07 Jan The Efficacy of Virtual Reality as a Mental Health Tool
Technological advancement in this digital age creates an ever-changing landscape for mental healthcare. There has never been a greater need for psychologists to have new and innovative means to reach people struggling with increased psychological distress. The COVID-19 pandemic has had a significant impact on the mental wellness of Americans, with the CDC reporting that during the pandemic, 40% of US adults reported depression, anxiety, or concerns with substance use. Traditional efforts may not be the most efficacious for all individuals seeking help to manage the emotional impact of the pandemic, opening the door for visionary, technological-based treatment options.
Virtual reality (VR) is a potentially potent treatment modality for treating mental health symptoms. Initial research into the use of VR technology identifies outcomes supporting the efficacy of VR in treating PTSD, depression, and anxiety disorders such as obsessive compulsive disorder (OCD), social anxiety, and panic disorders. Exploration of the opportunities associated with this treatment modality is essential for clinicians looking to adopt this technology to improve mental health outcomes for their patients. Considerations of the benefits of VR in clinical settings are explored, including features of VRET supporting positive outcomes in treatment and potential ethical implications.
Ecological Validity
Recent VR content is primarily designed to aid in exposure therapy for anxiety disorders, and there is promising evidence of the efficacy of VR for Exposure Therapy (VRET). VRET offers compelling outcomes in treating phobias, panic disorder, and PTSD, transporting clients into an immersive and interactive virtual environment that the clinician controls. In traditional Exposure Therapy, creating a safe, controlled environment for exposure to anxiety-inducing stimuli can be difficult and time-consuming. Individuals seeking help, for example, for trauma-related symptoms stemming from a severe car accident or phobia of flying, would be able to only engage in imagery exposure exercises in a traditional therapy session. This experience for the patient, while effective, can be limited as the practitioner has no ability to control the patient’s imagination. VRET would allow the clinician to offer an experience that would mirror the anxiety stimuli and control the intensity of such stimuli.
VRET experiences result in greater ecological validity; the clinician can create increasingly complex and believable scenarios. Take, for example, a fear of flying. In a traditional office setting, the clinical is limited to only imagery, posing barriers that prevent people with phobias from receiving the most effective and highest quality of care. In VRET, the clinician can create a virtual experience of taking a flight and hone in on the most significant aspects of the phobia. VR experiences can look, feel, and sound very real, promoting more significant and faster symptom improvements with lower relapse rates than non-exposure alternatives. A meta-analysis conducted in 2018 of thirty (30) studies on the efficacy of VRET for anxiety-related disorders reduced symptom severity and was a powerful medium for exposure therapy.
Controlled Environmental Elements
Psychologists and mental health professionals aim to do no harm to their patients, a delicate balance when conducting exposure therapy. The use of VR technology as a mental health tool allows for the interventions to be more consistent and progressive, which is more acceptable than reconstructing a real environment for patients who have been through trauma. The clinician has the ability as well to repeat the same stimuli, promoting desensitization to the trigger. Furthermore, there is an ability to have more direct control over the degree of exposure. For example, when treating a fear of flying, the scenario can include or exclude turbulence. The ability to control the experience of the patient gives the practitioner greater control to prevent re-traumatization through cautious assessment of response to the details presented. This promotes improved outcomes through more individualized care and enhanced engagement with the patient. When the intervention can be customized to meet their needs, this offers opportunity for the patient to communicate more openly when they know there can be immediate adjustment to the intervention.
Ethical Implications
The use of VR technologies is still new to the field of psychology, thus the ethical implications of VR as a mental health tool. Continued empirical research is still required to understand the effectiveness of this modality of treatment to support patients in overcoming significant mental health symptoms. The method of delivering these services is also a matter of ethical consideration. At this time, the use of VR technologies operated by a trained clinical provider is the preferred mode of service delivery, however with the continuing advancement of telehealth services may further revolutionize virtual reality in mental health care.