Gaming, Virtual Reality, and PTSD
Video games, spanning from the early days of Tetris and Super Mario Brothers, to Minecraft, Grand Theft Auto and Call of Duty, have been a part of almost everyone’s attempts at unwinding after a long day, actively avoiding homework, or housework. Video games are currently spanning to more active games. These games encourage you to get up and dance-battle your friends. There are even role playing games that involve headset communication. Video games are the ultimate leisure time activity that allows us to take ourselves out of the day’s worries. It allows us to focus on something out of this world; but what if we could use gaming as a means for something beyond just enjoyment?
Video games, or “Electronic Games” have been used for psychotherapy (EGP), these games, referred to as “serious games” developed for therapeutic purposes. There are also electronic games for entertainment (EGE) which are “off the shelf” games available at retail stores to the general public. These EGE’s were at first built for leisure, but have recently been used as a therapeutic tool; both EGE’s and EGP’s have shown potential to be applied to a variety of health and mental health matters and settings.
In psychotherapy, therapists will often used electronic games as “computer-assisted cognitive behavior therapy” which includes computer delivered information and interventions for client-specific models. In some cases, a specific game is created; these games can also include video demonstrations of relaxation inductions. In a review that looked at the impact of treating anxiety and depression symptoms, comorbid to PTSD, computer-assisted cognitive therapy (cCBT) has shown to be effective overall and can be “maximized through therapeutic exposure”. This exposure through EGP games specifically positively impacts symptoms of depression, while also being cost-effective for therapists.
In addition to improving the symptoms of anxiety and depression disorders, EGP have been developed to also enhance psycho-education, attitude change, relaxation and pain management, social skills, problem-solving skills, emotional modulation, self-control skills, motivation, as well as therapist client interactions.
Virtual-Reality Exposure Therapy (VRET) has also been used to expose clients to sources of anxiety and stress, within the safety and control of the therapist’s office. VRET has shown significant improvement for cognitive behavior therapy, as well as behavior therapy. In regards to PTSD, in research surrounding VRET in combination with cognitive behavior therapy, VRET was found to be “at least as useful as traditional exposure therapy”. Authors who published the research suggested that patients who respond better to prolonged experience to virtual reality may have a better impact from the VRET. Though not proven experimentally, the authors of the same study suggest that VRET may provide a more “robust positive effect” similar to other exposure-based treatments for PTSD, while providing treatment in a less stigmatized manner, in a more controlled; yet immersive way than traditional exposure therapy (Horne-Moyer 2014).
Clinical psychologist Dr. Kathleen M. Chard, who works at the PTSD and Anxiety Disorder’s division at the Cincinnati VA medical center, who has over 20 years in treating mental health disorders, claims that VRET is helpful among the Veteran population. Dr. Chard explains that the goal of this kind of therapy is applied to veterans with an end goal of processing their traumatic memories so that it no longer controls their life. Patients are given a control stick, which is attached to a weapon, as well as a pair of virtual reality glasses and headphones. Machines that can replicate smells are also used in this process. The goal is to recreate traumatic scenes in “vividly” accurate detail and change their perception of what happened.
“The VRE[T] treatment allows us to trigger memories about the event to obtain the full story…ones these memories are triggered, we can challenge those misperceptions in the veteran’s mind, including areas where they may be blaming themselves for things they could not have controlled or predicted” explains Dr. Chard. One symptom of PTSD is avoidance of thinking about the event, and emotional avoidance; resulting in an ultimate shut-down emotionally as to avoid reliving the event (Prine, 2016). However, experiencing those emotions, and being able to move forward is a natural part of life. The virtual-reality technology allows therapists to help challenge individuals about the event, and helps them process their emotions.
The effectiveness of using games as therapy has shown some inconsistencies in regards to results of improved symptoms across various studies, though a high number of investigations have shown electronic games to have positive effects on psychosocial functioning, including stress management, self-confidence, socialization, and quality of life. Virtual Reality Exposure Therapy may not always successful, but there is solid evidence of VRET and gaming having a positive impact in helping patients. VRET and video games, however, can be used as a means of helping patients in a new inventive way that cuts away some of the stigma or impact of seeking treatment. As studies have shown it to have similar levels of success with cognitive behavior therapy, it is clearly beneficial to allow new, innovative processes for treatment to come about in the clinical world.
Horne-Moyer, H. L., Moyer, B. H., Messer, D. C., & Messer, E. S. (2014, October 14). The Use of Electronic Games in Therapy: A Review with Clinical Implications. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4196027/
Moore, B. A. (2010, May 10). Video Game or Treatment for PTSD? Retrieved from https://www.psychologytoday.com/blog/the-camouflage-couch/201005/video-game-or-treatment-ptsd
Prine, B. C., Seck, B. H., & Mcdermott, B. J. (2016). Video Games Show Promise as Therapy. Retrieved from http://www.military.com/benefits/2014/04/09/video-games-show-promise-as-therapy.html
