Virtual reality for psychotherapy: Current reality and future possibilities.

Abstract

After a burst of popular interest, virtual reality (VR) faded somewhat from view, but research and development have continued. Applications have expanded as costs have come down and hardware has improved. Originally, VR was used to treat simple phobias, especially fear of heights and flying. Applications for claustrophobia, fear of driving, and fear of spiders ensued. Currently, there is ongoing work on posttraumatic stress disorder, eating disorders, sexual dysfunction, schizophrenic hallucinations, and addictions. Considerable success has been achieved in using VR for distraction from pain. Attention is now being given to panic disorder and agoraphobia. The latter syndromes require the use of simulated human beings (avatars). Existing avatars are standardized, schematic, and limited in their ability to interact, but exciting work is proceeding on the development of highly interactive avatars that can be personalized.The use of virtual reality (VR) technology in psychotherapy has taken some time to come of age. After capturing the public imagination some years ago, enthusiasm for VR flagged as a result of hardware limitations, the need for expensive equipment, and the lack of a commercial market. Recently, however, significant improvements have been made in computer speed and the quality of head-mounted displays. Further, costs have come down dramatically. The original studies were conducted with environments that were at best animated caricatures of real environments yet could cost over $250,000. Today, richer and much more complex environments perform effortlessly on typical desktop and high-end laptop computers.These technological developments have contributed to an increase in the amount of work being done with VR. Although it is difficult to estimate how many clinical VR installations are currently operating-there is no central registry-one company, Virtually Better, has systems in approximately 40 locations in 6 countries, including the United States, Canada, Australia, Israel, Argentina, and Ireland. These installations are in hospitals, universities, private practice settings, and small groups. Many of these sites conduct a mix of clinical training, research, and clinical work. Even more interesting is the fact that according to a recent poll published in an APA journal, the use of VR and other computerized Kalman Glantz, independent practice, Cambridge, Massachusetts; Albert (Skip) Rizzo,

Virtual Reality and Body Dissatisfaction Across the Eating Disorder’s Spectrum

“…Riva and his team were the first researchers to incorporate VR in the treatment of body image disturbances [33]. Their work was first applied to nonclinical samples, and since their results proved to be encouraging, they conducted the same treatment on samples of patients with ED.…”

“…It has proved to be an effective tool that allows for exposure, desensitisation as well as cognitive retraining [47,48]. Since it improves BI and body satisfaction when used in combination with cognitive-behavioral therapy [30,39], some researchers have argued that VR should not be limited to this therapeutic approach but could also be considered beneficial in other types of psychotherapy, such as the interpersonal therapy or the psychodynamic therapy [33,47,48]. Given that VR is an experiential form of imagery that can induce emotions similar to those present in real life settings [47], it seems especially appropriate to use it in psychodynamic therapy.…”

“…Moreover, VR provides a safe environment for eliciting and working on emotions in such a way that a corrective emotional experience becommes possible. Virtual humans can also represent an interesting tool to give access to repressed material [33] and to facilitate transference as well as resolution of past conflicts in clients [48,49].…”

Cybertherapeutic Theory and Techniques

“…Some research has begun to explore the use and effectiveness of such online audiovisual interventions (Day & Schneider, 2002;Glueckauf et al, 2002;Manchanda & Mclaren, 1998;Rees & Stone, 2005;Simpson, 2003). In this category of sensory-rich communication, we may also include the more imaginary multimedia environments in which the therapeutic process takes place in an artificially constructed scene or "virtual reality" -in some cases including visual icons called avatars that clients use to represent themselves within that environment (Gaggioli, Mantovani, Castelnuovo, Wiederhold, & Riva, 2003;Glantz, Rizzo, & Graap, 2003;Riva, 2000Riva, , 2003Schuemie, Van der Straaten, Krijn, & Van der Mast, 2001;Wiederhold & Wiederhold, 1998). These multimedia environments may simulate real situations, as in virtual reality (VR) treatments for phobias, or they may be purely imaginative and even fantasy-based scenes.…”

A Virtual Reality Exposure Therapy Application for Iraq War Post Traumatic Stress Disorder

“…Such use and value of VR for the treatment of cognitive, emotional, psychological and physical disorders has been well specified [7][8]. The first use of VR for a Vietnam veteran with PTSD was reported in a case study of a 50-year-old, Caucasian male veteran meeting DSM-IV criteria for PTSD [9].…”