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Virtual reality is about to completely transform psychological therapy

Oculus Rift TI 2
Oculus/Tech Insider

For many of us, something in the world can trigger a disproportionate or even irrational fear response.

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Peering off the edge of a building might might make someone feel dizzy and shaky; getting on a plane might cause a mind to start spinning in fear of some catastrophic failure; standing in front of a room full of people might cause a speaker's throat to close up.

Survivors of trauma, suffering from post-traumatic stress disorder (PTSD), can have it even worse. A crowded city street might trigger a soldier's memory of a past battle or roadside bomb, making normal interactions difficult or impossible. Victims of assault might by seized by fear after seeing a stranger on a quiet street.

Recovering from PTSD and overcoming anxiety disorders is challenging, time-consuming work; it's also essential for the many people who suffer from these conditions.

One unlikely tool that could make it easier for thousands of patients to get the help they need is virtual reality (VR) technology, which can mentally transport users to another time, another place, another state of mind.

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You slip on a headset and headphones and all of a sudden see and can move around in a three dimensional world, wherever the program is set. You could explore an underwater world or ride a roller coaster; you could experience the very thing that triggers your debilitating anxiety — all while guided by a professional to help you get past that fear.

Virtual reality in therapy now

Even though virtual reality itself is still a hard-to-grasp idea for most people who have not experienced it, the clinical use for VR as therapy has been generating a "rich scientific literature" for the past 20 years, according to Dr. Albert "Skip" Rizzo of the University of Southern California's Institute for Creative Technologies (where Oculus Rift creator Palmer Luckey previously worked on VR).

Rizzo has worked with clinical VR since the mid-1990s, winning an award from the American Psychological Association for his work developing treatments for PTSD. He's also developed VR therapies to teach people to use prosthetics and to recover physical capabilities after stroke or trauma, and is currently working on VR scenarios to help train people with autism spectrum disorder in vocational and social settings, among other things.

There's a lot of research that backs up the potential clinical uses of VR. But while VR has been around and in use for some time now, it's still been largely unavailable to much of the public, since access required investing in special systems and headsets. Since 2016 is the year that headsets like the Oculus Rift and HTC Vive will finally go on sale, that accessibility issue is about to totally change.

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"Finally, the technology has caught up with the vision in this area, and I expect it to really take off in the next year," Rizzo tells Tech Insider. "It has not been the theory or research that has held back clinical VR, rather the availability, adoption and costs that have limited its widespread use."

Right now, VR is largely used for exposure therapy, gradually exposing people to the situation that triggers their anxiety or PTSD. Exposure is one of the best treatments we have for both PTSD and certain anxiety disorders. Along with this, clinicians frequently use cognitive behavioral therapy to teach patients techniques for dealing with those situations.

virtual reality exposure therapy
One of the simulations developed by USC's ICT.
USC ICT/YouTube

Using VR (and perhaps some other additional tech), a clinician can recreate a scene that triggers fear or anxiety in a patient, putting them virtually on a plane or in a room full of people or even in a battlefield setting.

With guidance, people can grow accustomed to the scenario until they get to the point that they can cope with the scene. Researchers have treated people with arachnophobia by exposing them to virtual spiders and even more effectively, having them touch fake spiders during that process. Studies have shown that VR exposure therapy can help people with other conditions, including fear of flying, social anxiety, and — perhaps most well documented so far — PTSD.

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It may sound impossible that a virtual environment can seem so real that someone actually can learn something that's applicable to the real world. But even when the graphics aren't as realistic as one might hope, VR really can convey a sense of reality and presence that's almost impossible to understand without experiencing it.

As a 2005 review in Nature Neuroscience puts it:

You know that the events you see, hear and feel are not real events in the physical meaning of the word, yet you find yourself thinking, feeling and behaving as if the place were real, and as if the events were happening ... From a cognitive point of view, you know that there is nothing there, but, both consciously and unconsciously, you respond as if there is.

virtual reality therapy simcoach
SimCoach is one of USC's projects involving virtual human counselors.
USCICT/YouTube

The future of clinical VR

The development of commercial VR means that headsets will be widely available, which should open up access to these already-developed therapies for new patients all over.

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Still, Rizzo says that doesn't mean that people should start thinking they can just treat themselves for any sort of psychiatric condition.

"I think there are a lot of areas where with some clinician support we can amplify the effects of therapy by having self-administered VR," he tells TI, but "some forms of treatment really do require the guidance and diagnostic skill of a clinician."

The VR headset might become a therapist's office that can transport you to a new setting, but it won't replace therapists themselves.

Rizzo does think that our virtual interaction and virtual worlds will become much deeper in upcoming years, however.

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Right now there's a lot of excitement about building virtual worlds and spaces. Rizzo thinks the next big area will be the creation of AI-powered virtual humans that inhabit those worlds.

"People are going to play out a lot of interesting interactions with virtual people," he says, including counseling, mentoring, and teaching. These "virtual humans," which USC's ICT is working on developing, could be an addition to already existing clinical therapies, though they'll also play other roles.

And the potential that VR has to offer new experiences goes far beyond therapy, according to Rizzo. Those include "news stories, building empathy for the plight of others, and giving people experiences that they'd never have."

For Rizzo, therapy and medical applications are important, but that work is still just the tip of that iceberg for what can be done with the ability to virtually transport someone to a different place.

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"There are so many ways we can improve life for healthy people as well as for people with mental health conditions," he says.

Virtual reality Mental Health
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