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The Use of Virtual Reality in Clinical Psychology. Jo Hunt Cara Heneghan Jemma Hogwood Kelly Harris. Virtual reality used in…. Phobias PTSD Male sexual dysfunction Schizophrenia Addictions Autistic Spectrum Disorder Eating disorders Obesity. Why is it used?.
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The Use of Virtual Reality in Clinical Psychology Jo Hunt Cara Heneghan Jemma Hogwood Kelly Harris
Virtual reality used in… • Phobias • PTSD • Male sexual dysfunction • Schizophrenia • Addictions • Autistic Spectrum Disorder • Eating disorders • Obesity
Why is it used? • Active participation with 3D world • Learn to manipulate problems • High level of control • Safer, less embarrassing • Administered in traditional setting • Potential for visualisation • Active learning – encourages motivation • Objectively measure behaviour • Individualise treatment Riva 2005; Mantovani et al 2003; Weiss & Katz 2004
The Controversy Can therapeutic experiences in the virtual environment be successfully transferred to real life situations?
Treatments for obesity • Exercise and dieting • Pharmacological drugs • Surgery • Cognitive Behavioural Therapy • Self help groups • Telephone therapy • Internet & e-mail • Virtual Reality Riva 2005; Sutton 2005
The Case Study Riva et al 2001 • Experimental: 7 sessions of VR Treatment including low-calorie diet & exercise • Control: No VR sessions Same diet & exercise programme & psycho-nutritional group. • VREDIM (VR for Eating Disorders modification) • VEBIM (Virtual Environment for Body image modification)
Methodology • Psychometric Tests & Assessments • FRS (Figure Rating Scale)Thompson & Altabe (1991) • CDRS (Contour Drawing Rating Scale) Thompson & Gray (1995) • Also combines therapeutic methods: Socratic, Miracle Question, Cognitive and Behavioural approaches. • Head Mounted Display system • Joystick
The Zones • Zone 1: Stimuli that elicits abnormal eating behaviours • Miracle Question: Imagine life without the complaint. • Other Zones: To assess & modify symptoms of anxiety related to food exposure: Intergrating CBT methods (including Countering and Label Shifting). • Throughout all sessions the therapist uses the Socratic Style.
Results • Experimental: Reduced body dissatisfaction Reduced level of anxiety Increased self-efficacy Reduced over-eating Weight loss (mean 11.33kg) • Control: Increased exercise Improved ability and anxiety scores Weight loss (mean 7.58kg)
Advantages • Integration of different methods. • VR enhanced traditional methods due to increased presence. • Impacted aspects of body image disturbance not usually addressed by CBT: - self-efficacy - body experience disturbances
Body Image • Self-efficacy: - Increased control and motivation to change. • Body Experience Disturbances: - New experience and awareness of body. - Modified attitude to body due to differentiation between assumption and perception.
Criticisms of Study • The study only provides preliminary results • The social aspect of obesity? (The Psychologist, April 2005) • High cost, low access
The Controversy • Can the experiences of the virtual environment be transferred to the real world? Results suggest in this case… Yes! BUT… some issues to consider • Lack of qualitative evaluations from the client perspective • Role of motivation • Role of the therapist • Clear clinical guidelines needed
Conclusion • Not suggesting isolated use of VR • Integration of traditional psychological therapies into the VE * Cognitive * Behavioural * Psychodynamic * Experiential (Riva 2003) • Different aspects of problem are made accessible
References • Mantovani, F., and Castelnuovo, G., (2003). Sense of presence in virtual training: enhancing skills acquisition and transfer of knowledge through learning experience in virtual environments. In: Riva, G., Davide, F., and Ijsselsteijn, W.A., eds., Being there: concepts, effects and measurement of user presence in synthetic environments. Amsterdam: IOS Press. • Riva, G., (2005). Virtual reality in the treatment of eating disorders and obesity. IT and Communications. www.cybertherapy.info • Riva, G., (2003). Virtual Environments in Clinical Psychology. Psychotherapy: theory/research/practice/training, Vol 40(1/2), pp.1-9. • Riva, G., Bacchetta, M., Baruffi, M. and Molinari, E., (2001). Virtual Reality-based multidimensional therapy for the treatment of body image disturbances in obesity: a controlled study. CyberPsychology and Behaviour, Vol 4(4), pp.511-526. • Sutton, J., ed., (2005). A Big Issue (Special Feature). Psychologist, 18(4), pp.215-226. • Weiss, P.L. and Katz, N. (2004). The potential of virtual reality for rehabilitation. Journal of rehabilitation research and development, 41(5).