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Phobias

Can VR and AR Help with Phobias?

We examine the use of augmented and virtual reality to treat something almost all of us will be affected by: phobias

In line with Mental Health Awareness Month this May, we’re doing a series of articles looking at the relationship between the technologies we cover and mental health. Today, we turn our eye to the use of augmented and virtual reality to treat something almost all of us will be affected by: phobias.

What are Phobias?

Phobias differ from simple fears in that they are excessive and debilitating. Crucially, they are also irrational. Phobias encapsulate a host of fears, experienced to various different levels. While almost all of us will be mildly fearful of something, it becomes problematic when that fear is more intense – to the point of stopping people living their daily lives. Consider someone with needle phobia who cannot visit a doctor, for instance. Phobias can develop from critical, traumatic events, but can equally just slowly build over time.

With that in mind, many people seek treatment to overcome their phobias, with a practice known as “exposure therapy” being one of the most popularly deployed. That involves a therapist attempting to help a patient overcome fears, anxieties and phobias by gradually introducing them to the object of their fears. Importantly, exposure therapy does not seek to “cure” phobias, instead equipping patients with the confidence to manage an encounter with the object of their fears.

The analogue version of such an approach involves watching videos or encountering a stimulus in the real world. Increasingly, however, VR and AR technology is being deployed instead. The genius of using AR and VR in such an approach is that patients can be exposed to a virtual representation of something that scares them while ultimately knowing that they are in a safe environment.

Just having that knowledge that what you are seeing is virtual does not, of course, eliminate the fear response (as countless videos of people screaming while falling off virtual planks can attest to). While Richie’s Plank Experience is less an exercise in curing phobias, and more an exercise in exploiting them, there are plenty of serious attempts at using VR and AR in a clinical setting.

XR Treatments

Happily, this is not some pipe dream. AR and VR are currently being used in a host of real-world medical scenarios. And medical practitioners themselves are increasingly realising the benefits of the technology. According to GlobalData’s 2021 poll on digital health in neurology, 18% of 109 industry respondents thought AR and VR solutions would be the most suitable technology to treat mental and behavioural health conditions.

In 2020 in the UK, the Norfolk and Suffolk NHS Foundation Trust (NSFT) announced it had introduced virtual reality headsets to help patients combat phobias ranging from a fear of needles, heights, flying and spiders to agoraphobia and claustrophobia, as well as more unusual fears such as exams, driving, public speaking and storms.

“We are also able to completely control the virtual environment, such as changing the weather conditions for someone who is scared of flying, which can really help to prepare them to face every possible scenario in their everyday lives,” said Nesta Reeve, consultant clinical psychologist and clinical lead for the Wellbeing service. “Ultimately, we hope that more people will come forward to ask for help with their phobias now that we have this technology, and that using VR will help them to get better more quickly so that they can enjoy activities that many of us take for granted.”

VR also has enormous utility when it comes to placing people in locations it wouldn’t be safe to in the real world. When it comes to phobias, this is perfect for addressing a fear of heights, and NHS services in Oxfordshire and Buckinghamshire in the UK are duly offering VR exposure to heights.

Virtual reality treatment to be offered to NHS patients in Buckinghamshire and Oxfordshire

Their approach even leverages a virtual therapist who appears via a computer-generated avatar, and is voiced by a real person. In a randomised clinical trial of fear of height treatments, the VR therapy was shown to be effective for a fear of heights (which affects 1 in 5 people). After spending an average of over two hours in the simulation, all participants showed a reduction in fear of heights, with the average reduction being 68%.

Retired paramedic Richard, who received the treatment, said: “I lived with a debilitating fear of heights for all of my life and had to organise my life so that I completely avoided all situations that exposed me to heights and altitude as I would experience intolerable anxiety. Since having the VR-enabled therapy I can now go to my local shopping centre and I am able to freely walk around and go to all floors and even look out over the balcony. This is something that would have been simply impossible for me to do before having this treatment.”

Help at Home

While the use of AR and VR is a potentially cheaper option for treating patients in a clinical session, particularly for patients who only need a small amount of contact with a therapist, it also means help can be accessed remotely and in the comfort of one’s own home.

This concept of self-help powers services like oVRcome, which offers a range of VR simulations and modules for phobias, anxiety and depression – for use by children, teens and adults. The company provides its own virtual reality headset by which the content is accessed, which works by inserting a smartphone to display the content.

Meanwhile, the fact that AR can be so easily accessed from the ubiquitous smartphone means it has the greatest potential for at-home use, democratising exposure therapy by significantly lowering the barrier to entry. AR also confers its own benefits compared to VR, by blending a user’s own body and real surroundings with virtual elements.

One example in the world of AR is Phobys, a smartphone app which is designed to reduce the fear of spiders. The experience was developed as part of a study which found the “intervention led to significantly lower subjective fear” over a controlled two-week trial.

Effectiveness and Benefits

Among the other benefits of AR and VR exposure therapy is its repeatability (with patients allowed infinite attempts at their own pace) as well as privacy, with patients not being forced to reveal their fears to the outside world.

Interestingly, a study of the efficacy of VR for exposure therapy found varying amounts of potential depending on the specific phobias. In comparison with real-world exposure therapy, there was found to be no major difference when using VR as compared to the real thing. As such, the study recommends that VR for exposure therapy should be disseminated further – especially considering the potential for new technologies and techniques to have an even greater benefit.

Summary

It’s clear that AR and VR technologies have enormous potential for helping people safely overcome their phobias. Even in their relatively nascent stage, they are being put to use to help people in the real world. As technology develops, and virtual worlds become ever more realistic and interactable, there’s every chance AR and VR will become the treatment of choice for phobias.

Quelle:

Can VR and AR Help with Phobias?

26. Mai 2022 0 comment

Examples

How This NHS Trust Is Using VR To Treat Phobias

Patients in the East of England can now use immersive technology to help overcome mental health conditions. Gill Hitchcock finds out more.

Virtual reality has the potential to increase access to treatment for a range of conditions. There is no shortage of research demonstrating this, covering post-traumatic stress disorder, Parkinson’s, stroke, autism and more. But this year, Norfolk and Suffolk became one of the first NHS trusts to integrate VR into its psychological care pathways.

Using off-the-shelf VR headsets and specially created virtual worlds, the trust has been offering virtual treatment to patients struggling with disabling phobias. By gradually increasing patients’ exposure to situations they would usually avoid, the trust says it is helping them to manage their feelings in a safe and controlled environment.

Previously, there were practical difficulties in coaching patients through situations which were troubling them. Nesta Reeve, a consultant clinical psychologist and lead for wellbeing services at the trust, explains: “When you follow National Institute for Health and Care Excellence guidelines for the treatment of phobias, you tend to immerse people into the specific situation in real life.

“That is difficult for a therapy service because we are office-based, we tend to see people one after another and so we don’t really have the time to go out. Also, people who were successfully treated for phobias were having a lot of sessions in Improving Access to Psychological Therapies (IAPT) services.”

Automated treatment with VR, however, offers significant solutions. It means that patients do not have to leave the clinic, nor it is necessary for a clinician to be present.

“I think this is a great opportunity to use technology to help people get greater exposure to their fears and to overcome them without having to leave the clinic,” says Reeve. “It means we can treat people more quickly, and hopefully we will get more people coming forward with fears that might seem minor, but which are stopping them from doing something important.

“Fears of MRI scans and injections are good reasons for doing the exposure. But there are also people who are blocked in their careers for fear of public speaking, sitting exams or going into lecture theatres. This can help people to move their lives on.”

The catalyst for Norfolk and Suffolk’s innovation came when the East of England clinical network for IAPT put out a challenge for clinicians to find new digital ways of working.

With financial backing of £10,000 from the network, in mid-2019 Joe Embrey, a cognitive behavioural therapist at the trust, began testing VR to treat people with a fear of needles and agoraphobia.

“The trial showed that VR is a really effective at bridging the gap between real-life exposure and what the patient feels able to do at the time they enter treatment,” says Embrey. “It has been especially useful for things like needle phobias, because the process of preparing for and giving an injection is not something which we can easily replicate in the therapy room.”

Software challenges

Buying VR headsets was easy for the trust. Finding the right software was difficult. Reeve’s search failed to identify a UK supplier, but found a VR platform for psychology and mental health from Spanish company Psious. Its product includes fears of injections, scans, social situations, darkness, animals and agoraphobia.

Norfolk and Suffolk pays Psious €1,000 per licence. Although the licence can only be used with one patient at a time, the number of patients and times it can be used is unlimited.

“I know that Psious is used by private clinicians in the US and UK, but when I was in contact with company recently, I asked them if any other NHS trust was using their VR and they said that at the moment, no, we are the first,” says Reeve.

“But they are getting involved with the NHS in Manchester and they are keen to learn from our experience because there were a few blocks to implementing this. Not least, in the NHS it is quite hard to buy something bespoke. Buying something from Spain in euros was a little challenging too.”

Research at University of Oxford’s department of psychiatry into immersive VR to treat fear of heights, found patients were willing to go into situations that troubled them and to try new ways of responding. They were willing because they knew it was a simulation. But what the patients learned through VR, was transferred to the real world.

In Norfolk and Suffolk’s experience, patients are usually more willing to try VR than face a real-life situation. They can control and even stop the experience if they wish. And the system also enables them to monitor their anxiety and to know how their anxiety has reduced over time.

The Covid-19 crisis means that all the trust’s psychology consultations are taking place via phone or video. For the time being, the VR treatment is on hold. But when clinics are cancelled, staff are encouraged to use the time available to familiarise themselves with the VR system.

“Phobias can have a real negative impact on people’s lives,” says Reeve. “Now we have this technology, we hope that more people will come forward to ask for help with their phobias, and that VR will help them to get better more quickly so that they can enjoy activities which many of us take for granted.”

Quelle:Foto: Credit: Jazna Rossi/Pixabay

https://www.vrroom.buzz/vr-news/trends/how-nhs-trust-using-vr-treat-phobias

15. März 2021 0 comment