Virtual Reality Therapy

Description of the Strategy

Virtual reality describes a human-computer interaction that is more than just a multimedia interactive [Page 613]display as the user experiences a sense of presence or immersion in the virtual environment. To illustrate the importance of a sense of presence, imagine seeing a photograph of the Grand Canyon or even a videotape of it. One can get a sense of it but wouldn't feel present at the Grand Canyon. With virtual reality, one feels present in the virtual environment.

The setup for most virtual reality uses includes a computer to run the program and some viewing system. We use desktop computers now that the computing power is so great. Although some virtual reality systems use a series of large screens surrounding the user in a room, most applications in psychiatry and psychology use a head-mounted display. The headmounted display contains two television screens, one in front of each eye. Sometimes they are programmed to show the same image in each eye, and sometimes they are programmed to show slightly different images in each eye, producing stereoscopic display. There are often headphones, sometimes incorporating directional sound. There is a position tracker and sensor to pick up head movements and change the display in real time so that the user's view changes in a natural way with head and body movements. We have computer scientists, programmers, and graphic designers build the virtual environments. They are three-dimensional environments, and the user can often navigate around them using a joystick or other handheld device. Sometimes we use other props or devices, such as an actual railing that corresponds to a virtual railing or a subwoofer imbedded in the base of the chair or mounted below the chair to produce vibrations consistent with the sounds of the virtual environment. In all the environments, the patient experiences only computer-generated audio and visual stimuli, while “real-world” stimuli are shut out. The therapist communicates with the patient with a microphone connected through the computer to the headphones.

Our group at Virtually Better, Inc., has primarily used virtual reality as a medium for exposure therapy for individuals with anxiety disorders. We began with a virtual glass elevator modeled after the glass elevator at the Marriott Marquis hotel for people with the fear of heights. We also had a series of virtual outdoor balconies and a series of footbridges over a canyon river. Each bridge could be viewed from the other bridges and therefore added to the sensation of height. The revised height virtual environment uses a glass elevator, and the user can get off at floors and walk across a catwalk and look down. The next application was a virtual airplane we used for people with the fear of flying. It is a virtual passenger cabin of a commercial airplane. Most of the activity occurs out of the window, and the passenger can also view the window on the other side of the aircraft. It begins with the airplane engines off, then engines on, then taxiing to the runway then taxiing down the runway, takeoff, flying in both calm and turbulent weather, and landing. The passenger hears engine noises, the landing gear, the bells signifying the fasten seat belts sign, flight attendant and pilot announcements, thunder and rain during turbulence, and tires screeching upon landing.

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