Have you ever heard about virtual reality applications in the field of psychology? Virtual reality (VR) enables interaction with a 3D world by creating a simulated environment, immersing users in the experience. While VR is often associated with the video game industry, there have been trials exploring its use in the healthcare sector. Neurophysiologists Ronald Melzack and Patrick D. Wall developed the 'gate control' theory of pain in the 1960s, linking pain perception to brain functions. Doctors conducted experiments with burned patients, using virtual reality to distract them from pain while receiving treatment for their wounds. The results of these experiments were positive, suggesting that virtual reality applications could also benefit individuals with post-traumatic stress disorder (PTSD) after injury. They claim that virtual reality can alleviate both physical and psychological pain (Hunter & Hoffman, 2004).
Scientists have been conducting experiments using virtual reality technology in the field of psychology since the early 1990s. Virtual reality applications for human research and clinical intervention first emerged in the early 1990s, and after encouraging findings from clinical testing, training, and treatment within highly proceduralized virtual reality simulation environments, it became a useful direction for psychology and rehabilitation to explore (Lange et al., 2012). Despite promising results, ongoing experiments seek to address unanswered questions and concerns among both the public and scientists regarding this subject. Additionally, virtual reality applications in psychological treatments are not yet common. Even in video games, it is a new and evolving technology, with discussions about its affordability and other metrics. However, scientists continue to research side effects and other argumentative issues regarding virtual reality treatment. Despite the question marks in people’s minds, there are really promising results from the trials with people who have overcome their psychological issues thanks to VR applications.
According to recent estimates of the US population, the current 12-month prevalence for anxiety disorders is 18.1%, whereas, in Europe, a 13.6% lifetime history of any anxiety disorder was found (Opris et al., 2012). This result shows that anxiety disorders are a significant part of the population suffering from mental issues. Cognitive-behavioral therapy (CBT) is the most popular treatment for anxiety disorders, focusing on thoughts, feelings, senses, and physical actions. Virtual reality-based treatment has a powerful real-life impact, similar to classical evidence-based treatments (a form of cognitive behavior therapy) (Opris et al., 2012). The application of this subject is based on showing patients graphic simulations of their feared object, situation, or environment, and like other kinds of exposure therapy, virtual reality treatment involves gradually introducing patients to these stimuli (Hoffman, 2004). One notable application involves a woman with an anxiety disorder from spider phobia. Her condition worsened, and due to her fear, she was not able to leave the house. After only ten one-hour sessions with virtual reality-based therapy, her fear of spiders greatly reduced, and her obsessive-compulsive behaviors also disappeared. Her success was unusually dramatic: after treatment, she was able to hold a live tarantula for several minutes with little anxiety (Hoffman, 2004). According to this example, we can easily say that virtual reality-based treatments have the same logical background as classical treatments, and the results of both treatments are not different.
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The various assets offered by virtual reality, including increased ecological validity, objectivity, and assessment in interactive and functionally relevant scenarios, could support several opportunities for applications in both the clinical and research domains of neuropsychology (Schultheis et al., 2002). According to an article named 'Designing Informed Game-Based Rehabilitation Tasks Leveraging Advances in Virtual Reality,' virtual reality can offer safe and effective use in the rehabilitation context and home-based functional activity in daily life for clinical treatments. Virtual reality-based treatment offers some advantages, such as being performed inside the therapist’s office, a convenient and safe environment in itself, and the therapist having better control over the content and pace of the exposure. Also, the exposure can be repeated as much as needed (Opris et al., 2012). This treatment way could be more beneficial for both patient's and therapists' safety. Especially, while patients with post-traumatic stress disorder face their problems, it could be really important to create a safe yet realistic environment for them. Also, virtual reality usage during psychological treatment offers patients greater control, variety in response options, presentation of stimuli in three dimensions, the creation of complex scenarios, the generation of varying levels and combinations of multimodal sensory input potentially allowing audio, haptic, olfactory, and motion to be experienced simultaneously to the graphically rendered environment or objects, the possibility for participants to respond in a more ecologically valid manner, the precise and independent manipulation of the geometric and photometric relationships between objects, the possibility of examining sophisticated complex participants' behaviors, such as avoidance, and the study of situations which can be impractical, dangerous, or ethically questionable to be created in real life (Wilson & Soranzo, 2015). I believe each of these factors is important to create a successful therapy process. In addition to that, it could allow therapists to create simulations like some environments which real-life possibilities cannot offer if needed.
Despite all of these benefits, some people think that initial findings may be provocative; an analysis of the cost-benefit issues for the application of virtual reality technology is needed to better determine. Their thoughts might be right; eventually, virtual reality is something that can be offered by technology, and technological devices could sometimes have unpredictable outcomes. Also, there are allegations about the minimal risk of side effects that can occur during virtual reality applications. The most common risk of application is simulator sickness. Simulator sickness and motion sickness are similar in symptom constellation. Possible symptoms include vertigo, dizziness, headaches, and sweating. Although the rate of simulator sickness in clinical populations is not well known, prior studies reviewed herein have reported minimal negative reactions in participants with MS and TBI (Schultheis et al., 2002). Also, as another risk, some people mention the concept of presence. Virtual reality applications can make the participant feel as if the virtual objects are “really there” and respond accordingly; physical and psychological side effects from exposure to virtual reality-induced side effects. Differences in the perception of color, contrast, space, and movement, when compared to real life, can be a concern if the goal is the exact replication of perception in the physical world or an advantage when trying to create “impossible scenarios” (Wilson & Soranzo, 2015). Besides these problems, there is one more matter about its affordability according to Schultheis et al. (2015). Virtual reality is a new evolving technology, so it can be seen as expensive for some parts of the community. However, large clinical trials are also needed to determine the value of virtual reality. So far, the research has shown that the program poses little risk and few side effects. Because patients use the program in addition to traditional opioid medication, the subjects who see no benefit from virtual reality are essentially no worse off than if they did not try it. Virtual reality may eventually help to reduce reliance on opioids and allow more aggressive wound care and physical therapy, which would speed up recovery and cut medical costs. The high-quality virtual-reality systems that are recommended for treating extreme pain are very expensive, but doctors are optimistic that breakthroughs in display technologies over the next few years will lower the cost of the headsets. Furthermore, patients undergoing less painful procedures, such as dental work, can use cheaper, commercially available systems (Hunter & Hoffman, 2004). At the end of this discussion, there are some risks and problems; however, with better determination, virtual reality treatment can offer patients a more effective and quick way for treatment. Also, some companies support this case, and it is possible to find more sponsors for this epochal treatment.
In conclusion, despite the negative arguments, virtual reality applications are not so different from classical treatments as backgrounds and reasons to apply matter. In addition, they have variable benefits and conveniences during therapy. I believe it is important to provide both patient and therapist with a safe environment in which they can feel more secure and relaxed. Also, giving therapists the chance to change variables according to therapy manner provides more comfort and control in case of a crisis. Another opportunity virtual reality can offer is that it can easily use both home-based therapy sessions and in-office environments; besides, it can be repeated as much as the patient needs or the therapist deems sanction. For these reasons, I believe virtual reality applications should be conducted on patients with psychological problems to provide them with better treatment.
References
- Hoffman, H.G., (2004). Virtual reality therapy. Scientific America.com https://www.behavioralassociates.com/pdf/scientificamerica.pdf
- Opris,D., Pintea,S., Palacios,A.G., Botella,C., Szamosközi,S., & David, D., (2012). Virtual reality exposure therapy in anxiety disorders: A quantitative meta-analysis. Depression and Anxiety. (p.85-93) https://onlinelibrary.wiley.com/doi/abs/10.1002/da.20910
- Lange, B., Koenig, S., Chang, C.Y., McConnell, E., Suma, E., Bolas, M., & Rizzo, A., (2012). Designing informed game-based rehabilitation tasks leveraging advances in virtual reality. Disability & Rehabilitation .https://www.tandfonline.com/doi/abs/10.3109/09638288.2012.670029
- Schultheis, M.T., Himelstein, J., & Rizzo, A., (2002). Virtual Reality and Neuropsychology: Upgrading the Current Tools. Journal of Head Trauma Rehabilitation. https://journals.lww.com/headtraumarehab/Abstract/2002/10000/Virtual_Reality_and_Neuropsychology__Upgrading_the.2.aspx
- Wilson, C.J., Soranzo, A., (2015). The Use of Virtual Reality in Psychology: A Case Study in Visual Perception. Computational and Mathematical Methods in Medicine https://www.hindawi.com/journals/cmmm/2015/151702/
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