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The Team at Yale Medical School Talks About Their Emotional Support Program for Adolescent Cancer Patients Using Foretell Reality

“It’s that point in growth where you are stuck. You’re in between childhood and adulthood. You are trying to work your way through … the social structure of the world.”

-Asher Marks, MD

“And then you throw a cancer diagnosis on top of that, and … everything else takes a back seat.”

-Amanda Garbatini, LCSW


Meet Dr. Asher Marks and Amanda Garbatini

At Yale Medical School, Dr. Asher Marks and Amanda Garbatini are at the forefront of bridging the gap between medical treatment and mental health support for adolescents with cancer. Their commitment to improving the well-being of these young patients is truly commendable. They work with a population with particular struggles, conducting clinical research using emerging technology and writing a protocol to address every possible challenge that might occur using virtual reality remotely with the pediatric population.

Research Population and Measures

One of the significant barriers to effectively treating adolescent cancer patients is their mental health. Anxiety and depression can hinder the healing process, making it crucial to integrate mental health support into their treatment plans. Yale’s groundbreaking research focuses on assessing the impact of VR-based interventions on adolescent cancer patients’ resilience, depression, and anxiety. By carefully measuring these parameters, they aim to understand how VR can be used to bolster psychological well-being during cancer treatment.

Results That Inspire Hope

The clinical progress observed through this innovative approach is nothing short of inspiring. Preliminary results indicate that VR experiences provided using Foretell’s platform can significantly enhance the resilience of adolescents with cancer while reducing their levels of depression and anxiety.

The Power of VR

Foretell’s VR platform offers a diverse range of activities that cater to the unique needs of adolescent cancer patients. From guided relaxation sessions to immersive experiences that transport them to serene environments, VR becomes a therapeutic tool to ease their emotional burden. As Amanda Garbatini aptly puts it, VR creates a “safe space” for these young individuals. It offers them a respite from the harsh realities of cancer treatment and allows them to explore soothing and engaging environments, fostering a sense of empowerment and control over their own experiences.

Conclusion

Yale Medical School’s collaboration with Foretell is an example of how innovative technologies can enhance the treatment of difficult diseases. By addressing the mental health needs of adolescents with cancer, they are not only enhancing their quality of life but also paving the way for connections, friendships, and support within an isolating journey. Through VR peer support groups, the journey of healing becomes a holistic experience that empowers young patients to conquer their challenges and emerge stronger than ever before.

Read the research protocol below:

JMIR Research Protocols – Use of Immersive Virtual Reality Spaces to Engage Adolescent and Young Adult Patients With Cancer in Therapist-Guided Support Groups: Protocol for a Pre-Post Study

About Foretell

Foretell is dedicated to improving the lives of patients and healthcare providers through the transformative power of virtual reality. To learn more about Foretell and how it is transforming the healthcare landscape, visit our website.

Therapy and Support

Group Therapy and Peer Support with Foretell Reality: Get to Know Each Other Anonymously, Overcoming the Fear of Stigma and Judgement

Introduction

In recent years, virtual reality (VR) technology has made significant strides in transforming the way we connect, communicate, and heal. One groundbreaking application of VR technology is in the realm of peer support and group therapy, where platforms like Foretell Reality are revolutionizing the way people access mental health services. In this blog post, we’ll explore 8 ways in which Foretell Reality is being used to provide an innovative and effective approach to support groups and group therapy.

1. Get to Know Each Other Anonymously

Foretell Reality provides a unique opportunity for individuals to participate in support groups and therapy sessions while maintaining complete anonymity. This anonymity is crucial for those who may fear judgment based on their physical appearance or social factors. With avatar representations and voice masking options, participants can engage authentically without the fear of being judged, enabling them to open up and share their experiences without reservations.

2. Practice Coping Skills with Immersive Exposure

VR offers an immersive environment for individuals to practice coping skills and emotional regulation techniques. Through immersion, users can confront and navigate challenging situations safely. This is especially valuable for those dealing with trauma, anxiety, or phobias, as they can gradually expose themselves to triggers in a controlled and supportive environment.

3. Stretch and Meditate in a Serene Temple

Foretell Reality offers a range of serene environments, including a meditation temple on a secluded island. These environments are designed to promote relaxation, mindfulness, and self-grounding. Users can engage in meditation and mindfulness workshops, fostering a sense of calm and inner peace in a tranquil virtual setting.

4. Share Your Feelings in a Safe Setting

In Foretell Reality, participants can communicate through 3D avatars, which enables natural communication using voices, body language, facial expressions, directional gaze, and hand gestures. This immersive interaction creates a sense of presence, facilitating more open and honest conversations compared to traditional video or phone calls.

5. Exercise and Play with Your Peers

Foretell Reality incorporates various activities and games that promote bonding and teamwork among participants. From ball games to spatial drawing, users can engage in playful activities that help break the ice and create lasting bonds. The platform also allows users to explore 360-degree images and videos together, fostering a sense of togetherness and shared experiences.

6. Engage in Fun Group Activities

The virtual environments in Foretell Reality are designed to evoke awe and create a sense of community. Users can engage in group activities like going to the movies, swimming, or sitting around a campfire roasting marshmallows. These environments support up to 25 active participants, and the number of seats can be adjusted to create an intimate setting, even when connecting with a larger group.

7. Express Yourself with 3D Art Therapy

For those who find it challenging to express themselves verbally, Foretell Reality offers a unique avenue for self-expression through 3D art therapy. Participants can create art in a virtual space, allowing them to convey their emotions and experiences in a creative and therapeutic way.

8. Relieve Physical Stress and Discomfort

Foretell Reality aims to make support groups and group therapy accessible to individuals facing physical and technical limitations. The platform offers both seated and walking modes, accommodating users with varying levels of physical mobility. Users can engage in activities and therapies that cater to their specific needs, reducing physical discomfort and barriers to participation.

Conclusion

Foretell Reality is reshaping the landscape of peer support and group therapy by harnessing the power of virtual reality. By eliminating barriers to access, offering anonymity, and providing immersive experiences, this platform is enhancing the way individuals receive support and connect with their peers. As we move forward, the potential for VR technology to revolutionize mental health care continues to grow, offering hope and healing to those in need.

Collaboration, Therapy and Support, VR-Related

Unleashing Joy and Healing: Foretell Reality’s Dog Park

One unique application of VR is found in Foretell Reality’s virtual dog park—a digital haven designed to combine the therapeutic benefits of social recreational activities and the unconditional love of our furry friends:  Crumb Bun, Gooby, and Mabel!

A “Pawsitive” Approach to Recreational Therapy

Recreational therapy has long been recognized as an effective way to enhance physical, emotional, and psychological well-being. Its goal is to help individuals cope with challenges, improve their quality of life, and achieve a sense of joy and accomplishment. With the advent of virtual reality, this therapeutic approach has taken a giant leap forward, allowing users to engage in activities that transcend the limitations of the physical world.

Step into the Virtual Dog Park

Imagine putting on a VR headset and finding yourself standing at the entrance of a picturesque dog park with an urban background, bathed in warm sunlight. Lush greenery surrounds you, and the air is filled with the joyous barks and playful antics of virtual dogs of different breeds and sizes. This is the virtual dog park offered by Foretell Reality—a digital space where users can immerse themselves in an oasis of serenity and happiness.

The Healing Power of Interaction

The heart of the virtual dog park lies in its lifelike interactions. Users can approach the virtual dogs, kneel down, and even pet them using VR controllers. They can also give them treats, throw them toys, and play games with them and their peers. Studies have shown that physical interaction with animals can lead to reduced stress, lowered blood pressure, and increased release of oxytocin—the “bonding hormone.”

A Sense of Presence and Belonging

For those who may be physically restricted or unable to access traditional outdoor spaces, our virtual dog park offers a unique opportunity to connect with nature and animals as well as bond with other people. The immersive environment fosters a sense of presence and belonging, allowing users to temporarily escape from the confines of their physical limitations and experience the joys of being outdoors and surrounded by the companionship of dogs.

Tailoring the Experience

Foretell Reality’s virtual dog park allows users to customize their surroundings, choosing from various interactive elements like a hot dog cart, a swing set, and a dock on a lake. You can sit in a semicircle and have a discussion while the dogs come to you to play or choose a more active setting to play around with the dogs and chase them around.

The Therapeutic Potential

While the virtual dog park undoubtedly offers moments of fun and delight, its potential for therapeutic use is profound. Research has demonstrated that interactions with animals, even in virtual environments, can help alleviate symptoms of anxiety, depression, and loneliness. Moreover, the sense of accomplishment that comes from bonding with virtual dogs and engaging in playful activities can boost self-esteem and overall mental well-being.

Closing Thoughts

As technology evolves, so too does our understanding of its potential to improve our lives in unexpected ways. Foretell Reality’s virtual dog park is a shining example of how virtual reality can be harnessed for recreational therapy, offering individuals a chance to experience the joys of canine companionship and the healing power of nature, regardless of their physical circumstances. With each interaction, users can find solace, happiness, and a renewed sense of connection—one virtual dog park visit at a time.

Coaching, Collaboration, Other, Soft Skills, Therapy and Support, VR-Related

Explore Foretell Reality’s Accessibility Features

At Foretell Reality, our mission has always been to create inclusive and immersive experiences that enhance human interaction. We believe that emerging technology should be accessible to everyone, regardless of their abilities or preferences. This month, we are thrilled to showcase our commitment to accessibility and highlight the various options we have integrated into our platform to enhance user experiences for individuals with diverse needs.

1. Closed Captioning for a Seamless Visual Experience

Understanding the importance of accessibility in media content, we have taken significant steps to ensure no one is left out of the experience. With the addition of closed captioning, our users can now enjoy private and group conversations, irrespective of hearing impairments. Whether it be a group conversation or a one-to-one private chat, closed captioning ensures that the narrative reaches everyone.

2. Enlarged Text for Improved Readability

We recognize that users may have varying visual capabilities, and reading small text can be a challenge for some. To address this, we’ve introduced an option to enlarge text across our entire UI system, including notifications, closed captioning, and tooltips. By making text size customizable, users can adjust it to suit their comfort and avoid eye strain, providing a more enjoyable reading experience for all.

3. Real-Time Spoken Notifications for Visual Impairments

For individuals who face difficulties in visually identifying notifications, we’ve incorporated a spoken notification feature. Users now have the option to receive the notifications in spoken form, ensuring they never miss an essential update.

4. Optimized App for Colorblindness

Accessibility shouldn’t be limited to 95.5% of the population with great color vision. Color plays a significant role in design and user interfaces, especially in VR. Foretell’s new design ensures that vital information is conveyed through visual cues such as tooltips, icons, and animations, allowing colorblind users to engage seamlessly with the platform. We have also redesigned the color scheme to be higher in color contrast, accommodating the potential needs of those who are colorblind.

5. Single-Hand Mode for Different Levels of Mobility

For individuals with both temporary and permanent mobility issues, we’ve implemented a single-hand mode feature. Navigating through our platform using just one hand is now possible, providing greater convenience to those who may have limited mobility.

At Foretell Reality, accessibility is an ongoing journey, and we remain committed to continuously improving and expanding our features to cater to diverse needs. We firmly believe that everyone should have the opportunity to explore and enjoy the wonders of virtual reality and related technologies.

VR is a technology that can unite people from all walks of life but is still behind on some critical accessibility features offered in other devices like phones and computers. At Foretell, we are mindful of the different population segments, as we enhance our platform to foster a culture of inclusivity and empowerment.

Stay tuned for more updates on accessibility and other exciting features from Foretell Reality!

Industry News, Other, Therapy and Support, VR-Related

Foretell Reality at AWE with Yale University

Asher Marks, MD, Medical Director of Pediatric Neuro-Oncology at Yale University School of Medicine, recently spoke at AWE Europe about his collaboration with Foretell Reality. Featured alongside CMO of the Glimpse Group, James Watson, Dr. Marks explained the value of VR in clinical treatments for pediatric cancer patients, a support group therapy in VR, and why the Yale School of Medicine chose to partner with Foretell Reality.

“We needed a company that was going to work with us to customize the experience for what we felt our patients needed, and what our patients said they needed.” Yale Oncology Department chose Foretell because it is a peer-to-peer secured application, has great spatial audio, is hardware agnostic, and is customizable, Dr. Marks says. In his talk, Dr. Marks also highlights how VR has a lack of distraction, includes body language, a shared space, and opportunities for self-expression through avatars. His study participants followed his sentiment, saying “I preferred VR to Zoom due to the fact that it felt more immersive as though I was leaving my house to attend group”. “I would prefer a VR group to a Zoom group, as this feels more immersive” another participant agrees.

“Participation went from 0% to 73% when we put our patients into social VR support groups,” said Dr Marks, highlighting the significant impact the VR-based cancer support groups have had. “It was extremely helpful to be able to vent to people who actually get it”, adds another cancer participant. The support groups aimed to improve psychosocial care for cancer patients aged 18-25. But using the phone was their grandparents’ technology, and using Zoom was their parents’ technology, Dr. Marks says. VR, however, was something new and exciting. As an added benefit, the groups allowed patients with Leukemia to interact without having the increased risk of infection spread. Some patients joined support group sessions from the hospital, and some others were homebound. “I think I greatly benefitted from the group and it made me feel less isolated”, says a patient after participating in the program.

After over 9 months of detailed planning, Dr. Marks and his team ran Phase 1 and 2 pilot clinical trials with assessment tools such as resilience surveys to measure results. The average participant age was 19, and the most common diagnosis of participants was Acute Lymphocytic Leukemia. They had four patients per group, a professional social worker, and an invisible observer. The results were very encouraging: they found statistically significant improvements in resilience. “I was a little embarrassed to be myself, but this group provided me with the confidence to be myself.” adds one member.

Following this collaboration, The Glimpse Group is working to make the implementation, management, and measurement of XR technology in healthcare easy, and to promote more studies and partnerships. As XR becomes more mainstream, the cost of entry will become more affordable, Asher Marks adds. One of the major benefits of this study will be that it sets a precedent for other healthcare organizations, as mentioned in their Q&A.

Virtual Reality Reminiscence Therapy
Mindfulness, Therapy and Support, VR-Related

The Power of Virtual Reality Reminiscence Therapy

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. 

VR for Agoraphobia
Therapy and Support, VR-Related

Virtual Reality to Treat Agoraphobic Avoidance

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

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.

Mindfulness, Therapy and Support, VR-Related

Four Real World Examples of VR for Mindfulness and Meditation

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.

virtual reality (VR) zoom fatigue
Therapy and Support, VR-Related

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

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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