How Long Before We See Virtual Reality Headsets in Our Mental Health Wards?
There's more to virtual reality than having a new way to watch porn or make gaming more intense.
Virtual reality, we're constantly told, will revolutionise how we go about our daily lives, ski-goggle headsets permanently strapped onto our faces. Soon, immersive 360-degree games and films will be nothing but unremarkable. And as that smug conference photo from February suggested, Mark Zuckerberg will presumably wield full control over our most insignificant thoughts and feelings.
But maybe I should take back my snark, because portable headsets may have the potential to help treat certain mental illnesses. At this stage, in the UK at least, we don't know fully how effective "virtual reality therapy" really is, but we may not be far off from seeing it in NHS clinics around the country.
Let's go back for a bit. Therapists have been using VR therapy to treat arachnophobia, fear of flying and fear of public speaking and post-traumatic stress disorder (PTSD), for about 20 years.
People with PTSD are "cutting themselves off from their emotions" says Professor Barbara Rothbaum, a clinical psychologist at the Emory University School of Medicine, who created a VR simulation programme to treat combat servicemen and women who'd been stationed in Iraq. "So the advantage with virtual reality therapy is that it becomes such a potent stimulus, that it's harder to avoid."
So far, therapeutic VR has mostly treated PTSD and anxiety disorders through exposure therapy – where you try to desensitise a patient by gradually re-exposing them to their fear or trauma. But recent studies have shown VR could also be applied as a therapy for people with bipolar disorder, autism spectrum disorders, eating disorders, addiction and depression.
A paper from the British Journal of Psychiatry's online publication, for example, found in February that immersive VR could encourage people suffering from depression to be simultaneously less self-critical – a crucial depressive trait – and more compassionate towards themselves. The process involved a technique known as "embodiment": a sort of body-swap where a participant's avatar would flip between representing themselves and a distressed child. The person in the scenario would comfort the child, then change to "being" the child and hearing the comforting words their original avatar had just said.
Dr Caroline Falconer, a research fellow at the University of Nottingham, was one of nine authors on the paper, where nine out of 15 participants in the UK reported a reduction in self-criticism after this eight-minute therapy. "We were basically hypothesising that in that situation the participants were giving compassion towards themselves," she says – a hunch that now looks to be correct.
Falconer and her colleagues plan to trial the therapy with more people, then personalise the avatar scenarios, with an aim to next focus on people living with personality disorders. "Given how you can shift perspectives so easily using VR," she says, "you could model some sort of interpersonal situation and allow someone with a personality disorder to embody another avatar and that may help them understand their point of view."
Dr John King, a clinical psychologist at UCL who also worked on the recent depression study, says hopes NHS clinics will soon pilot the technology. "What's really exciting for us is that, in the two or three years since we started this project, the cost of entry into this kind of technology has completely transformed," with prices for the equipment they used dropping, he says, from around £50,000 to £2,000. "We're hoping to deploy [this newer, cheaper technology] in a few local clinics."
If this trial's successful, it's still unclear where such therapies might fit into the NHS: In a GP surgery? Or a specialist mental health service? For the moment, they just don't know. "There's still a lot of work to be done within the NHS," says Falconer. "Some people there aren't comfortable with the technology – maybe because their tech or computer literacy isn't quite up to scratch – so that's something else we need to tackle." She also stresses that she sees VR more as a complement to existing therapies like cognitive behavioural therapy (CBT) than a treatment in itself. "From my perspective, this isn't about replacing. It's about trying to enhance what's already there, and also having something that's really engaging for patients."
For King, meanwhile, VR could be an extra tool that therapists use before another, more established treatment becomes available – and as waiting lists for psychotherapy continue to swell, this new shortcut could prove incredibly helpful.
So with prices of VR headsets now plummeting and big guns like the Oculus Rift and HTC Vive finally up for public consumption, might these therapies one day evolve into a mass-market method of treatment, to pick up from Superdrug, or Boots? "It is increasing interest in the area," says Falconer. "The gaming industry is really driving the tech and this is lowering costs, so it may give us the opportunity to implement this technology within in an NHS setting. Or, dare I say it, for people to implement it within a home setting."
"As well as being able to do something in the clinic, we might be able to give them something which they could take home and plug their smartphones into," adds King, referencing plug-in headsets pioneered by the likes of Google Cardboard. "It's exciting times," he says, "and we're only really just beginning."
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