What did we learn from our first pilot on how Virtual Reality can be used to support young people?
Although for many people Virtual Reality (VR) may seem like something from the future, its use as a means for changing the way we see and interact with the world is rapidly increasing. In 2018, the Children’s Society began to pilot the use of VR with young people who access ‘Pause’, one of our mental health drop-in centres in Birmingham. During this pilot, young people told us they already had experience of using VR: “this is how I learned about a volcano in my geography class” and “this is where I make friends.” Given the continued rise of the use of VR in a range of sectors, such as education, communication and psychological therapy, VR is becoming an increasingly relevant technology to explore in our work with children and young people.
Pilot 1: VR and anxiety in school
When we started our first pilot, we knew from practitioners in Pause that young people who access the drop in service often struggle with anxiety, but also that communicating about anxiety is difficult. Yet in order to offer them the right support, Pause practitioners rely on young people to recall situations that make them feel anxious for the purpose of giving them coping techniques they might apply the next time it happens. We also knew VR was being used in exposure therapy to help people who struggle with anxiety learn to cope in triggering situations. The narrative appeared seamless: Could we find out about the common, real life scenarios many young people in Pause struggle with, and give young people an opportunity to practice coping techniques ‘in’ such situations with the help of VR, from the safety of the drop in environment and with a Pause practitioner present to guide them?
What did we do?
We researched our hypothesis well. We talked to Pause practitioners about what coping techniques they teach young people and what challenges the young people they work with face; and we asked young people directly. A poll of over a hundred young people that come to Pause revealed school environments were most triggering for young people, and we held co-design sessions with young people to find out what situations they often find challenging. Young people drafted story boards of three situations in which:
· they are asked to read out loud in class
· they have to take an exam under time pressure
· they have to walk through busy corridors with other young people whom they found intimidating.
We collaborated with a VR company (The Fred Company, see https://www.thefred.company/) and a school to shoot these scenarios in 360 together with young people, and developed coping cards that could be accessed in the VR experience, to practice relaxation techniques. We also printed physical coping cards that young people could stick in their pocket and take with them to school. We trained Pause practitioners to use the VR headsets with young people, organised an exciting launch and tested the product for 3 months.
What have we learned?
An evaluation of the pilot showed mixed results: practitioners had only used the VR with 12 young people, and although the young people were enthusiastic, practitioners were reluctant to incorporate the tool in their practice. When we unpicked these results together with practitioners, we learned that we made a few mistakes both during the set-up of the pilot, as well as in the development of the scenarios. In retrospect, the narrative upon which our first pilot was based and how we came to it had some flaws. VR was used to treat anxiety through exposure, and we had conducted extensive research that showed young people in Pause faced anxiety in schools. What we had failed to do however, was explore alternatives to an exposure approach and explore the context in which VR needed to be used with the same depth. We also underestimated the level of training practitioners needed to be comfortable in administering this new approach, and overlooked simple things like making sure the headsets were stored in a place that was visible and easy for practitioners to access.
It was not until a second pilot that we realised VR could be used to access a varied offer of tools that have therapeutic benefits, something which matches the variety of approaches used in a drop-in context much better — especially given the variety of young people that walk through the door. We also learned later that we had been incredibly privileged with the level of access we had to practitioners and users in Pause, but had focused on the users more than on the practitioners. That said, we did finish the pilot in time with the miraculous support of a Pause practitioner (despite the fact we had not freed up her time to support the pilot) with an impressive product as a result.
While the devil had been in the details, we did get something important right: Pause practitioners were enthusiastic about meeting young people at their level, with technology that was familiar to them and got them excited. And though the content of the scenarios was an important factor that deterred them from using the VR in a context where contact with a young person was often brief in nature with little knowledge of their backgrounds, they did realise that VR triggered an enthusiasm in young people that could aid their ability to develop a relationship and enhance communication.
What is next?
With these lessons in our back pocket, we are currently undertaking 2 new pilots that will run until May 2020. One of them takes place in Pause again and focuses on making VR accessible for young people with learning difficulties. In addition to showing us our scenarios were difficult for young people who struggle to read or calculate, this pilot re-emphasises a need to accommodate for the needs of a variety of users. Based on the feedback from young people and practitioners, we are testing solutions that are more positive in nature and focus on the positive effects of coping techniques to do with relaxation or distraction that better suit the need a young person may have to be able to talk about their anxiety or simply calm down. We are also exploring VR experiences for young people who need passive, simple approaches as well as young people who need active, stimulating approaches in order to engage.
For the second pilot we are working together with the local authority and CCG in Salford to understand how VR might help young people in care. The project initially had intended to apply the same approach as pilot one, based on exposure, which has taught us that context is key to get this approach right. However, when we gathered insights in the nature of the anxiety and level of trauma young people in care may face, we soon realised very few young people in care would benefit from the ability to ‘practice’ challenging situations in VR through exposure. Again, the devil is in the details. For instance, while being able to prepare for change is important for young people in care, the changes young people in care are faced with are very diverse: a different care home, a new school, different transport journeys, new young people entering the home and leaving again, and social workers that change too.
Nevertheless, we did identify a common experience for young people when they transitioned to semi-independent living and are exploring how VR can be used for them to get a ‘peek’ into life in a semi-independent unit to make young people less anxious when they have to move there. Based on the knowledge we gained about the non-clinical ways in which VR can benefit young people’s mental health and well-being, we are also looking at how VR can be used by young people to regulate emotions and find ways to relax while they are in residential care.
The coming months are both exiting and a little daunting for various reasons. For one, we will have to pin down some of these ideas and develop them into new prototypes in a relative short time period. We also have to start thinking about what learnings from these pilots tell us about how to scale some of the VR concepts we are developing and for which environments they would generate the most impact. To be able to make these decisions, our ability to continue to test and evaluate our current work will be key.
By March 2020 we will have filmed new scenarios for children living in care, we will have completed our research to understand how VR could help young people with learning difficulties and also have explored how VR could help reduce the risk young people face from exploitation. These will all be pieces of a bigger jigsaw puzzle that will help us develop a strong programme of work around VR for the organisation in 2020 and beyond.
