Words are powerful and the way we talk to ourselves can have profound effects on self-image, how we interact with others, and how we handle life’s stressors. And even if we understand the value of compassionate words, we may find it much easier to extend them to family, friends, and strangers than to ourselves. 

Our internal voice can be overly harsh and critical at times, but for those suffering from depression, that negative self-talk can lead to a debilitating cycle that is difficult to escape. A recent Science Focus article on VR’s impact on mental health highlights a recent study that seeks to dampen this voice. Professor John King and Dr Emma Jayne Kilford at University College London are creating a virtual reality intervention that supplements face-to-face therapy with the goal of strengthening one’s ability for self-compassion. 

The intervention consists of a virtual room that includes two avatars – a child and an adult. The avatars can be designed to look like the participant presently and as they looked in childhood. Before entering the virtual room the participant learns a “compassion script” that includes three strategies to improve the mood of someone in distress – validating experience, redirecting attention, and activating a positive memory. The participant then enters the room in the role of the adult with the task of speaking to the child until the child’s distress is lessened.

Next the participant enters the room as the child and watches the play-back of the avatar representing their adult self. As the child avatar, the participant is experiencing receiving compassionate words from his/her adult “self”. 

A larger trial is now taking place, based on initial results of a sample of very self-critical or depressed patients. The initial results are promising, showing a reduction in depression and self-criticism and improvement in self-compassion. 

Foretell Reality can not only create scenarios for practicing self-compassion but as a multi-user platform, we can create role-play scenarios with other participants to increase empathy, which is fundamental to implicit bias and other types of training or therapy exercises.  

Virtual Reality (VR) is often touted as an ‘empathy machine’ for its ability to change pre-conceptions by providing a convincing experience from someone else’s point of view. Whether to combat racism or bullying or increase medical school students empathy toward patients, VR is increasingly being used as a tool to challenge biases and encourage compassion and understanding.  

There are various ways to design VR experiences that facilitate this type of introspection including role play with avatars, narrative storytelling, simulations, and 360 video. A recent study focused on the latter approach to determine whether a 360 video in VR taken from the point of view of a woman would increase empathy in men about what it is like to face sexual harassment.

The study, titled ‘The impact of 360 video in VR on How Does It Feel to Be a Woman Victim of Sexual Harassment? The Effect of 360°-Video-Based Virtual Reality on Empathy and Related Variables,’ recruited 44 men in Mexico City and had them experience two different conditions. In one condition, participants watched the 360 video in VR to experience what it is like to be a female victim of sexual harassment (SH) from a first-person perspective. In the other,  the same story was presented in text format and the participants had to imagine the content of the story as if it were happening to them. 

Among the findings were:

“A tendency (marginally significant) to experience higher empathy after the 360° video than after the narrative. Furthermore, we found a carryover effect of the 360°-video condition. That is, empathy after the narrative was significantly higher when the 360° video was presented before the narrative task rather than after it.”

“Regarding the sense of oneness and perspective taking, [participants] were significantly higher after the 360° video than after the narrative task. A carryover effect on perspective taking was also found because scores in the narrative condition were higher when the 360° video was presented before the narrative task than when it was presented after it.”

In summary, the researchers concluded: 

“Despite its limitations, this study raises new possibilities in the prevention and treatment of SH toward women. Empathy, perspective taking, and sense of oneness could be target therapeutic components in interventions designed to decrease SH behaviors through a VR tool that is affordable for clinicians.”

Among other features, the Foretell Reality Virtual Reality (VR) platform provides the ability for one or more people to experience 360 video and then meet together as anonymous avatars to discuss the experience. We welcome partners interested in leveraging this and other tools to overcome biases and increase empathy. Click here for a demo or to contact us.

Binge eating disorder (BED) is characterized by episodes of eating large amounts of food while experiencing a loss of control. It is the most common eating disorder in the United States, and it can be life threatening if not addressed.

To treat the condition, cognitive behavioral therapy is often applied but, according to researcher Stephanie M. Mannasse, this type of treatment is largely ineffective at targeting the loss of control because it is difficult to transfer treatment gains to real-world eating behavior. 

To address this issue, Mannasse developed a proof-of-concept study and enrolled 14 adult subjects with a recent history of binge eating into a two-week Virtual Reality (VR) training program. The training followed a go/no-go paradigm.

“Throughout a series of trials, subjects were shown realistic 3D models of either a binge food item (e.g., pizza, fries), a fruit or a vegetable, or a neutral item (e.g., bowl, fork). The binge food items were paired with a “no go” cue, fruits and vegetables were paired with a “go” cue, and neutral items were paired with a “no go” cue half of the time and a “go” cue the other half of the time.” 

Clinical interviews were conducted before, during, and two weeks after the training program and the following results were noted:

• Subjects showed reduced binge eating behavior throughout the training.
• Bingeing episodes continued to drop during the two-week follow-up period.
• Subjects rated most aspects of the training favorably, with many indicating that it was easy to use.
• Participation was high, with subjects missing an average of only one training per week.

The power of VR to change behavior in this study can be further extended and enforced by bringing people together who are also fighting BED in safe, anonymous, moderated VR environments.

The Foretell Reality platform offers features, tools, and spaces for VR support groups, VR group therapy, and other social behavioral treatment approaches like role play and guided exposure therapy. To schedule a demo, click here.  

The recent pandemic has drastically changed nearly all aspects of our lives. Stay at home orders are causing people to feel confined and anxious and the closure of gyms, parks, and community centers have forced millions to suddenly adopt a sedentary lifestyle. The WHO recognizes the pandemic as posing a significant threat to global mental health, stating that quarantine and self-isolation can lead to negative feelings such as “stress, depression, irritability, insomnia, fear, confusion, frustration, and boredom”.

Many studies have shown the efficacy of Virtual Reality (VR) for helping people manage stress, anxieties, and depression. VR has also been shown to promote physical well-being. Physical movements exerted through virtual reality games like Beat Saber can greatly increase heart rate and burn hundreds of calories in a single session. 

Now a study conducted by Alessandro Siani and Sarah Anne Marley, two leading faculty members at the University of Portsmouth’s School of Biological Sciences, has aimed “to evaluate the effectiveness of VR as a physical and mental health aid for people observing social distancing due to the Covid-19 pandemic.”

Here are some highlights of the study which consisted of surveys submitted by 646 participants from around the world:

• Over 75% of participants agreed or strongly agreed that their use of VR increased during the pandemic.
• Over 60% of participants agreed or strongly agreed that VR was a good way to keep fit during lockdown
• Close to 80% of participants agreed or strongly agreed that VR has a positive impact on their mental health during lockdown

In conclusion, the researchers stated: “The majority of the population surveyed in this study, regardless of their gender and age, reported that their VR use has increased during the lockdown, and expressed overwhelmingly positive opinions on the usefulness of VR as a way to keep busy and improve their mental and physical wellbeing.” 

The Foretell Reality platform offers features and environments for support groups, 1:1 and group therapy, and guided stress and anxiety relief.  

With suicides in the military up more than 20% this year from 2019, the United States Department of Defense recently announced the use of a VR training program designed to help prevent suicide among Air Force veterans. The program features a 30-minute VR training scenario in which participants must convince an airman to seek mental health support during a period of emotional distress. 

Participants must ask the airman, who is powered by artificial intelligence (AI), a series of prewritten questions. Those who struggle to effectively ask these questions will receive assistance from a qualified mental health professional. The coaching is intended to help both veterans and their spouses better understand what questions to ask, how to properly respond, and why one should ask these questions.

“The unique part of this VR training is that it’s voice-activated, so you’re required to say things out loud that maybe you’ve never had to say before,” explained Master Sgt. Shawn Dougherty, a VR facilitator at Travis Air Force Base, which is one of the locations utilizing VR suicide prevention training. 

Virtual reality provides a unique opportunity for individuals to confront challenging interpersonal situations through realistic simulations. In the instance above, this is accomplished through the use of an AI ‘bot’ but the same types of simulations can also take place with other real people. 

Foretell Reality is a social Virtual Reality (VR) platform for support groups, group therapy, guided exposure therapy, and other therapeutic practices like role playing and mindfulness training.

Foretell Reality’s social capabilities can be particularly effective in addressing various behavioral health issues when combined with programs originally designed for single individuals. In the example above, veterans and their spouses could join support groups in VR after navigating the solo training in order to talk about their experiences. Further, the AI bot in the simulation could actually be replaced by another real person which could allow for more unscripted and exploratory treatment options. 

Interested in learning more about social VR for behavioral health? Schedule a demo.

Patient benefits of cognitive behavioral group therapy (CBGT) are well-supported and include group cohesiveness and interpersonal learning. And from a therapist perspective, the delivery of treatment to multiple patients at once is time-efficient.  CBGT is a particularly effective treatment for depression, but due to factors such as inaccessibility and social anxiety, a significant number of patients with depression drop out of therapy or do not attend at all. 

To reduce barriers to treatment for depressed patients, digitally-enabled formats are on the rise in healthcare. Virtual reality group therapy (VRGT) allows patients in any location to gather and interact in a computer-generated environment that feels real.  Two VR studies have shown a decrease in depression symptoms in widowers and patients with disabilities, but neither study used group therapy as the format, nor were the studies specifically developed for depressed patients.  For the first time, a recent qualitative study assessed the views of stakeholders (patients and therapists) on CBGT experienced in a virtual reality format.  

The study’s findings were generally positive and coalesce around several themes. Patients cited the ease of attending a session from home, which is particularly useful for those with physical disabilities and social anxiety. The use of an avatar was also generally regarded as positive, since depressed patients may not be motivated to tend to their personal appearance and appreciate the anonymity that the avatar provides. Avatar usage may increase engagement because “a patient talking about their problems cannot see whether other patients are judging them or look bored and disengaged.” Patients and therapists both cited the anonymity of avatar-based group therapy as minimizing patients’ social anxiety because it takes away the fear of being recognized. 

Foretell Reality has developed an avatar-based, multi-participant virtual reality platform specifically designed for group therapy. We work with our clients to customize the software to fit their needs. Click here to view a short video or here to schedule a live demo.

Great conversation with A Fine Time for Healing podcast host Randi Fine this morning. We were joined by XRHealth‘s Dr. Orit Avni-Barron to discuss various applications of Virtual Reality (VR) for behavioral health. The hour flew by and we covered a lot of ground.

The podcast was broadcasted live and will be archived here as well as on Apple Podcasts, iHeart Radio, Stitcher, Podbean, Podbay, TuneIn, Player FM, Podchaser, Listen Notes, Castbox, Podfanatic, and Ivoox.

A recent article in the New York Times highlights the particular challenges of addiction treatment during the pandemic. The article contends that, at its core, addiction is often fueled by feelings of isolation and disconnectedness and the inability for people to meet together and with clinicians and facilitators has lead many to relapse or worse.

How could Virtual Reality (VR) help? The article highlights several areas where the feeling of presence, focus, and connectedness afforded by VR could lessen the feeling of being alone and more closely represent the therapeutic benefits of in-person interactions.

A Shared Experience

Excerpt from NYT Article: “In the 80-year history since addiction treatment began, we’ve never experienced anything as challenging as this,” said Marvin Ventrell, chief executive of the N.A.A.T.P. “You have to put people in social settings to heal, and Covid conspires against that.”

VR replicates the feeling of being physically together with other people. Everyone in a VR environment sees the same thing as everyone else just as they would if they were sitting together in a shared space. If you and I look out the window to our left, we will see the same scene regardless of where we may be in the real world. This is in sharp contrast to video calls where participants are stacked together in boxes, each in their own world, with no common point of view or ability to truly share in the same experience; a situation that can actually lead to greater feelings of isolation.

Avatars that Emote

Excerpt from NYT Article: “What is more supportive than walking into a room and seeing a human you can touch?” asked one client, Maureen. “What’s been missing is body language, our ability to hug each other. All that stuff is important when people are going through the difficult experience of getting off drugs or alcohol.”

The feeling of proximity in VR is unlike any other digital medium. Lifelike avatars can gesture, point, fist bump, high five, and even hug resulting in sensory feedback (haptics) through the controller. Objects like balls can be passed between people sitting in natural relation to one another and spatial audio allows for more authentic conversation flow. Though VR is not an ultimate substitute for physical human interactions, it is as close as we have to that sensation and, with continuing improvements to avatar expressions, movements, and haptics, the line will only blur further between mind and virtual body.

Focused, Distraction-free

Excerpt from NYT Article: “Many of our clients were riddled with fear and anxiety,” said Rose Foley, who runs mental health services for a Hazelden Betty Ford center in Chelsea, Manhattan. “I remember working with clients and hearing the sounds of sirens from outside their apartments. It was a traumatic time.”

Group and one-on-one video sessions are prone to both technical and situational intrusions. For those seeking help, these distractions can be frustrating and can adversely affect the healing process as they break the sense of connection and togetherness. VR headsets are self-contained units that block out visual and auditory interference. Since everyone is using the same device, the experience is consistent among all participants which leads to a more focused sessions in environments designed to induce a sense of calmness and safety.

Accessibility Meets Control Over Identity

Excerpt from NYT Article: Some positives have come from virtual care. John Driscoll, head of recovery services at Hazelden Betty Ford, said the number of patients choosing to attend sessions biweekly has doubled. The organization’s recovery program for families, which used to be local, is now on video and open to families around the globe, serving more than 2,500 people since the summer.

If there is a sliver lining in the challenges of the last year, it is that access to and utilization of telebehavioral health has increased dramatically. While in-person treatment may still be ideal, the ease of joining remote sessions has reduced barriers and stigmas to those seeking help who otherwise might not have tried. Though not yet as omnipresent as smartphones and laptops, VR offers the same ability to connect with anyone around the globe but with the added advantage that those who wish to remain off camera or anonymous are not left feeling excluded. VR creates a level social playing field where identity is fully in the hands of the participant at any stage of the process. This allows people to explore treatments before committing and removes the self-consciousness that comes with appearing on camera throughout the treatment process.

Beyond Four Walls or a Screen

As the vaccine rollout gains traction and we are eventually able to return to our normal lives, there will still be a prominent role for VR in addiction treatment in the following capacities:

• Remote Treatment: Even when the pandemic ends, there will be many people who seek remote treatment for a variety of reasons (affordability, accessibility, anonymity).
• Ongoing support: Those who have left a treatment center can continue to meet with peers and with counselors in a familiar shared space.
• New treatment models: Role play, withdrawal distraction, and exposure therapy both outside and within centers can offer alternatives to traditional treatments.

At Foretell Reality, we work with our partners to develop behavioral health applications that bring patients and clinicians together in VR environments for connection and healing. Both now and into the future, we see a tremendous opportunity to work with addiction treatment centers and facilitators to help those in need of connection and care.