Social Skills Acquisition in Virtual Reality-Based Interventions for People with Mental Health and Substance Use Disorders: A Qualitative Exploration (Preprint)

Abstract

BACKGROUND People with concurrent mental health and substance use disorders (MHD and SUD) suffer from marginalization, leading to high levels of mortality and morbidity. Social participation requires certain social abilities, which are often inadequate in this group. Focusing on functional recovery and aiding people in the process of becoming active and participating citizens are thus key parameters in the recovery process for people with MHD and SUD. Recent research on virtual reality-based interventions shows a particularly promising trans-diagnostic potential in improving social functioning and quality of life across the spectrum of neuropsychiatric disorders. However, research on digitalized cognitive remediation does not show generalization to everyday life. Key working mechanisms of the interactive, digital social environments in virtual realities have yet to be identified. We also lack understanding of how we can best design and structure immersive learning experiences to promote social skills acquisition and retention for people with mental health and substance use disorders. OBJECTIVE The aim of this study was to explore how virtual reality-based interventions may be tailored to promote social skills acquisition and retention for people with concurrent mental health and substance use disorders. METHODS Eight individual in-depth interviews with adults in recovery from mental health and substance use disorders were conducted in a mmedium-sized municipality in eastern Norway during the fall of 2022. The interviews were analyzed using template analysis in a process involving peer researcher collaboration RESULTS The present study shows that human capacity to achieve sustained learning outcomes from multisensory perception in immersive learning experiences is limited in general. This study also shows that people with mental health and substance use disorders have particularly deficient immersive learning abilities, as well as disadvantageous social learning prerequisites. CONCLUSIONS Social skills acquisition and retention depend on restructuring dysfunctional cognitive schemas in the virtual reality user’s long-term memory. Chunking VRI content into micro scenarios that may be repeated and structured according to individual learning prerequisites may enable the restructuring of a dysfunctional social schema and possibly ensure the storage of the new, repaired schema in the user’s long-term memory. It is therefore suggested that virtual reality-based interventions for social skills training should be designed as short, focused micro scenarios, orchestrated in a sequenced or otherwise carefully and deliberately structured learning workflow. CLINICALTRIAL clinicaltrials.gov ref. NCT05653167