Proof of Concept of an Eclectic, Integrative Therapeutic Approach to Mental Health and Well-Being Through Virtual Reality Technology.

Paul Frewen,Talia Kielt,Rakesh Jetly,Divya Mistry,Christine Wekerle,Ruth A Lanius,Jenney Zhu

doi:10.3389/fpsyg.2020.00858

Abstract

Across three studies, we provide a proof-of-concept evaluation of an integrative psychotherapeutic application of virtual reality (VR) technology. Study 1 (n = 36) evaluated an unguided “safe-place” imagery task, where participants were instructed “to create a safe space… [such as] a scene, item, design, or any visual representation that makes you feel safe” using either the Google Tilt Brush application (VR condition), the standard Microsoft Paint application (2-D condition), or via eyes-closed mental imagery alone (IMG condition). Study 2 (n = 48) evaluated a narrative episodic recall task, where participants viewed their childhood and adult homes and places of schooling either using either the Google Earth VR application (VR condition) or the standard Google Earth application (2-D condition) or recalled these places with their eyes closed via mental imagery alone (IMG condition). Finally, Study 3 (n = 48) evaluated a guided wilderness imagery task, during which different scripts were narrated, specifically, a trail walk in autumn, a spring meadow, and a hillside walk in snowy winter, while either these same scenes were visually presented using the Nature Treks VR application (VR condition), the scenes were presented using the same software but shown on standard computer monitor (2-D condition), or participants’ eyes were closed (IMG condition). Order of intervention format was randomized across participants. Across all three studies, quantitative survey ratings showed that the VR format of intervention delivery produced greater positive affect and satisfaction and perceived credibility ratings as an intervention for trauma- and stressor-related disorders and psychological well-being as rated by university students who varied in traumatic and stressful life event history and symptoms of posttraumatic stress disorder, whereas qualitative findings revealed additional themes of experiential response including increased experience of presence and vividness in the VR condition. Future research directions and clinical applications are discussed.

Highlights

Paul Frewen1*, Divya Mistry1, Jenney Zhu1, Talia Kielt1, Christine Wekerle2, Ruth A
We conclude that the safe place exercise produced the greatest perceived satisfaction and credibility as an intervention for trauma- and stressor-related disorders and mental health and well-being more generally when completed within the immersive format of virtual reality (VR) as compared to standard laptop screen (2-D) format or using visual imagery alone, whereas visual imagery was preferred over the 2-D format in certain respects
The practice of Virtual Reality Integrative Therapy (VRIT) can be understood as involving the selection of different VR interventions to suit the presenting problems of different clients partly based on client preference

Summary

Introduction

Paul Frewen1*, Divya Mistry, Jenney Zhu, Talia Kielt, Christine Wekerle, Ruth A. One can conclude from these results that VRET is more effective than no treatment, but not more effective than non-VR exposure therapy These results agree with an earlier systematic review suggesting significantly better PTSD outcomes for VRET when compared to inactive (waitlist) control, but only equivalent efficacy in comparison with active controls (e.g., traditional imaginal and in vivo exposure therapy) (Gonçalves et al, 2012). Such results are broadly consistent with findings observed for VRET for other anxiety disorders (e.g., Opris et al, 2012)

Methods

Results

Conclusion