Can virtual reality improve mental health? | Crain's

Can virtual reality improve mental health?

Virtual reality is no longer just a gimmick from sci-fi TV shows. Thanks to recent advancements in technology, everyday smartphones can be used in affordable mainstream VR headsets like the Samsung Gear VR and Google Daydream View.

While the technology has a major stake in the recreational market, many entrepreneurs are thinking outside the box and expanding VR into all aspects of our lives—even mental health. Everyone from certified clinicians to amateur app developers has begun to recognize its usefulness in mental health treatments.

Breaking the stigma on casual meditation

Josh Farkas of Cubicle Ninja developed Guided Meditation VR three years ago when the latest wave of VR was taking off.

“I’ve been meditating for over 10 years now and found it to be a really integral part of my personal growth. The challenge is trying to spread the word to other people,” Farkas said.

He believed that marrying meditation with VR would make the practice an accessible one, and one that people would be more likely to try if they could easily download the program and experience it from home.

“It was really perfect for virtual reality, as it takes you out of your traditional every day and places you in this new, neutral spot where you can refocus and recenter and then head back into your life,” Farkas said.

Taking the user experience to the next level, Guided Meditation even integrates biometrics. On the Samsung Gear, users can scan their fingers on the device before and after meditating to see how their heart rate changes.

The company reports that it has captured 2.5 million heartbeats in the last 10 months, which the team is now studying to better understand VR in general and meditation efficacy.

Researchers at Masaryk University, in the Czech Republic, recently studied the physiological and psychological impacts of relaxation exercises in virtual reality. 

The study's authors wrote that such exercises were "significantly effective in increasing the comfort and reduction of impulsivity, restlessness, anxiety and blood pressure" among the 40 participants.

Supporting trauma victims with gradual exposure 

It’s not just casual meditation that’s making waves in VR. Clinical psychologist Dr. Skip Rizzo of the University of Southern California Institute for Creative Technologies (USC ICT) has been working with virtual reality to treat mental illness since the mid-1990s.

Rizzo connected with USC scientists and programmers to study post-traumatic stress disorder after the war with Iraq began in 2003.

“I saw a game called Full Spectrum Warrior that USC ICT had a hand in developing. It’s an Xbox game, but it also has Army endorsement as a training tool. And when I saw the promo for it, I thought it looked just like Iraq. So I went to ICT and I asked them if there was any chance we could get access to some VR assets [to] build a mockup of VR exposure therapy approach for PTSD for people in Iraq and Afghanistan,” Rizzo said.

According to the National Center for PTSD, 7.8 percent of all Americans suffer from PTSD at some point in their lives. Estimates of diagnosed veterans range from 8 to 18 percent.

The Center also identifies some form of prolonged exposure therapy as one of the most common ways physicians and psychologists recommend treating PTSD. Traditionally the patient is encouraged to reimagine and describe their extreme memories of combat. The more aggressively they face their fears, the less afraid of them they become.

But it’s not an easy task.

“Many patients are unwilling or unable to effectively visualize the traumatic event, and this may result in treatment failure. In fact, avoidance of reminders of the trauma is inherent in PTSD and is one of the cardinal symptoms of the disorder,” Rizzo wrote in “Virtual Reality Applications for the Assessment and Treatment of PTSD.”

That's where virtual reality comes in.

Rizzo's team developed several different combat scenarios in their Bravemind program, and use it to place veterans directly into Iraq or Afghanistan.

An early clinical trial of the software found that "after an average of seven sessions, 45 percent of those treated no longer screened positive for PTSD and 62 percent had reliably improved," Rizzo wrote in "Virtual Reality."

“We know that VR can effectively deliver exposure therapy [and] provide distraction from painful medical procedures. We know that VR can make physical rehabilitation exercises that are very boring, repetitive and frustrating [better],” Rizzo said.

Bravemind now boasts 14 distinct worlds, is used by more than 70 mental health facilities across the country and is in the process of spreading around the globe. The Canadian military recently adopted the technology and it may soon be in Norway and Denmark, according to Rizzo.

It’s not commercially available—it must be run by a trained clinician who has experience with PTSD exposure therapy and computer VR operation. But virtual reality is gaining enough popularity and media exposure that Rizzo believes that its future with mental health treatment will be long and bright.

“When these headsets become like a toaster, where every home [has one], and people are well familiar with the idea of VR and immersion and interactivity in these scenarios, they’ll come to expect or maybe want their kids to have some VR component in their education,” Rizzo said.

Bringing therapy home with you

Dr. Brenda Wiederhold, a longtime colleague of Rizzo's and fellow pioneer of VR-driven mental heath treatment, may be well on her way to making that happen. She also worked with VR exposure therapy for wartime PTSD cases at the Virtual Reality Medical Center, but got her start with even more common phobias--flying, driving, public speaking, heights, etc.

"I was already using regular exposure therapy--having the person sit and imagine what they were afraid of or actually taking them into a real world setting--prior to getting into VR. So it was an intuitive, natural fit for me," Wiederhold said.

Similar to Rizzo, her patients are submerged in their fears during controlled sessions. But through her private practices in San Diego and small clinics overseas in Belgium and China, she's taking the software's accessibility to the next level.

"If you have a specific phobia, I do part of the treatment in session with you and then I’m going to send an app that we’ve developed home with you on a mobile phone with a Samsung Gear VR or Google Cardboard so that you can do some of the treatments in between sessions at home on your own. And what that does is cut down on the number of sessions people need," Wiederhold said.

She's been utilizing these apps for more than two years, as soon as the mainstream VR headsets became available. Some of the apps can even link to fitness watches to track heart rates during at-home therapy.

Wiederhold is hopeful that younger generations will take to the technology more readily than her own has.    

"Right now, one of the problems is that no matter if you use virtual reality or if you use traditional talk therapy--two chairs in an office--you’re going to get reimbursed the same exact thing from insurance. So a lot of people don’t want to go back for the extra training, they don’t want to go to the extra expense of buying the equipment even though a lot of the studies have shown that it works better, more efficiently and more effectively," she said.

But her strides in making this form of therapy more accessible are well on their way to erasing the stigma that surrounds mental health, whether that be with casual meditation or aggressive treatment of PTSD.

And Rizzo got right to the point.

“Mental health is no less important than physical health.”

June 27, 2017 - 5:54pm