Virtualware has been collaborating or the past two years with researchers at the King’s College London, Institute of Psychiatry, Psychology and Neuroscience who have been studying the use of Virtual Reality to research, assess and treat people with mental health problems. This collaboration began based upon Virtualware’s experience in the development of VR applications for the treatment of mental health conditions, specifically phobias, through its pioneering VR product VirtualRET.
Dr Lucia Valmaggia, whose work with VR for psychosis has been internationally recognized including in a documentary, and Dr Mar Rus-Calafell, another early adapter of using VR as a diagnostic and treatment tool in projects in her native Spain, headed up the first VR project that Virtualware helped developing 2015. The resulting VR application was used to investigate the psychological mechanisms associated with increased paranoid ideation in social situations.
The new VR environment enables participants to experience several social interactions during a Party in a Pub. This allows the real-time assessment of thoughts, feelings and behaviours which people experience during the virtual party.
The first stage of testing the new VR environment has been completed. The results show that it is well accepted, safe to use and that it can trigger the thoughts, feelings and behaviours associated with paranoia in real-life situations. In the next phase, they will test if the new VR Party can help people who experience paranoia and distress in social situations.
Both Dr Valmaggia and Dr Rus-Calafell are supervising another VR application being developed by Virtualware at King’s, this time directed at young teenagers. We spoke to both to get their views on the use of Virtual Reality in the field of mental health and to learn more about the VR projects they’ve worked on with Virtualware.
Could you both give us a brief introduction to your backgrounds?
We are both clinical psychologists. We work as clinical academics which enables us to combine clinical practice with research and teaching.
How did each of you first come upon using Virtual Reality for treating mental health disorders?
Lucia: Around 2001 I heard Professor Daniel Freeman talking about the work he was doing with Professor Mel Slater to investigate paranoia using VR.
Mar: Back in 2009, I started working with a prestigious Spanish team, led by Professor Cristina Botella, Professor Rosa Banos, Professor Miquel Tortella-Feliu and Professor Jose Gutierrez-Maldonado, who are pioneers in the application of VR for treatment of anxiety disorders. Following their guidance, I designed a VR based application to improve social functioning in people with psychosis which was part of my PhD in the University of Barcelona.
Could you please explain the initial VR project which Virtualware collaborated with both of you and its outcomes?
The first project we did with Virtualware is the VR Party in a Pub describe above. We are very satisfied with the result of our collaboration and it has been a real pleasure to work with Virtualware. It has been easy to communicate to the team what we needed and we felt they also understood the rationale of the project.
Could you also discuss the current project you are supervising in collaboration with Dr Charlotte Gayer-Anderson & Professor Craig Morgan?
Charlotte is researching how life experiences in childhood can impact on the mental health of young people. Together we have developed a VR school canteen. We are interested in researching if young people exposed to different life events experience different thoughts, emotions and behaviours in the same environment. For example, if you have been bullied you may experience more anxiety in a school canteen than someone who has not been bullied.
What do you feel Virtual Reality offers to Neuropsychology that other technologies don’t?
VR enables us to reproduce real-time situations in a lab. It enables us to assess real-time reactions to social situations and gives us the possibility to manipulate the social situation. E.g. you could change the number of people in a VR environment, or the background sounds.
How do your patients react to using VR?
Most service users are enthusiastic about using this new technology to overcome some of their problems. Several studies have demonstrated that it is a safe technology to use with people with severe mental health problems and that it does not exacerbate any symptoms or causes any adverse event related to the technology. Unfortunately, some people still experience cyber sickness when using the VR headsets but this is less of an issue with the newest headsets like the Oculus.
Is there a difference in using new technologies like VR for diagnosis rather than treatment, or can VR be used effectively for both?
VR can be used for both but, the content of the virtual environments can be different. Also, we should point out that VR is not a standalone intervention but is embedded within a course of therapy and that a therapist is always present during the assessment and the treatment.
Are there certain mental health conditions/pathologies that you feel would see more benefit from the use of VR in early detection and perhaps treatment?
Research to date shows that VR assisted therapy can be used with all mental health issues. We have recently published a review in the journal Psychiatry Research in which we analysed the effectiveness of VR based interventions for mental health problems and its promising possibilities for future developments (Valmaggia, Latif, Kempton, & Rus-Calafell, 2016).
Where do you think we are heading in terms of using immersive technologies like Virtual Reality and Augmented Reality, as well as other technologies, to diagnose and help treat mental health disorders? Do you envisage a time when mental healthcare professionals will be using high-tech solutions like VR daily to treat patients?
We think VR and AR will become embedded in the research assessment and treatment of mental health problems as well as being used in prevention strategies. However, it is early days and more research is needed to develop an evidence-base for these interventions.