Tele-health options are on the rise in recent years, and have especially flourished during the COVID-19 pandemic. Mental health therapy has evolved from largely in person-only to including other methods like web-based applications (e.g. Zoom) and Virtual Reality (VR) that make health care accessible in the comfort of one’s home without the constraints of transportation and other logistical barriers. Researchers are beginning to study the dynamics of virtual communication and how this medium compares with face-to-face conversation. Findings can be especially relevant for mental health therapists who seek to provide the ideal environment for patient comfort to disclose thoughts and feelings, thereby facilitating more effective therapy. 

At Edith Cowan University in Australia, researchers studied social interaction in two contexts – one in which participant and researcher engaged in casual conversation, and the other in which the participant was instructed to disclose both positive and negative personal experiences to their research conversational partner. These contexts were studied within a face-to-face condition as well as a virtual condition, wherein the researcher was represented via avatar in real time through face and body motion capture.

While participants had an overall slight preference for face-to-face interaction, one of the findings is of particular relevance to mental health practitioners. In the disclosure of negative information context a significant portion of the participants (30%) preferred the interaction with the avatar over the in-person conversation, specifically on the facets of self-disclosure, comfort, and being able to relax and be oneself. The researchers suggest, “the increased sense of interpersonal distance in VR may be why some of our participants indicated such preferences for VR over face-to-face for negative disclosure”. Furthermore, they surmise that a study conducted specifically with a socially anxious participant population could yield an even greater preference for virtual reality when disclosing negative experiences.

It also makes sense to consider that participant comfort level with the avatar could be higher in conditions that more closely align with communication norms. In the present experiment, the virtual partner, represented through an avatar, was standing while the participant was sitting.  This dynamic of the participant sitting while the avatar stood had the potential to lessen participants’ level of comfort and ability to relax, as it may have felt more unnatural. Ideal study conditions would have mimicked the typical conversational interaction of two people sitting and speaking (as was the case in the face-to-face interaction), but researchers had the avatar standing behind a desk in the VR condition to avoid a potentially distracting technological effect of the avatar “clipping” with the table. Clipping is a technical glitch that can be easily avoided with a careful design of the VR environment.

Also, in this study, only the research conversational partner was represented via avatar while participants were not. Participants were aware that they were not anonymous as their conversation partner could see them sitting with a VR headset on. Further studies that allow participant anonymity that shields identity through an avatar could be useful to mental health practitioners. For many suffering with anxiety and depression, their physical appearance (for example, due to hair loss associated with chemotherapy or body image issues) can be a deterrence to participating in group therapy. It may be possible that the avatar anonymity in VR could increase their willingness even more to disclose information and participate in group discussion.

Foretell Reality is a VR platform that provides safe, secure environments, customizable avatars, and moderation tools for clinicians to facilitate individual and group therapy sessions, support groups, and other behavioral health treatments.

Speaking with a therapist or social worker over video has become much more commonplace over the past two years for obvious reasons. The experience, though not perfect, provides for ‘face-to-face’ communication, albeit in two-dimensional space, and it addresses the need for remote treatment which is critical.

The same cannot be said when it comes to group therapy and support. The Brady Bunch style grid of faces on a flat screen simply does not work well when it comes to facilitating open and natural group conversation.

Virtual Reality offers an alternative to video, one that realistically mimics a group setting and the dynamics of group interactions in three dimensions rather than two. Not only that, features such as personalized avatars, shared customizable environments, and moderator controls provide certain benefits not possible online and even with in-person groups.

Below are examples of five groups where VR offers specific benefits over video.

Rare Diseases

People with the same rare diseases and their families face many unique challenges including physical limitations, lack of information, and the ongoing emotional toll of living with uncertainty. Support groups in VR offer an alternative to having to be on camera whatever condition you may be in. Everyone in the group appears as a playful though expressive avatar adding levity to difficult conversations. And VR is an amazing tool for sharing information whether it is videos, websites, or even 3D models and 360 videos related to a particular condition.

Recovery

Anonymity is critical to many people seeking recovery, particularly for those who may be well known in their profession or community. This dissuades many people from seeking the support of others. VR allows complete anonymity through an avatar and voice masking while also providing the feeling of shared presence that is core to the support group experience.

Dialectical Behavioral Therapy (DBT)

Group sessions are one of the main activities in DBT therapy. Each session follows curriculum developed by clinicians and lead by trained therapists. Sessions can cover concepts like distress tolerance, acceptance, and mindful awareness and involve sharing of videos and other materials as well as role play. VR is a very powerful tool for mindfulness exercises and it has often been called the ’empathy machine’ for its ability to change ingrained attitudes and behavior.

LGBTQ+

We wrote a recent blog post about the challenges and opportunities social VR presents for the LGBTQ+ community. Safe, secure support groups lead by either a peer, social worker, or clinician offer an alternative to those who want to remain anonymous but also still feel viscerally connected to others. Avatars also offer a unique opportunity to explore identity and empowerment without the constraints and limitations of real world appearances.

Autism

Autism is a spectrum disorder meaning it affects everyone differently. Adults and children with autism may have varying levels of challenge with behavior, social skills, verbal and non-verbal communication, and sensory and attention issues. A tailored group experience in VR lead by a trained therapist offers a focused and controlled experience not possible online. Spaces specifically designed to feel calming and comfortable can also allow for practicing social skills and interpersonal communication through avatar role play. Similarly, the anonymity afforded by an avatar facilitates open conversation and provides an avenue to explore facial expressions and gestures.

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.

According to the Mayo Clinic, “socializing not only staves off feelings of loneliness, but also it helps
sharpen memory and cognitive skills, increases your sense of happiness and well-being, and
may even help you live longer.”

But what do you do if in person social interactions could be dangerous to your physical health?

A recent study out of the Netherlands analyzed the psychological benefits of using social virtual reality
platforms during the COVID-19 pandemic. Researchers posited that “by offering (virtual) spaces where users can hang out, chat, and play games together in apparent physical proximity, social VR apps could be especially well-suited to foster feelings of social connection among users.”

Based off a dataset of 220 surveys of respondents who were active users of social VR platforms during the pandemic, the study looked at how both social presence and spatial presence affected three different areas – relatedness, establishing meaningful and rich social interactions, self-expansion, going into unchartered territory to widen our understanding of who we are and how we view life, and enjoyment, taking pleasure in something.

After analyzing the results of the surveys, researchers wrote that the “findings suggest that social VR can provide psychological benefits in terms of relatedness, self-expansion, and enjoyment, which are associated with the immersive properties of the medium.”

Among the study’s highlights:

Spatial presence predicts relatedness, self-expansion, and enjoyment.

A sense of spatial presence, a “users’ sense of being physically located in, and enveloped by, the virtual
environment,” was a key contributor in relatedness, self-expansion, and enjoyment. Directly
interacting with a virtual environment elevated the user experience and made social VR
platforms much more rewarding through the natural interactions that it fostered.”

Social presence predicts relatedness and enjoyment, but not self-expansion.

The feeling of social presence, “a users’ sensation of being physically co-located and socially connected with others,” was another predictor in relatedness and enjoyment but did not involve self-
expansion.

Playful activities are associated with self-expansion psychological benefits.

Contrary to popular belief, taking part in playful activities, such as gaming or
exploring virtual worlds correlated with a high level of satisfaction and obtained psychological
benefits. Socialization activities are associated with relatedness and enjoyment outcomes.

With Omicron potentially signaling the end of the pandemic, social distancing guidelines will be rescinded, but the need for social VR platforms will not waiver. Terminally ill hospital patients, people with
high social anxiety, or even shy teens can fulfill their needs for social interaction through virtual
reality. According to the researchers, in a low-risk environment that offers anonymity, “social VR
can help users satisfy their psychological need for relatedness, that is, the need for establishing
meaningful and rich social interactions, which is considered a fundamental human
psychological need.”

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.