Virtual Reality as an Alternative to Anesthesia and Painkillers

by Michele Oberly

July 23, 2022

Hospitals across the UK are embracing virtual reality (VR) as a tool for pain distraction during surgery and are finding that the benefits extend even beyond minimizing pain.

A recent article published in The Irish News takes an in depth look at the impact VR is making for patient populations. By using VR, the elderly are sometimes able to avoid anesthesia, which can result in serious side effects for older patients, including postoperative cognitive dysfunction. VR is also being used for children, as the sensory experience helps anxious and fidgety young patients to sit still during complicated procedures. And VR’s benefits extend to all patients as it has been shown to reduce anxiety before, during, and after procedures. An additional important use is the treatment of chronic pain as an alternative to addictive painkillers, which can result in long-term substance abuse disorder. The article cites a 2020 review from Health Technology Wales, which concludes that VR is actually more effective at reducing pain during and immediately after procedures than standard care, such as painkillers.

Beyond improved patient care, hospitals experience the added benefit of reducing overall costs. Anesthesia itself is expensive, and it often requires an overnight stay. Many patients (not just the elderly) are adversely impacted by anesthesia and experience symptoms like vomiting and chills, which extends their hospital stay.

So why are the VR simulations, from a roller coaster ride to a wildlife safari, so effective? According to Jordan Tsigarides at the University of East Anglia, “VR is immersive. It floods the brain with audio-visual signals, engaging the senses and diverting the brain’s attention from processing pain signals…by putting someone in a situation outside of their normal environment, VR can be relaxing. And if you add in an engaging task such as a game, then it’s not hard to grab their full attention.”

Industry News, Soft Skills, VR-Related

VR Body Transfer for Animal Empathy

by Michele Oberly

June 30, 2022

As environmental catastrophes are increasing, Daniel Pimentel at the University of Oregon wondered whether Body Transfer using virtual reality (VR) would help humans to identify with other animals and increase the empathy required for strong conservation efforts.

Body Transfer, sometimes referred to as body ownership, is an illusion that tricks the mind using visual and sometimes haptic input into experiencing the embodiment of another human or animal. Through an immersive 15-minute VR simulation participants in Pimental’s study experienced the plight of an endangered loggerhead sea turtle as it navigated (often man-made) hazards from birth to adulthood, including treacherous obstacles like fishing nets. Participants were given a firsthand perspective through a specially designed chair that mimicked a sea turtle’s paddling posture (they perceived their own arms as flippers), and through haptic vibrations along their spine when they encountered motor vibrations of nearby boats.

Through a series of four experiments, Pimental and fellow researchers concluded that virtual embodiment of a sea turtle can offset compassion fade, which is an inverse relationship wherein empathy actually decreases as the (human or non-human) casualty victim count increases. Moreover, Body Transfer allowed participants to see other turtles in the simulation as part of their in-group, thereby facilitating reciprocal altruism, and that embodiment of the sea turtle increased the threat perception, influencing the amount of money that participants donated to hypothetical conservation efforts.

Mindfulness, Therapy and Support, VR-Related

The Power of Virtual Reality Reminiscence Therapy

by Michele Oberly

May 31, 2022

Cognitive decline can lead to social isolation and many older people suffer from dementia-related anxiety. In a recent article, The New York Times took a look at a practice to help minimize the effects of the disease using virtual reality (VR) reminiscence therapy. Traditional (non-VR) reminiscence therapy has been practiced for several decades and allows older generations to reconnect with joyous and meaningful events of their youth through photographs, videos, and music. Along with positive feelings, nostalgia can help cultivate confidence and long-term perspective, at a time when many are grappling with the instability of short-term memory loss. For those who do not experience a significant improvement in well-being from traditional reminiscence therapy, the addition of virtual reality elements can be a dramatic turning point.

The immersive experience of VR reminiscence therapy is helping patients to socialize in their daily lives, reversing the pre-treatment pattern of isolation. The article focuses on John Faulkner, a seventy-six year old resident of Central Parke Assisted Living and Memory Care in Mason, Ohio. Mr. Faulkner was withdrawn and showed no discernable improvement with reminiscence therapy by simply viewing photos until the center used an immersive virtual reality experience that allowed him to virtually walk along Ireland’s Cliffs of Moher where he had once visited in person with his wife. Over the course of his weekly 45-minute VR sessions, Mr. Faulkner not only became more sociable with other residents, he now requires less medication to treat his anxiety. A senior administrator at Central Parke stated that residents who engage in VR reminiscence therapy have experienced up to a 70% reduction in their usage of antipsychotics.

The article emphasizes the substantial shift the population will experience over the next forty years, as the 65+ age segment is expected to double in size. Technological tools will likely be very impactful to aid younger generations in caring for the elderly. In addition to VR reminiscence therapy, virtual reality is being used to treat elderly patients who suffer from chronic pain as well as post traumatic stress disorder (PTSD). Recent research at MIT has also shown that VR can decrease depression and social isolation in seniors. And a study is currently underway at the University of Santa Barbara, California using VR technology that allows families to take trips with their elderly family members. Not only can a senior revisit places where meaningful events took place, they may soon be able to bring along their grandchildren to experience the exuberance of the jazz age, for example, or to visit the town they grew up in.

Foretell Reality focuses on bringing people together in VR to enhance human interaction and facilitate social connection, often guided by mental-health professionals.

Therapy and Support, VR-Related

Virtual Reality to Treat Agoraphobic Avoidance

by Jonathan Collins

May 19, 2022

As defined by the Mayo Clinic, agoraphobia is “a type of anxiety disorder in which you fear and avoid places or situations that might cause you to panic and make you feel trapped, helpless or embarrassed.” This can range from using public transportation to standing in line in a grocery store. Most people diagnosed with agoraphobia fear public spaces and crowds, thus they confine themselves to their home in order to avoid having a panic attack. Treatment involves psychotherapy and medication, but it takes time for symptoms to improve. Cognitive behavioral therapy is the most widely used treatment because it gradually exposes patients to anxiety-inducing situations, teaching them how to manage their symptoms and overcome their fears.

A recent study out of England analyzed the effectiveness of virtual reality therapy to treat agoraphobic avoidance and patients with psychosis. Researchers analyzed 346 patients who were clinically diagnosed with psychosis and “had self-reported difficulties going outside due to anxiety.” Over the course of 26 weeks, researchers conducted “a parallel-group, single-blind, randomized, controlled trial across nine National Health Service trusts in England.” They split patients into two groups – a VR therapy group and the usual care alone group (control). The VR group was immersed in several different environments over the course of treatment. Whether it be visiting a coffee shop or entering a waiting room, patients were coached the entire way through and encouraged to let go of defensive behaviors. Compared to the usual care alone group, the VR therapy group showed “significant reductions in agoraphobic avoidance and distress” in everyday situations. VR therapy “particularly benefited patients with severe agoraphobic avoidance, such as not being able to leave the home unaccompanied.”

The results of this study indicate VR therapy as a powerful adjunct to cognitive behavioral therapy. This means that, with the use of immersive technologies such as VR, therapy will become much more widely accessible and affordable to patients, especially those who may be too anxious to leave their homes for treatment. Foretell Reality is a social VR platform that provides safe spaces for therapy and support, soft skills development, and other interpersonal activities like real time collaboration and group events. Please visit our website for more information or to schedule a demo.

Therapy and Support, VR-Related

VR for Treating Anxiety and Depression

by Michele Oberly

May 12, 2022

If you live in the U.S. where the combined rate of anxiety and depressive disorders among adults is approximately one in three, you likely know someone who suffers from the disorders’ crippling symptoms such as hopelessness and guilt. Perhaps you yourself have experienced a depressive episode and were encouraged to seek help, but for a multitude of reasons that we will touch on later, you didn’t. Virtual Reality (VR) reduces the barrier to engagement in mental health treatment and recent research shows that it can be used as a powerful tool against anxiety and depression.

The focus on anxiety and depression is relatively recent, but the relationship between VR and mental health is decades old. The first mental health breakthrough occurred in the 1990s when VR exposure therapy was used to treat war veterans with Post-Traumatic Stress Disorder (PTSD). VR exposure therapy simulates life-like stimuli in a controlled environment. Under the supervision of a mental health professional, patients confront the object or scenario they fear, thereby diminishing their anxiety over time. VR exposure therapy treatments were also developed for phobias such as claustrophobia, arachnophobia, and fear of flying. Additionally, early VR therapies focused on cue reactivity for addictions like nicotine. Because VR makes the scenario feel real, patients are able to practice their behavior when confronted with stimuli (e.g. a crowd of people smoking) that trigger their arousal and anticipation.

Early VR treatments like exposure therapy and cue reactivity were one-on-one. And often the therapist was not immersed in the space with the patient, but rather was guiding the session from the outside. More recent technological developments have enabled multiple participants to interact in a shared environment, which has made VR support groups and group therapy a reality.

In one example, Yale School of Medicine partnered with Foretell Reality to study the viability of VR support groups for adolescent cancer patients. VR allows something that other types of therapy (e.g. tele-health via video) do not – anonymity. If you’ve experienced depression or know someone who has, you’ll be familiar with the heavy burden of social interaction. If you’re losing your hair due to cancer treatments or your depression has taken a toll on your hygiene habits, you can understand why some would avoid group therapies altogether. Because VR is avatar-based, patients do not feel judged as they are not physically “seen.” At the same time, they can still interact with other avatar patients through body movement and gestures as if they are in the same physical space.

Anonymity helps solve the burden of stigmatization regarding physical appearance, but that isn’t the only barrier that VR addresses. Those suffering from depression and anxiety may experience challenges focusing. With a VR headset on, it isn’t possible to look at your phone or be distracted by the television. A patient is fully immersed in a virtual supportive environment: chairs in a circle, the cushy pillows… everything looks… real. And the possibilities are endless. Perhaps your support group is meeting by the ocean or on a serene clifftop nestled in the clouds. You are there – and you didn’t even have to leave your home. You can use different settings for a daily meditation or mindfulness practice, walk on the beach with your guide while discussing your feelings, or play a virtual ball game with your peers.

And that brings us to another barrier to mental health treatment: the physical one. Some patients are disabled and literally cannot leave their homes. Others live in a rural area with no accessible support group within hundreds of miles. And depressed patients may at times not feel physically capable of leaving even their beds. A $300 headset and internet connection is all one needs to connect socially from anywhere in the world.

VR technology has been evolving for over two decades, and has greatly accelerated in the past couple of years. This evolution comes just in time for using VR effectively for various (tele) mental health purposes. In less than ten years, the World Health Organization predicts that mental health disorders will be the leading burden of disease worldwide. We must use every available tool to treat mental health disorders, and VR is here to help.

Soft Skills, VR-Related

Three Examples of Virtual Reality (VR) in the Courtroom

by Jillian Renken

May 2, 2022

An increasing number of educators and attorneys are bringing immersive virtual environments (IVE’s) to the courtroom in different ways. Below are three examples of how VR is being leveraged in legal settings.

Moot Court

The law school at The University of Ottowa is among the first programs to conduct moot court sessions in VR. Moot court simulates a court hearing in which students argue to appeal a case. They must prepare legal research, write briefs, and complete oral arguments in front of a panel of judges. Although these simulations are typically held in classrooms made to look like courtrooms, the COVID-19 pandemic halted all in-person trials, forcing the university to explore other options for holding moot court. They decided to implement VR into their curriculum to solve this problem, but as physical courtrooms became available again, faculty pushed to continue using the technology. According to Ritesh Kotak, a third-year Juris Doctor student, virtual reality “includes everything you can imagine from customizing a courtroom” to “doing training, and getting students excited.” Kotak asserts “The metaverse is here to stay so, from an educational perspective and a judicial perspective, there’s a lot of merit to using it.”

Crime Scenes/Evidence Viewing

In a recent study at the University of South Australia, researchers measured the discrepancy in jurors being shown a crime scene through a series of photographs versus being immersed in the same exact crime scene in virtual reality. Two groups of 15 participants were asked to come to a verdict on a deadly hit and run scenario. Not only were the VR participants “significantly more accurate in remembering the correct placement of evidence items”, but they came to a nearly unanimous decision, while the other participants were completely divided in their decision. Overall, 13 of the 15 participants who viewed the crime scene in VR ruled “death by dangerous driving”, while 8 of the 15 people who only viewed photographs voted on a more lenient “death by driving without due care.” Because more information can be presented in VR, participants were able to better understand the situation at hand, and thus were 9.5 times more likely to choose the “death by dangerous driving “ verdict. Although some people may be hesitant to implement VR due to its high price tag, the cost would be negligible juxtaposed to the immense cost of organizing on-site crime scene visits. Between transporting the jury and scheduling the trial to work with everyone’s schedules, it can cost thousands of dollars, whereas recreating a crime scene in VR is relatively inexpensive. If virtual reality presents the evidence of a crime in a more accurate manner, thousands, if not, hundreds of thousands of trials could reach different, more just verdicts. Dr Andrew Cunningham, from UniSA’s Australian Research Centre for Interactive and Virtual Environments, believes that this study “provides unequivocal evidence that interactive technology leads to fairer and more consistent verdicts, and indeed could be the future of courtrooms.”

Pre-trial Exposure for Lawyers and Those Taking The Stand

From a preparation standpoint, VR offers benefits to both lawyers and those taking the stand. Lawyers typically practice their cases in front of other experts to test their performance under the pressure and stress that they will most likely face in the courtroom. With the help of virtual reality, lawyers can practice arguing their case in front of a virtual crowd, which is proven to simulate a similar emotional experience to that of a real courtroom. Furthermore, if lawyers view a crime scene in VR, they will have a better understanding of the witness’s perspective pre-trial and may even increase out of court settlements. With VR, witnesses can also prepare themselves for questioning and depositions. By running through a trial beforehand, they will be better prepared to tell their story, be questioned by lawyers, and avoid experiencing the emotional rollercoaster that many witnesses face.

Foretell Reality is a VR platform for simulations and role play training including features like personalizable avatars, realistic environments, and 360 video viewing. Visit us today for a demo.

Coaching, Soft Skills, VR-Related

Virtual Reality (VR) Provides Unique Opportunities for Coaches

by Michele Oberly

April 29, 2022

Role-play is an integral part of a child’s development and a potent tool for the continuation of skill acquisition and honing long into adulthood. Because it allows participants to learn, not by reading a book or listening to a lecture, but by actually doing and practicing, role-play is experiential learning – an accelerated learning method. Medical students, teachers, and in more recent years, managers, have all benefited from role-play scenarios. Coaching managers using role-play scenarios helps them to build skills through rehearsal and direct feedback.

Effective managers require competence in many areas with communication as the common denominator across the skillset. Considering that the number one reason employees cite for leaving a position is the relationship with their manager, investing in management coaching is paramount for retention. All types of communication can be rehearsed in role-play scenarios, but of particular significance is navigating difficult conversations, such as delivering a negative performance review. Difficult conversations are inherently uncomfortable for most people, and thus are often avoided or rushed in order to minimize discomfort. Role-play is a type of exposure that desensitizes the participants’ fear and anxiety to engage in conflict, thereby facilitating more productive conversations.

Given the global nature of modern companies, it often isn’t feasible for an executive team or for regional managers to gather in one place for management coaching. This difficulty has been further exacerbated by the COVID-19 pandemic. And there is an evolving trend of companies offering employees a work-from-home or hybrid (remote/office) model to attract sought-after candidates. Virtual Reality (VR) coaching offers a unique solution: through multi-participant VR simulations, teams can gather in an immersive space, such as a boardroom, without needing to leave their homes.

Coaching in VR is not just logistically convenient, but it offers features that are not possible with in-person coaching. Foretell Reality’s platform allows users to build their own avatars. This can be an empowering experience but also allows participants to switch roles easily. By choosing a different avatar and playing the role of the employee on the receiving end of a negative performance review, managers can stand in the (virtual) shoes of the employee, thus increasing their capacity for empathy. They can understand what it feels like when feedback is indirect and vague, for example.

Another unique feature Foretell offers is a playback “hologram”. Role-play scenarios can be recorded and participants are given the opportunity of observing their avatar following the exercise. Rather than a coach giving feedback regarding lack of eye contact, for example, the participant can actually observe her avatar avoiding direct gaze, perhaps by looking down or to the side. In fact, Foretell’s software can even measure the amount of eye contact during conversations. Through watching the hologram recording, participants can more objectively observe their behavior. They might be surprised to observe that they came across as rather aggressive through their hand gestures or tone of voice. Having these epiphanies through direct observation is more powerful than hearing the feedback second-hand from a coach. Of course, the coach can play an instrumental role by helping the participant process their observations and imparting helpful guidance for the next practice round.

Recording and playback in Foretell Reality.

Additional features include a personal tablet for each avatar that is not viewable by other participants. This creates a potential for dynamic role-play scenarios wherein each participant has an objective that they need to achieve during the exercise. The tablet may contain information about their role-play partner, perhaps related to their background and performance issues. The coach has the ability to change an objective at any point during the scenario. Additionally, Foretell’s VR software includes a “whisper” feature that allows a coach to speak to one of the participants, and only that participant can hear the feedback. In the middle of a heated scenario, a coach might whisper a tactic to help diffuse tension, for example.

The potential for virtual reality coaching is limitless. It does not require travel or other logistical hurdles. Rather, managers can be instantly transported to a shared space with a coach, to build the confidence and skills needed to be more effective managers. Foretell Reality’s features create the perfect environment for creative role-plays and instant feedback.

Mindfulness, Therapy and Support, VR-Related

Four Real World Examples of VR for Mindfulness and Meditation

by foretelladmin

April 25, 2022

According to a Harvard Health, mindfulness is “a key element in stress reduction and overall happiness” and is known to “help relieve stress, treat heart disease, lower blood pressure, reduce chronic pain, improve sleep, and alleviate gastrointestinal difficulties.”

Despite its benefits, however, mindfulness training can be intimidating to non-practitioners and particularly difficult for remote participants. This has lead researchers to investigate how Virtual Reality (VR) can be used to lower the barriers and increase the efficacy of meditation practice for a variety of purposes and populations. Below are four recent examples.

To Increase Positive Emotion in the General Population

A recent study out of Melbourne, Australia is one of several that points to VR as a viable option for improving mental health and mindfulness. Mindfulness is a great way to improve mental health, however, under normal circumstances, is a difficult habit to adopt due to environmental and personal distractions. Virtual Reality (VR) directly addresses these challenges “by providing an immersive environment for practicing mindfulness and by supporting the user to orient attention to the present moment within a tailored virtual setting.” A group of 37 participants were recruited to trial a VR mindfulness app in which users were presented with 360 video of a “peaceful forest environment with a guided mindfulness voiceover.” Researchers analyzed participant scores on the State Mindfulness Scale, Simulator Sickness Questionnaire, arousal, and positive or negative emotion before and after users participated in the simulation. Although there were initial concerns about simulator sickness and negative emotion, neither of these variables produced any notable changes following the simulation. However, state mindfulness and positive emotion significantly increased, participants reporting that “the use of VR helped them to focus on the present moment by using visual and auditory elements of VR as attentional anchors.” The spatial presence of virtual environments allowed participants to practice mindfulness and meditation, positively affecting their mental health and well-being.

To Reduce Stress In the Workplace

A study out of England analyzed workplace stress specifically in the National Health Service (NHS) and tested the effectiveness of Virtual Reality in decreasing levels of stress and promoting overall well being. “Work-related stress, defined as ‘a harmful reaction that people have to undue pressures and demands placed on them at work’ is one of the most important emerging risks in occupational management and health.” This stress is threatening not only the quality of services provided, but the sustainability of vital healthcare systems and corporations around the world. Researchers provided a 10-minute VR relaxation experience to 39 trauma staff working in a fast-paced environment. Following the session, participants “reported significantly increased feelings of happiness and relaxation, and significantly decreased feelings of sadness, anger, and anxiety.” Furthermore, patients experienced a significant reduction in heart rate and yielded high acceptability ratings. Ultimately, the study found that VR relaxation sessions were beneficial to the health and well-being of healthcare workers, and many were excited at the opportunity to implement it into their everyday lives.

To Help Treat Opioid Addiction

VR mindfulness and relaxation are also being implemented in the midst of the opioid epidemic. This epidemic is an ever-so-present problem in our society, and the key to preventing further damage is by exploring viable alternatives to pain relief. According to The Gate Theory of Pain proposed by Melzack and Wall in 1965, “a person may interpret pain stimuli differently depending upon mental/emotional factors such as attention paid to the pain, emotions associated with the pain, and past experience of the pain.” Believe it or not, we can essentially “distract” our way out of pain. Virtual Reality addresses two of Melzack and Wall’s points – attention and emotional state. Through VR technology, patients can escape to an alternate reality, sending positive signals to their brain and subsequently lessening the pain they are experiencing. This technology dates back to 1996, when the Harborview Burn Center “successfully piloted the use of VR for burn patients with severe acute pain,” which inspired other providers to make VR technology accessible to patients experiencing acute pain. Recent studies have shown promising results for relieving chronic pain as well, patients reporting high levels of satisfaction and a significant reduction in overall pain. Although VR cannot fully take the place of opioids, it can definitely be used as an alternative for certain candidates, considering their level of pain and potential risk factors.

To Act As A Moderator of Psychedelic-Assisted Psychotherapy

Virtual Reality is another promising candidate as a moderator of Psychedelic-Assisted Psychotherapy (PP), a “unique psychopharmacological model that leverages the profound effects of the psychedelic experience.” PP is highly reliant on two key factors – the patient’s mindset and their surrounding environment. Consequently, meditation, relaxation, and visualization are supplemental tools in creating the most effective environment for this therapy. Virtual Reality is a promising candidate to provide these tools, given its evidenced capacity to “aid relaxation and reduce anxiety; buffer from external stimuli; promote a mindful presence; train the mind to achieve altered states of consciousness (ASC); evoke mystical states; enhance therapeutic alliance and encourage self-efficacy.” Because there was little empirical evidence on the joint application of VR technology in Psychedelic-Assisted Psychotherapy, researchers aimed to gather evidence on the ability to achieve a deeper sense of consciousness in a virtual environment.

They found 7 different ways that VR can be used to support psychedelic treatments:

1. Mitigate psychological side effects through enhancing the state of relaxation,

2. Help participants sustain their focus on intention by removing familiar cues that keep them tethered to their external world,

3. Encourage entering the inner world of experience by inducing a mindful presence,

4. Deepen the intensity of acute psychological and emotional states via simultaneous targeting of ME-evoking pathways,

5. Prime the capacity to achieve an altered states of consciousness (ASC) through familiarization and comfort with the ASC experience,

6. Enhance and maintain a hierarchy-free therapeutic alliance that is consistent throughout treatment,

7. Strengthen resilience and a sense of agency around facing challenging experiences.

It is also important to note the comfort and safety of the environments that VR provides, allowing patients to temporarily distract themselves from the emotionally taxing process of overcoming and treating PTSD or related disorders. Researchers ultimately recommend that VR be introduced into PP, as long as it is “developed in accordance with a robust protocol…and accompanied by thorough training of any practitioners involved in therapy.” Virtual Reality has the ability to transform the future of psychedelic treatments, as long as appropriate precautions are taken to not introduce disturbing or traumatic triggers or distract from the inner narrative.

The Foretell Reality platform provides safe VR environments to support various mental health treatment protocols including those that incorporate mindfulness training and relaxation experiences as part of the protocol. To learn more about our platform, please reach out to us for a demo.

Coaching, Soft Skills

Update with Video: Dating Coach Leverages VR to Improve Relationships from the Start

by Cameron Wong

April 7, 2022

Dating is hard. It was hard before the pandemic, but especially now as many singles are resuming in-person dating, it’s tough to ignore the social skills which atrophied over quarantine. While social encounters like first dates were always awkward, social anxiety is particularly (and predictably) acute post-pandemic, illustrating how many people could benefit from practicing social skills in safe, controlled, simulative environments. The pandemic saddled us with a “new collective experience of social anxiety,” prompting many to seek help reintroducing themselves into the dating pool.

Video captured during one of Grace Lee’s sessions in Foretell Reality.

That’s where someone like Grace Lee comes in. Grace is a dating coach who specializes in online dating: she helps curate your online profile, diagnose first date successes and mishaps, deepen your ability to connect on dates, and ultimately equip you to present a fully realized version of yourself to others. Her line of work falls into the category of soft skills training, forming the foundation of her partnership with Foretell Reality. Foretell Reality specializes in creating tools in Virtual Reality (VR) for soft skills development, corporate training, executive coaching, group and individual therapy, peer support, and other social situations where participants benefit from participating and practicing in VR.

But while soft skills like communication and empathy are increasingly valuable, both professionally and personally, they are very difficult to develop. Testing grounds like mock interviews and other role-play scenarios can be awkward at best and intimidating at worst. Trial-by-fire education, meanwhile, can lead to a slew of bad experiences and missed opportunities with little sense of progress being made. The convenience, accessibility, and anonymity VR offers address many of these issues, but even Foretell Reality General Manager Dror Goldberg acknowledges that “no matter how awesome the VR experience is, it eventually comes down to the specific curriculum and the specific instructor” helming the ship. Foretell, meet Grace; Grace, meet Foretell.

Recently, I interviewed Grace and Dror to learn more about the new partnership between Foretell Reality and Grace’s company, A Good First Date. We talked about the advantages VR offers for date coaching and soft skills development, the importance of virtual embodiment, and how the pandemic changed the worlds of dating and VR. From the outset, Grace made it clear that they were not working toward dating in VR. Grace firmly maintains that “through all of these changes,” both technological and epidemiological, “people who are looking for a real relationship want to meet in the real world.” VR is instead a revolutionary tool, improving elements of date coaching like conversing in a safe space, first date scenarios in romantic settings, live feedback between coach and trainee, and reflection by playing back a recording of the scene.

Given the importance of physical attraction in dating, it may seem counterintuitive that anonymized avatars are a key advantage of VR. But remember that this isn’t VR dating, it’s VR date coaching: you’re training for a date in-person by simulating dates in VR. “The use of avatars is of critical importance because of the anonymity it provides,” Grace explains. Avatars “take away the anxiety people have about their appearance,” allowing you to instead “show up as a neat representation of yourself and act more like yourself” for the simulated dates. Dror agrees that avatars “eliminate the obstacles to behaving naturally,” in VR scenarios, stripping date simulations down to the trainable elements: the dynamic of conversation and the art of getting to know someone.

Virtual avatars are a boon to soft skills training in general, as they allow users to feel more comfortable practicing social skills and sharing personal experiences in group settings. Embodied in a new persona, users can feel safer and behave more naturally without feeling exposed or judged. Avatars, as Dror puts it, present “a way to liberate yourself when you want to share emotions, when you don’t want to be stigmatized, when you don’t want to be judged,” a crucial advantage for date coaching in VR compared to coaching in-person. Dating is particularly personal and intimate, and the more comfortable individuals feel when practicing their first dates, the more effective date coaching will be.

The medium of VR also benefits instructors, as it transforms how instructors occupy space during simulations and equips them with quantifiable data for in-the-moment feedback. The ability to record and playback sessions beat-by-beat is highly valuable for instructors. How many times did you interrupt during a conversation? How many closed-ended questions were posed? Instructors in traditional settings may pick up on these trends in broad strokes, but with video feedback, “date coaching can become a measurable, iterative process.”

Watching replays of past date coaching sessions could be uncomfortable for users, but avatars provide a degree of separation which allows users to objectively self-reflect. Grace explains that with avatars, “people will be able to observe themselves, but in a way that doesn’t feel as embarrassing as it might if it was an actual video from real life.” VR also smoothens the trainer-trainee dynamic: normally, an instructor hovering over you while you try to ignore their presence leads to mixed results at best. In VR, however, the instructor can remain entirely invisible while observing the first date interaction between two participants. Instructors can choose to what extent they’re engaged in the simulation: they can remain entirely unheard and unseen, they can participate as an explicit third party, or they can provide live feedback to individual participants without the other knowing.

Toward the end of our interview, I asked Grace and Dror the same question pertaining to their respective fields: how has the pandemic changed dating and VR? Both responded with answers framed by the same theme: openness. Grace described how during the pandemic, “a lot of people started to question the way they were dating,” with social isolation in particular prompting people to “really look more seriously at pursuing a meaningful relationship.” As the pandemic precluded hookup culture and quarantine drastically constricted social circles, people became more open to the idea of forging a deep connection with a partner. A successful and genuine first date becomes even more important in a world where real-life social interaction is limited.

Dror’s answer echoed similar sentiments. Connectivity was what people missed most during quarantine, and many are now recognizing the need to develop technologies which bring people together digitally. Dror identifies how the pandemic “prepared the hearts and minds” of consumers to adopt VR technology. With restrictions lifting and many reentering the dating pool with a fresh mindset, now is the ideal time to learn how to bring substance and meaning to a relationship from the very first date. Substantial first dates can now be practiced and perfected in VR, equipping users with the experience and confidence to go from a good first date to a great new relationship.

Therapy and Support, VR-Related

How VR can address shortcomings of video-based group telemental health sessions

by Jillian Renken

March 30, 2022

In person group-based intensive outpatient programs (IOPs) have shown promising results for adults with serious mental illnesses. At the start of pandemic, these IOPs were forced to meet remotely through video-based telemental health (TMH) platforms presenting an opportunity to better understand the benefits and drawbacks of online group therapy.

A recent study from the Mayo Clinic focused on TMH group-based IOPs, providing insight into the effectiveness of and overall patient satisfaction with this type of treatment. Researchers interviewed 76 patients with diagnosed serious mental illness (SMI) who participated in an online video group based IOP.

Researchers gathered their data using a 17-item questionnaire covering 3 areas: “IOP TMH satisfaction, future recommendations, and video technology challenges.” According to the feedback they received, “the majority of patients reported high satisfaction, comfort, appropriateness, relevance, and compatibility” of the TMH service, 92.5% of them reporting “that they would recommend this service format to a friend or family member.” Most patients were glad to have the option for treatment during COVID, one even commenting that it was “just like being in a room full of people” and it “saved [their] life.”

Despite the fact that group telehealth was viewed favorably overall, there were reported challenges during the program. Slow internet connection, poor video camera quality, login problems, and accidental removal from the session were the most highly reported of these challenges. One of the participants noted that the Zoom meetings didn’t feel as welcoming, and “’there couldn’t really be a discussion [as if they were] sitting in the same room.’” Another wanted “more collaboration among the patients.”

Other participants wished they had used “’more of the Zoom features such as the whiteboard,’” or recommended “’some tabs to find things [easier].”’ There seemed to be a large disconnect with the learning materials in general. Patients suggested that administrators work on “improving the structure of the binder.” Some of the patients didn’t like the program at all because of the video format and desired something more immersive and interactive.

Though the study affirms that remote group therapy was well received in general, there were clear deficiencies noted. Virtual Reality (VR) for group therapy addresses many of these concerns and offers other benefits not possible through video-based TMH.

“poor video camera quality”

Instead of sitting in front of a camera, group therapy in VR allows participants to sit, lie down, or walk around in their physical environment. More importantly, everyone is portrayed as a personalized avatar which creates a consistent visual and auditory experience regardless of room lighting or camera or microphone quality. The need not to be on camera also takes away judgement of physical appearance and removes outside environmental distractions.

“there couldn’t really be a discussion [as if they were] sitting in the same room”

Unlike group video sessions in which everyone is arranged on a flat grid, VR sessions are held in a shared, 3D environment. This means that participants who look around the room will see one another from the same perspective as they would in the physical world. For example, to see the person who is slightly out of view to my left, I would turn my head in that direction and they would appear in front of me. Since everyone is sitting in a shared environment, they also see the same things as one another creating a stronger sense of connection.

“more of the Zoom features such as the whiteboard”

Just as with Zoom, VR offers many tools for collaboration and instruction including white boards, sticky notes, and media presenting. But VR also provides the ability to manipulate and pass 3D objects, draw in space, and watch fully enveloping 360 video.

“more collaboration among the patients”

True collaboration in Zoom in a challenge because we as humans collaborate in 3D space. VR provides the ability to collaborate in ways not possible on Zoom whether that means team building exercises, collaborative role play with avatars, or simple games that bring people together.

“improving the structure of the binder”

A foundation of many IOPs is the presentation of a structured curriculum which is outlined in binders provided to patients who follow along during each session. With limited space to view and absorb material, video sessions present a challenge when it comes to conveying this material. With VR, patients can reference their binder from their own personal screen while also collectively viewing material on the therapists screen(s). Navigating between materials and interacting with them is much more intuitive as it mimics the 3D world.

VR also provides benefits not identified above. For example, avatars allow for exploration of identity, role play activities and anonymity if desired. All or parts of sessions can be recorded and played back in 3D allowing for analysis and reflection from the group. And analytics such as time spent speaking and direction of gaze provide insights for both patient and therapist.

Foretell Reality is an avatar-based, multi-participant virtual reality platform specifically designed for group therapy and support. Please click here for more information or to schedule a demo.

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