What Is Virtual Reality Therapy?

Virtual reality exposure therapy (VRET) is a psychological treatment method that combines specific stress scenarios of virtual reality with exposure therapy. It is a transformation form of traditional behavior therapy and a classic reality situation exposure therapy. Alternative form of treatment. Virtual reality integrates real-time computer graphics, physical sensory sensing, and visual imaging technologies to provide visitors with a near-real, immersive and interactive virtual environment.

Virtual reality (VR) is a technology that has developed rapidly in recent years. Burdea, a pioneer in the field of virtual reality, believes that "virtual reality is a synthetic computer user interface that simulates reality through a variety of perception channels such as seeing, hearing, touching, and smelling." Virtual reality is a computer system that can be created and experienced. It uses computer technology to generate an audiovisual touch through some special equipment, such as helmet-mounted displays, graphic glasses, data gloves, stereo headsets, tracking systems, three-dimensional space sensors, etc. Smell and so on feel the real virtual space-time world. Users can interact with the virtual environment through the sensor device and change the virtual environment according to their own wishes. The feeling and movement are exactly the same as in the real world, and they have a strong "in-person" feeling and experience. It emphasizes realistic feelings, natural interactions, and unique imagination. In the early years, because VR equipment and systems were too expensive to produce, VR technology was only used in a few areas such as military and industrial design. With the development of computer technology, the cost of VR equipment and system production has dropped significantly, and VR technology has also become more and more widely used. In foreign countries, some researchers have applied VR technology to the field of psychotherapy, and have achieved good results. ^[1]

Exposure therapy is a treatment that establishes a new behavioral model by exposing patients to prolonged exposure to the stimuli that cause their symptoms, allowing the patient to adapt to eliminate symptoms, and changing the perception and understanding of stimuli. This method is based on Foa and Kozak's emotional processing theory. Traditional exposure therapy is divided into real-world exposure and imaginary exposure, but both real-world exposure and imaginary exposure have certain limitations. Real-world exposure is often difficult to implement and has certain risks. Especially in the treatment of patients with fear of heights, if they are exposed to the actual scene, they are more likely to be at risk, and the same is true for the treatment of animal phobias. Imaginary exposure often requires patients to have good imagination Poor individuals can affect the effectiveness of treatment because they cannot achieve a good infiltration effect. ^[1]

In order to be able to present a more complete exposure scene in exposure therapy, virtual reality is often required to present a specific stress scene, which has led to the combination of virtual reality technology and exposure therapy, that is, virtual reality exposure therapy. ^[1]

Virtual reality exposure therapy has many advantages over real exposure and imaging techniques in enhancing and speeding up the treatment process.

Compared with real exposure

(1) Virtual reality exposure can be completely controlled: the quality, frequency and intensity of exposure can be performed entirely by the therapist in the office, and can be stopped at any time when the patient cannot bear it.

(2) Patients can repeatedly expose specific fear stimuli. In the typical case of Wiederhold, a patient was only afraid of the plane landing process. With virtual reality exposure therapy, patients can practice multiple landings in an hour without wasting time traveling by air. In addition, the therapist can monitor the patient's response (both psychological and physical response) with different instruments while exposing and observe whether the patient's symptoms have decreased.

Compared to imagined exposure

Virtual reality exposure therapy has a high degree of immersion, which can present patients with more realistic stimuli, because it has the ability to stimulate different sensory channels, such as vision, hearing, and touch, so as to help patients feel immersed in reality. In. Through virtual exposure, the therapist can see what the patient sees and can accurately identify the stimuli that cause the patient's anxiety.

In short, the flexibility of virtual reality allows therapists to tailor specific treatment systems to meet the needs of different patients. Its advantages can be summarized as: interactivity, flexibility, controllability, confidentiality, security, time saving, cost savings and repeatability. ^[1]

First, compared to traditional exposure therapies, virtual reality exposure therapy is relatively expensive due to its addition to a virtual reality system. Virtual reality systems need to use a large number of 3D rendering technologies, so the requirements for hardware facilities are higher, which brings higher experimental costs. In addition, a lot of manpower and material resources need to be invested in the maintenance of the equipment.

Second, the development of virtual scenes is difficult. Virtual reality exposure therapy is often based on the presentation of virtual reality scenes. Therefore, it is necessary to have a certain degree of fidelity in virtual reality scenes, which will place high technical requirements on developers. ^[1]

Application of virtual reality exposure therapy in psychotherapy

Virtual reality exposure therapy phobia

Virtual reality exposure therapy focuses more on the treatment of special phobias, such as spider phobia, phobia, and flying phobia.

Spider phobia

Watching a virtual spider through a virtual helmet display can effectively treat spider phobia. Augmented virtual reality exposure therapy also includes the possibility of touching the real thing (wool fabrics can provide a spider-like feel). There have been many cases of using virtual reality therapy to treat spider phobia, including one experimental study on the control of spider phobia. In the study, 28 adults with spider phobia were treated with virtual reality exposure therapy and evaluated. The course of treatment included standardized questionnaire measurements, emotional stroop tests, behavioral avoidance tests, and measuring the frequency of heartbeats when participants saw living hairy poisonous spiders. Each test result shows that virtual reality exposure therapy has a good effect on the treatment of spider phobia.

2. fear of heights

Phobia of heights is one of the earliest mental illnesses treated with virtual reality exposure therapy. There have been many cases of using virtual reality exposure therapy to treat height-phobia in foreign countries, most of which are case studies, and some of them are studied by randomized and controlled group experiments. In one study, Coelho et al. Used a case study approach to treat 10 patients with height-phobia by presenting three virtual exposure scenarios. A return visit one year later found that their avoidance behavior, height fear, and attitude were all Significant improvement. In another study, Emmelkamp et al. Used randomized controlled intergroup experiments to treat 33 subjects with virtual reality exposure therapy and imaging exposure therapy, and finally concluded that virtual reality exposure therapy and imaging exposure therapy are decreasing. Anxiety and avoidance have the same effect.

Virtual reality exposure therapy anxiety disorder

Patients with anxiety usually experience more intense levels of fear and worry. Studies have shown that one of the most effective ways to treat anxiety disorders is exposure therapy. In the past few years, researchers in the clinical and related research fields have begun to use virtual reality to formulate specific virtual situations and expose patients to them, thereby triggering their anxiety and achieving the purpose of treating anxiety disorders.

Social anxiety disorder

In a study using virtual reality exposure therapy to treat social anxiety disorders, the participants were 36 men with an average age of 26 years. Participants were asked to enter the immersive virtual reality environment-a party of 5 virtual characters, 4 of whom sat far away from the subject and they talked to each other, and another single female sat compared to the subject. Close to the participant, introduce herself and start a conversation with the participant. The process of conversation is from shallow to deep. The experiment included a social anxiety questionnaire before and after the test. During the experiment, there were records of physiological indicators such as skin conductance and heart rate. The final conclusion is that: through a short period of virtual reality interaction, that is, virtual reality exposure therapy, the anxiety level of participants with social anxiety can be greatly relieved.

Test anxiety disorder

In a study of virtual reality exposure therapy for test anxiety disorder, 21 students participated in the experiment, of which 11 students had high test anxiety and 10 students had low test anxiety. The virtual situation is presented according to the time of the test preparationthe examinee's home, subway, and test location. The results showed that the students in the high test anxiety group showed higher levels of anxiety. When exposed to the virtual reality environment, the students in the high test anxiety group showed more depression than those in the low test anxiety group. This result indicates that the virtual reality situation can stimulate the emotional response of students with anxiety in the high exam, but it has not confirmed that the virtual reality exposure therapy has a therapeutic effect on the students with anxiety in the high exam. ^[1]