Virtual Trauma Interventions for the Treatment of Post-traumatic Stress Disorders: A Scoping Review

Knaust, Thiemo; Felnhofer, Anna; Kothgassner, Oswald D.; Höllmer, Helge; Gorzka, Robert-Jacek; Schulz, Holger

doi:10.3389/fpsyg.2020.562506

Cited by 23 publications

(21 citation statements)

References 104 publications

(346 reference statements)

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“…Given the ubiquitous use of psychotropic drugs in psychiatry, their impacts on VR immersion remains a significant practise issue. 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.…”

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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“…Inaccurate beliefs about treatment consequences (e.g., iatrogenic effects, reduced therapeutic alliance) have been a well-documented barrier to the dissemination of in vivo exposure therapy, which remains underutilized even among trained clinicians (45). Current evidence suggests that concurrent use of common pharmacological treatments (e.g., olanzapine, antipsychotics, antidepressants) with VR have minimal adverse effects (20,23,48,49) and that alliance when using VR is similar to face-to-face therapy (50,51). However, both areas remain under-researched and warrant further attention.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2022

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Therapeutic virtual reality (VR) has the potential to address the challenges of equitable delivery of evidence-based psychological treatment. However, little is known about therapeutic VR regarding the perspectives and needs of real-world service providers. This exploratory study aimed to assess the acceptability, appropriateness, and feasibility of therapeutic VR among clinicians, managers, and service staff working in mental healthcare and explore potential implementation barriers and enablers. Eighty-one staff from a network of private psychiatric hospitals in Victoria, Australia (aged M + SD: 41.88 + 12.01 years, 71.6% female; 64% clinical staff) completed an online survey, which included the Acceptability of Intervention Measure (AIM), Appropriateness of Intervention Measure (IAM), and Feasibility of Intervention Measure (FIM). While 91% of participants had heard about VR technology, only 40% of participants had heard of therapeutic VR being used in mental healthcare, and none had used therapeutic VR in a clinical setting. Most participants perceived VR to be acceptable (84%), appropriate (69%), and feasible (59%) to implement within their role or service and envisioned a range of possible applications. However, participants expressed concerns regarding safety, efficacy, and logistical challenges across clinical settings. Findings suggest a strong interest for therapeutic VR among Australian mental health providers working in the private system. However, dissemination efforts should focus on addressing identified barriers to ensure mental health providers are adequately informed and empowered to make implementation decisions.

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“…The upside of VRET is it doesn't rely much on the patient's imagination and allows to create traumatic stimuli that is more controlled and realistic. 3,4 In conclusion, exposure of virtual reality environment supports wider methodologies in clinical studies because it supports standardization duration and type of exposure for all patients. The purpose of this article is to systematize the studies that have used virtual reality in the treatment of PTSD.…”

Section: Introductionmentioning

confidence: 66%

Efficacy of Virtual Reality Exposure Therapy for Post-Traumatic Stress Disorder: A Systematic Review

Nugraha¹

2021

Preprint

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Background: Post-traumatic stress disorder (PTSD) develops as a result of directly experiencing, witnessing, or being repeatedly exposed to aversive details of, a potentially traumatic event such as death, combat, sexual assault, or serious injury. It involves a persistent feeling of fear that results from inadequate consolidation of trauma memory. PTSD negatively impacts patients' daily lives and is associated with a higher risk of death. The downside of trauma-focused imaginal exposure therapy is the inability of patients to recall the underlying traumatic event and its effects. The development of modern technology has made it possible to overcome the downside. Virtual reality exposure therapy (VRET) is now available for alternative choice of PTSD therapy. VRET is allowing to create traumatic stimuli that are more controlled and realistic. VRET supports wider methodologies in clinical studies because it supports standardization duration and type of exposure for all patients. This study aimed to verify the efficacy of Virtual Reality Exposure Therapy (VRET) for Post-Traumatic Stress Disorder (PTSD).Methods: The search strategy was conducted through PubMed, LinkSpringer, and LIVIVO. About 71 articles were retrieved using ‘post-traumatic stress disorder’ and ‘virtual reality exposure’ keywords. Further, screening was carried out and resulted in 8 articles. In the end, four articles were included. To be eligible, the articles should be randomized controlled trial articles, published from 2011-2121, and published in English.Results: Four RCTs included in this study reported that VRET has a significant effect in reducing CAPS and PTSD symptoms. One study also reported that VRET could help with depressive symptoms and reduce autonomic symptoms such as heart rate as a response to trauma cues. Conclusions: VRET has an obvious and significant impact on alleviating PTSD symptoms, even though if there were a more standardized protocol or more diverse RCT the effect and use of VRET could be even more promising thus making VRET has more ground to be applied to the general population.

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Virtual Trauma Interventions for the Treatment of Post-traumatic Stress Disorders: A Scoping Review

Cited by 23 publications

References 104 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

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

Efficacy of Virtual Reality Exposure Therapy for Post-Traumatic Stress Disorder: A Systematic Review

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