VRET is simply Virtual Reality Exposure Therapy. Now let’s talk about Exposure therapy. Exposure therapy is a specific type of cognitive-behavioural psychotherapy technique that is often and more recently being used in the treatment of mental illness especially anxiety, phobia and PTSD. Exposure therapy (ET) involves exposing the target patient to a trigger source or context without the intention to cause any danger. ET would help patients overcome their anxiety or distress by developing a coping mechanism and a form of resilience over time.
Recently, numerous studies have demonstrated the effectiveness of Exposure Therapy in the treatment of disorders such as generalized anxiety disorder, social anxiety disorder, obsessive-compulsive disorder, PTSD, and specific phobias. When used properly and professionally under the supervision of an experienced, licensed therapist who specializes in these kinds of conditions and treatments exposure therapy is a safe and effective psychotherapeutic technique.
A BIT OF HISTORY !!
Let’s do some history together, it is exciting to know that the geographical origin of the exposure therapy technique is from Africa. ET as a mode of therapy began in the 1950s, at a time when psycho-dynamic views dominated western clinical practice and behavioral therapy was first emerging as a succinct methodology for psychotherapy practice. James G. Taylor, South African psychologists and psychiatrists first used exposure as a way to reduce pathological fears, such as phobias and anxiety-related problems, and they brought their methods to England in the Maudsley Hospital training program. He was the first psychologist known to use exposure therapy treatment for anxiety, including methods of situational exposure with response prevention — a common exposure therapy technique still being used.
Since the 1950s several sorts of exposure therapy have been developed, including systematic desensitisation, flooding, implosive therapy, prolonged exposure therapy, in vivo exposure therapy, and imaginal exposure therapy. Today, at least according to the “Handbook of Exposure Therapies”, exposure is the most effective treatment for anxiety, OCD, post-traumatic stress, and similar problems. The recent positive remarks and successes around the exposure therapy has seen the early deployment of a technology that had been said to be in search of a real purpose. Don’t think too far, I am referring to Virtual Reality!
VRET : Virtual Reality Exposure Therapy
Virtual Reality is a computer-generated scenario that simulates experiences. This immersive environment, used for simulated exposure, can be similar to the real world, creating a new experience. It is widely used as an alternative form of exposure therapy, in which patients interact with harmless virtual representations.
Traditionally stimuli are looked for in actual physical situations (in vivo) or by having the patient imagine the stimulus (in vitro). In a bid to initiate and facilitate a therapy process, it is difficult for one to imagine a trigger scenerio properly and expose himself or herself to that environment. This gives room for the application of virtual reality in medicine and therapy.
In PTSD (Post Traumatic Stress Disorder)
In the case of PTSD, exposure therapy is intended to help the patient face and gain control of the fear and distress that was overwhelming in the trauma they had experienced. This must be done very carefully in order not to re-traumatize the patient. In some cases, trauma memories or reminders can be confronted all at once ,this system is known as “flooding”, while for other individuals or traumas it is preferable to work gradually up to the most severe trauma, this is referred to as “graduated therapy”.
However, using relaxation techniques and either starting with less upsetting life stressors or by taking the trauma one piece at a time (”desensitization”) can be the most suited approach to dealing with the patients mental illness. A therapist works with the client to determine which method is best suited for the particular client and their trauma. A patient is never forced to engage in treatment they feel uncertain about, or are afraid of. A good therapist will help explain the kinds of techniques they would like to use and ensure all of the patient’s questions are answered to their satisfaction. VRET is introduced hereby, providing simulated Virtual Graded Reality Exposure Therapy (VGRET) which takes a patient through graduated scenes of a trigger environment. This would help the patient adapt to the environment and overcome his or her mental illness.
Nevertheless, mindfulness, relaxation and tranquility scenes could be introduced by the clinical psychologist earlier to the higher levels of triggered stressors. VR applications are being developed to research the risk of developing PTSD following trauma, mental resilience training for veteran soldiers and other high risk groups around the world, most especially in the Middle East.
In PHOBIA (fear of events, heights, driving etc)
In the cases of phobia, exposure therapy is used in conjunction with relaxation exercises and/or imagery. In conjunction with learning how to bring about a relaxed state at-will, the therapy technique gradually exposes patients to what frightens them and helps them cope with their fears. Exposing someone to their fears or prior traumas without the client first learning the accompanying coping techniques — such as relaxation, mindfulness, or imagery exercises — can result in a person simply being re-traumatized by the event or fear. Therefore exposure therapy is typically conducted within a psychotherapeutic relationship with a therapist trained and experienced with the technique and the related coping exercises. When looking to engage in exposure therapy to help treat your PTSD or phobia, look for a psychotherapist with experience or a specialty in this kind of psychotherapy.
Fear of driving for instance is as a specific phobia where the thought or experience of driving triggers intense fear and may reliably trigger panic attacks. Hence, Driving phobia frequently co-occurs with panic disorder, acute stress disorder or post-traumatic stress disorder after a motor-vehicle accident, or other anxiety disorders. Already some experiments have proven VR to be a useful tool in treating specific phobias such as fear of heights, fear of spiders, fear of flying and claustrophobia, as well as agoraphobia.
IN AUTISM AND SOCIAL ANXIETY
Virtual reality has been shown to improve the social skills of young adults with autism. In one study, participants controlled a virtual avatar in different virtual environments and maneuvered through various social tasks such as interviewing, meeting new people, and dealing with arguments. Researchers found that participants improved in the areas of emotional recognition in voices and faces and in considering the thoughts of other people. Participants were also surveyed months after the study for how effective they thought the treatments were, and the responses were overwhelmingly positive.
Meanwhile, one can overcome social anxiety by developing communication skills from a simulated audience or a specified trigger environment.
IN PAIN AND DEPRESSION
Distraction is a technique by which VR can have benefits in the treatment of pain. If these new mechanisms can lead to new treatment options for patients with chronic pain, VR may have the ability to help reduce opioid use and misuse among chronic pain patients. VR is a non-invasive option for the treatment of pain but it can cause motion sickness, dizziness, and nausea, so it may not be for everyone.
According to Anita Gupta, MD, and colleagues at Princeton University and Drexel University College of Medicine, “Each patient needs to be assessed on a case by case basis, and I would certainly try this as part of a traditional treatment plan, with routine guidance from a board-certified pain specialist who understands the risks and benefits of all treatments involved, and what works best for the patient,”
Because of the potential for harm with the Exposure kind of therapy technique, it is not recommended that a person ask a therapist or other professional who isn’t specifically trained and has a lot of experience in these techniques. Besides, its advantage of eliminating dangers from real stimuli, VRET is also extremely convenient and can even be set up at home for its mobility. Patients will thus benefit from self-guided treatments outside the clinic.