Mental health treatment probably isn’t the first use case you imagine when thinking about practical applications of VR. You don’t need to have a degree from an online masters program in counseling psychology to know that excessive use of video games and social media has been proven to promote negative mental health outcomes.
But what if there was another side to the coin? What if not all video games were bad — what if they could actually help Improvement What about mental health outcomes? Turns out, this is true – recent studies suggest that virtual reality treatments may be just as effective as current preferred treatments for people with major depressive disorder.
Psychiatric conditions
Of particular note is a study that compared the use of traditional behavioral activation therapy (BA), a standard front-line treatment, to behavioral activation therapy administered using the Meta Quest 2 VR headset (XR-BA) for treating symptoms of major depressive disorder. Behavioral activation therapy for depression involves monitoring the individual’s daily activities and identifying how they play a role in the “vicious cycle” aspect of depression. This typically involves scheduling enjoyable and meaningful activities to help break free from negative emotional and cognitive cycles, and active problem-solving to avoid or overcome potential barriers to engaging in those positive activities.
The alternative XR-BA involved replacing users' typically preferred activities with unstructured use of the Meta Quest 2 headset, mostly involving games such as Beat Saber and video experiences such as YouTube 360. Participants in the study demonstrated similar improvements using XR-BA compared to traditional BA. XR-BA participants also reported that the novelty of the experiences available to them encouraged them to continue treatment, and some participants showed improvement even before starting treatment; researchers believe this was due to excitement at the prospect of using a new technology.
This shows real promise for the potential of virtual reality tools that could equal or perhaps even exceed the efficacy of equivalent first-line treatments for major depressive disorder. It also suggests that VR could provide relief for people who are unable to access the activities they normally engage in for their BA treatment as a result of injury, illness, physical displacement or other circumstances.
Virtual reality has shown promising results in other treatment modalities as well. Recent studies have demonstrated VR’s potential to help with conditions that require exposure-based treatment. Panic disorder and agoraphobia have shown particularly promising results, with several studies finding that patients may benefit from using VR therapy to receive initial exposure to threatening stimuli in a controlled environment, helping them to become more accustomed to the presence of these perceived threats in a low-risk environment, before moving on to more direct exposure.
These treatments showed equally effective long-term results compared to the most common treatment, cognitive behavioral therapy (CBT). In fact, in most cases, patients and their doctors managed to achieve results faster or in fewer sessions than equivalent traditional CBT treatment regimes. Patients also reported better experiences with VR-based therapy for these conditions compared to CBT. These results indicate that VR-based treatments have serious potential for treating these conditions.
And it's not just VR – other virtual therapies are also promising. Even traditional video games, if properly designed, can help patients suffering from conditions such as anxiety disorders. The Mindlight game, designed to boost attention and help manage stress in the workplace, has shown results comparable to CBT, the gold standard for treating anxiety disorders. While patients reported that the skills learned in Mindlight felt less relevant to their everyday experience than CBT, the reported reduction in anxiety symptoms was comparable.
Behavioral and developmental conditions
VR has also been used in trials to help treat eating disorders. Virtual environments are used to help patients “explore and challenge body image distortions”, and to help them explore other stimuli related to body dysmorphia. These studies have shown that patients' ability to accurately identify their body shape and make more realistic assessments of their body size improved even after the study. Patients who participated in VR therapy showed a significant decrease in body image disturbances and a greater reduction in overall symptoms compared to those who received traditional treatments. Clearly, VR has a lot of potential to help people with eating disorders.
Other conditions are promising, but more studies are needed regarding the effectiveness of VR treatments. One condition that has shown promising initial results with VR treatments is autism spectrum disorder. Studies have shown that some patients with ASD can effectively improve their social skills by practicing in simulated environments. Others have benefited from virtual practice to improve their ability for theory of mind, emotional recognition, and other basic communication skills. However, the results suggest that larger, more comprehensive studies would be beneficial and the current results are not large enough to conclusively state extreme benefits in treating ASD with virtual reality solutions.
Addiction is another such condition. Early studies have shown that virtual environments are effective in eliciting craving responses from patients, demonstrating the potential of VR for studying the effects of these cravings without exposing patients to drugs directly. Some studies focusing on nicotine addiction showed promising results, with participants who participated in VR therapy, as opposed to controls, showing a significant decrease in cigarette consumption in the weeks and months following the study. Unlike many addiction-related studies, VR-related studies of addiction patients repeatedly demonstrated high rates of participation, indicating that at the very least, patients are more likely to participate in VR-based therapy as opposed to other, more traditional treatments.
Clearly, virtual reality and other virtual experiences have a place in modern treatment paradigms. Benefits have been demonstrated in a wide range of conditions, from mental conditions such as depression and anxiety to behavioral conditions such as addiction and eating disorders. Certainly the coming years and decades will bring improvements in both delivery mechanisms and hardware, as well as refined and more targeted treatment modalities for this promising treatment paradigm. With so many promising results, and these technologies just beginning to reach maturity and widespread adoption, surely the future will bring hope for even more effective treatments and the patients who can benefit from them.
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