Woman wearing a virtual reality headset

VR could be an “efficacious tool” in psychiatric treatment, review says

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Virtual reality (VR) technology could be an effective basis for treatment for phobias, PTSD, anxiety and a range of other mental health conditions, according to a research review published in the latest issue of the Harvard Review of Psychiatry.

The first paper to discuss using VR to treat a psychiatric condition was published in 1995. Since then, as virtual worlds have become more immersive and the cost of headsets has fallen, VR is now in a position to enter psychiatry as a potential therapeutic tool.

The review considered the current state of research on VR technology in psychiatric treatment for various disorders, and found that while more research would be desirable, VR showed potential to help patients struggling with mental health conditions.

“Virtual reality is potentially a powerful tool for the psychiatric community,” said Dr Jessica Maples-Keller, clinical psychologist at the University of Georgia and lead author.

“It allows providers to create computer-generated environments in a controlled setting, which can be used to create a sense of presence and immersion in the feared environments for individuals suffering from anxiety disorders.”

A lot of research has focused on exposure-based therapies for certain types of anxiety disorders, such as social anxiety, fear of flying, or fear of open spaces. By exposing patients to increasingly realistic situations which provoke a small fear response, patients are encouraged to build resilience to the object or situation that they fear.

A considerable number of studies, the authors report, have also looked into the use of VR to help patients with post-traumatic stress disorder (PTSD) confront traumatic memories. For instance, a therapist working with a veteran could recreate the experience of being in combat, while a therapist working with a car crash victim could recreate a safe simulation of a road accident.

Patients suffering from these disorders have reported reductions their anxiety after VR-based therapy and in some cases, found VR more helpful than traditional approaches to therapy.

“VR is potentially a powerful tool for the psychiatric community because the user experience can be consistently replicated, tested, and modified within a safe environment,” the researchers write.

Studies have also looked into the use of VR to treat patients with panic disorders, obsessive-compulsive disorder, schizophrenia, acute and chronic pain, autism spectrum disorder, addictions and eating disorders. While VR has proved a promising therapeutic aid many of these studies are preliminary, featuring small patient numbers and low methodological rigor.

The authors suggest that it would be beneficial to carry out better-powered and controlled studies comparing VR treatments to traditional treatment approaches.

“It will be important that these are treated as tools and therapists are properly trained in their applications,” they write, emphasising that the introduction of VR to mental healthcare would require therapists to undergo specialised training.

“Overall, meta-analyses have indicated that VR is an efficacious tool, compares favourably to existing treatments, and has lasting effects that generalize to the real world,” they conclude.

The review appears in a themed issue of the Harvard Review of Psychiatry focused on emerging technology and telehealth in psychiatry. The issue highlights the application of other emerging technologies in healthcare, such as internet-based approaches to cognitive behavioural therapy for depression and technology-based interventions for substance abuse.

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