Virtual Reality Therapy with Children

Description of the Strategy

Virtual reality is a medium of human-computer interaction that is more than just a multimedia interactive display, as the user is no longer simply an external observer of an image but becomes an active participant within a computer-generated, three-dimensional virtual world. Efforts to create this experience of presence or immersion in the virtual environment include multisensory stimuli involving visual, auditory, and kinesthetic. To illustrate the importance of a sense of presence, imagine seeing a photograph of the Grand Canyon, or even a videotape of the Grand Canyon. 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 software program and a viewing system. The software programs are virtual environments created by computer programmers and graphic designers. The viewing system can be a series of large screens surrounding the user in a room, also known as a “cave.” Most applications in psychiatry and psychology, however, use a helmet-like head-mounted display consisting of display screens for each eye. With advances in technology, it is possible to show slightly different images in each eye, producing a stereoscopic display, which can add a sense of visual depth. There are often headphones, sometimes incorporating directional sound. A position tracker and sensor is used 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. Finally, the user can navigate physical movement within the virtual environment through a handheld puck, similar to a joystick. Other props or devices can also be used, such as an actual railing that corresponds to a virtual railing, or a subwoofer embedded 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.

Virtual reality is frequently used as a medium for exposure therapy to treat anxiety disorders. Examples of some of these applications include a virtual glass elevator and atrium building with catwalks for people with the fear of heights. In this environment, the user can control movement by opening and closing the elevator doors, ascending and descending throughout the building, and walking across a catwalk, able to look both up and down in the atrium. The next application was a virtual window seat in the passenger cabin of a commercial airplane used for people with the fear of flying. The program 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. In addition, a virtual thunderstorm environment is used for people with a fear of thunderstorms. It consists of a living room with a large picture window. The sky starts off blue with birds chirping and, as the therapist directs, darkens to gray and ominous and develops into a lightning and thunderstorm. The patient sits in a chair in front of the window and can view the weather outside and hears the thunderclaps. These three environments—heights, flying, and thunderstorms—are suitable for treating children and adults.

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