Abstract
Abstract The application of virtual reality (VR) as a supportive tool in psychotherapy has gained great popularity in recent years. Especially for addiction therapy, a combination of virtual exposure and learning or training coping skills by using biofeedback has a high potential to improve conventional therapy. To add value, the new therapy system has to meet the needs of patients and practitioners likewise. Added values consistently named by experts included, but were not limited to, new possibilities of creating individual exposition or coping scenarios, enhanced psychoeducation, a shorter duration of treatment, telemedical aspects, the possibility of measuring and predicting craving and finally an improvement in abstinence. Besides literature research, we evaluated existing technical solutions in the field of virtual addiction treatment, surveyed experts and evolved a concept that led to a first prototype. The prototype consists of a wireless VR headset and a wireless multi-sensor system for measuring the physiological reaction to stimuli or the effectiveness of coping strategies by means of biofeedback. For further studies we developed both, a virtual exposure and a coping scenario and tested the hardware and software in a pilot study in order to elaborate factors that could negatively affect the therapy adherence, the effectiveness of exposition (immersion) and possible hurdles in practical use. Cybersickness and the lack of haptic feedback turned out to be the main limiting factors. Concepts for the next iteration of the therapy system will reflect these points for upcoming clinical studies. In our proof of concept, we demonstrated that virtual therapy can be implemented with a reasonable effort of time and costs. The combination of software and hardware, that supplements the traditional therapeutic approach, lays the foundation for upcoming clinical use and trials to prove the better outcome of VR enhanced addiction therapy.
Highlights
The application of virtual reality (VR) as a supportive tool in psychotherapy has gained great popularity in recent years
Other addiction related practitioners, therapists, support group instructors and patients were asked about their experiences, preferences and how so-called “serious games” with digital tools like VR could provide added value in the context of exposition therapy
The expert input was a major influence on the design and development of a first VR addiction therapy prototype
Summary
Since the beginning of the COVID-19 pandemic, German psychotherapists report a 40% increase in requests and more than one third of patients has to wait longer than six months to get a treatment appointment [1]. Important parts are the promotion of a disease understanding, to develop an awareness for situations, that typically led to the consumption of the substance and to train the patient how to deal with the urge (craving) for the substance. Those common modules are an important part of psychoeducation. To answer whether VR therapy provides a benefit compared to conventional approaches, clinical studies and as a matter of fact, functional prototypes are needed For this very new approach, there is not much information on which requirements such a combined system needs to meet.
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