthemes). The themes encompassed enabling factors and potential barriers that need to be addressed for successful implementation of VR. Clinical factors highlighted the influence of knowledge or perceptions about appropriate clinical applications, therapeutic efficacy, safety and ethical concerns, and patient engagement. Organisational factors emphasised the importance of service contexts, including having a strong business case, stakeholder planning, recruitment of local opinion leaders to champion change, and an understanding of resourcing challenges. Professional factors highlighted the need for education and training for staff, and the influence of staff attitudes towards technology and perceived usability of VR.Conclusions: In addition to enabling factors, potential implementation barriers of therapeutic VR were identified, including resourcing constraints, safety and ethical concerns, negative staff attitudes towards technology and VR system limitations. Future dissemination should focus on addressing knowledge and skills gaps and attitudinal barriers through development of clinical guidelines, training programs, and implementation resources (e.g., adoption decision tools, consultation opportunities).

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Section: Implications For Future Implementationmentioning

confidence: 99%

Implementation of Therapeutic Virtual Reality Into Psychiatric Care: Clinicians' and Service Managers' Perspectives

et al. 2022

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“…As translational psychedelic science advances, a complete understanding of the molecular cascades and bidirectional information exchange processes between internal and environmental systems will require analysis across genome, transcriptome, proteome, metabolome, microbiome, epigenome, connectome, physiome and exposome (environmental) levels (390). Deciphering the precise interaction between these systems may advance treatment personalization algorithms, perhaps assisted by advances in technology, such as virtual reality (391,392), smartphones (393) and biosensors/biofeedback (394). Yet, it should be noted that even if the whole endeavor reduces down to an elaborate set of multi-layered fluctuating ones and zeros or some superposition thereof, or special molecular configurations and information processing pathways yet to be discovered, it is the relationship between the complex configurations underlying our experiences and the empathetic sharing and compassionate understanding of those experiences with others and the environment that is the matter of meaning and the potential of psychedelic therapy.…”

Section: Personalized Psychedelic Therapymentioning

confidence: 99%

Psychedelic Therapy's Transdiagnostic Effects: A Research Domain Criteria (RDoC) Perspective

et al. 2021

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Accumulating clinical evidence shows that psychedelic therapy, by synergistically combining psychopharmacology and psychological support, offers a promising transdiagnostic treatment strategy for a range of disorders with restricted and/or maladaptive habitual patterns of emotion, cognition and behavior, notably, depression (MDD), treatment resistant depression (TRD) and addiction disorders, but perhaps also anxiety disorders, obsessive-compulsive disorder (OCD), Post-Traumatic Stress Disorder (PTSD) and eating disorders. Despite the emergent transdiagnostic evidence, the specific clinical dimensions that psychedelics are efficacious for, and associated underlying neurobiological pathways, remain to be well-characterized. To this end, this review focuses on pre-clinical and clinical evidence of the acute and sustained therapeutic potential of psychedelic therapy in the context of a transdiagnostic dimensional systems framework. Focusing on the Research Domain Criteria (RDoC) as a template, we will describe the multimodal mechanisms underlying the transdiagnostic therapeutic effects of psychedelic therapy, traversing molecular, cellular and network levels. These levels will be mapped to the RDoC constructs of negative and positive valence systems, arousal regulation, social processing, cognitive and sensorimotor systems. In summarizing this literature and framing it transdiagnostically, we hope we can assist the field in moving toward a mechanistic understanding of how psychedelics work for patients and eventually toward a precise-personalized psychedelic therapy paradigm.

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“…This will likely move parts of psychiatry from a drug-centered treatment to a treatment centered on human experience and its social contexts. This paradigm might also open new avenues for using non-pharmacological methods for inducing altered states of consciousness and virtual reality (VR) for the treatment of psychiatric disorders, probably even in conjunction with psychedelics [55].…”

Section: Discussionmentioning

confidence: 99%

The Potential Role of Psychedelic Drugs in Mental Health Care of the Future

Gründer

Jungaberle

2021

Pharmacopsychiatry

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Serotonergic psychedelics such as psilocybin, lysergic acid diethylamide (LSD), or dimethyltryptamine (DMT), as well as psychoactive drugs that trigger phenomenologically- related experiences like 3,4-methylenedioxymethamphetamine (MDMA) and ketamine, belong to the most promising treatment approaches in contemporary psychiatry. Psychedelic-assisted psychotherapy is not only a new treatment paradigm in psychopharmacology, but it also requires a redefinition of psychotherapeutic processes and the contextualization of psychopharmacological interventions within a new treatment infrastructure. Crucial for future practice and research in the field are (1) informed patient referral and co-treatment practices, (2) screening (e. g., choosing the right patients for these therapies), (3) the dosing preparation sessions, (4) the assisted dosing sessions as well as after-care procedures such as (5) psychological integration and (6) supporting the development of structured patient communities. Definition of future treatment delivery infrastructures and requirements for therapist training are further challenges for research and practice. Finally, the implementation of psychedelic-assisted psychotherapy in routine mental health care must be embedded into public communication about the potential and risks of these innovative therapeutic approaches. This paper provides a synopsis of challenges for practitioners, researchers, and regulators to be addressed in the approval processes of psychedelics.

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Psychedelics and virtual reality: parallels and applications

Cited by 26 publications

References 78 publications

Implementation of Therapeutic Virtual Reality Into Psychiatric Care: Clinicians' and Service Managers' Perspectives

Implementation of Therapeutic Virtual Reality Into Psychiatric Care: Clinicians' and Service Managers' Perspectives

Psychedelic Therapy's Transdiagnostic Effects: A Research Domain Criteria (RDoC) Perspective

The Potential Role of Psychedelic Drugs in Mental Health Care of the Future

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