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

by Pia Behmuaras

November 27, 2023

“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.

VR-Related

Social Prescription with Virtual Reality

by Pia Behmuaras

February 15, 2023

What is Social Prescribing?

Social prescription is a method used by healthcare professionals to refer patients to non-medical sources of support, such as community groups, charities, or arts and leisure activities. These activities are normally conducted in community centers or social settings. The aim of social prescribing is to help address social, emotional, and practical needs that may be contributing to their health condition.

Why VR?

Virtual reality (VR) is conducive to social prescribing as a way to provide people with non-pharmacological interventions for a range of physical and mental health conditions. VR is a technology that supplements in-person or online activities, as well as a standalone intervention. One example of social prescribing in VR is recreational therapy, where patients get together with therapists virtually to play games and sports or to try out new hobbies.

VR transcends the limitations of social prescribing exercises in person because it removes the logistical hurdles of transportation, space, and required equipment. It also surpasses the capabilities of video calling by allowing participants to interact with each other and virtual objects in three dimensions. It offers simulations that would not be accessible in any other format due to the high cost, the physical and mental availability of patients, or even the rules of physics and nature.

How is Social Prescribing Used?

Overall, the use of VR for social prescribing can be a powerful tool for providing non-pharmacological interventions to patients and helping them to improve their physical and mental health. To use VR for social prescribing, healthcare professionals first assess the needs of their patients and determine which VR experiences would be most appropriate. Next, they refer the patients to the right VR program and follow up to monitor their progress and adjust the intervention as needed. This process is sometimes complemented by metrics provided in VR apps such as speaking time, gaze, and other biosensors if provided by the platform and accompanying hardware.

VR Social Prescribing for Mental Health

Luckily, social prescribing in VR can be an effective intervention for many different groups of people with a variety of mental health conditions. Some common examples are as follows:

Anxiety and stress: VR programs that use techniques such as exposure therapy or relaxation training can be helpful for people with anxiety and stress. For example, a VR program might involve mindfulness meditation workshops for multiple people to come together regularly in VR.

Social isolation: VR programs that offer social support and connection can be helpful for people who are isolated or lonely. For example, a VR program might connect patients with similar health conditions in virtual reality support groups, allowing them to share their experiences and offer each other support.

Other mental health conditions: VR programs that offer cognitive behavioral therapy or other mental health treatments can be helpful for people with mental health conditions. For example, a VR program might involve helping a patient with depression to identify and challenge negative thought patterns by utilizing behavioral therapy techniques like cognitive restructuring.

VR Social Prescribing for Physical Health

Chronic pain: VR programs that offer guided relaxation stretching or yoga exercises can be helpful for people with chronic pain. For example, VR programs that guide patients through a series of stretching exercises and relaxation techniques can help them manage their discomfort and learn from each other. When these sessions are conducted in groups, it can encourage participation and build a sense of community over time.

Physical rehabilitation: VR programs that involve virtual reality exercise and movement can be helpful for people undergoing physical rehabilitation. Especially because they can be done from home at the patient’s will. As an example, a VR program might involve recreational therapy activities like VR golfing or ping-pong to help them regain strength and mobility after an injury or surgery. This, in turn, can help them maintain their mental health as well.

These are just a few examples of how VR can be used for social prescribing. VR programs can also be tailored to the specific needs and goals of the patient, making them a highly flexible and effective tool for improving health outcomes.

Foretell Reality

Foretell Reality is a VR platform used to enhance social interaction by allowing professionals to conduct group or one-on-one sessions with their customers. Among our use cases are support groups, soft skills training, exposure therapy, and recreational activities like roasting marshmallows and playing the guitar by a campfire. We offer professionals customizable solutions that are most appropriate for their patients and use cases. Please visit our website to schedule a demo.

References:

Can digital technologies play a role in social prescribing models? (theiet.org)

VR Applications: 23 Industries using Virtual Reality (virtualspeech.com)

Loneliness and Social Isolation – HelpGuide.org

ChatGPT: Optimizing Language Models for Dialogue (openai.com)

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

Foretell Reality at AWE with Yale University

by Pia Behmuaras

December 13, 2022

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.

VR-Related

VR for Spatial Navigation Training

by Pia Behmuaras

September 30, 2022

Capacities of VR

Virtual reality (VR) is a computer-generated technology that creates immersive and interactive experiences transcending physical boundaries. Currently used by clinicians and therapists alike, VR can assist many types of physical and mental rehabilitation programs. This includes the clinical assessment, training, and feedback on performance for spatial navigation challenges.

VR helps scientists measure the strategies different age groups and primate species use for navigation. In evolutionary psychology, it is used to test spatial cognitive abilities such as learning, memory, and spatial navigation. Studies examine navigation through mazes and environments with various 3D and 2D landmarks and sometimes track neural activity.

Researchers use VR in one of the most challenging areas in neuroscience: the investigation of cortical mechanisms. It is technically challenging to perform neurophysiological recordings on people who move freely and navigate various scenarios throughout the day. So, VR offers control over landmarks, distractions, and spaces to assess attention and behavior.

Treatment and Rehabilitation

A study shows that VR can help neurologically assess and rehabilitate conditions such as spatial disorientation. Spatial disorientation is a severe case of difficulty navigating all types of environments, new or routine, commonly caused by brain damage. A verbally-guided VR-based navigation training program improved route finding for 11 participants with spatial disorientation.

VR training could also help treat landmark agnosia, a condition where patients cannot locate landmarks in the real world, impairing their navigation. Trials were even successful with more common conditions such as amnesia. These simulations have shown to have ecological validity, as virtual representations of real-life environments have successfully trained individuals to navigate real-life environments.

One key benefit to spatial navigation training is protecting the hippocampus against age-related changes during early and late adulthood. With VR, training can be done from anywhere in the world and with fewer physical barriers to accessibility. Since there are over 171 million VR users worldwide, implementing spatial navigation training in VR games could also achieve widespread preventative success.

Foretell Reality

Foretell Reality is an inclusive social VR platform where up to 15 active users can meet for live therapy and support groups. In the app, users can walk or teleport around open spaces, exploring private and public environments. Some spaces also provide navigation simulations such as mazes that allow for real-time spatial navigation training with professionals.

References:

Virtual reality in neurologic rehabilitation of spatial disorientation – PMC (nih.gov)

VR Training with Spatial Knowledge and Navigation (1library.net)

Spatial navigation training protects the hippocampus against age-related changes during early and late adulthood – ScienceDirect

Virtual reality in neurologic rehabilitation of spatial disorientation – PMC (nih.gov)

Landmark Agnosia: Evaluating the Definition of Landmark-based Navigation Impairment | Archives of Clinical Neuropsychology | Oxford Academic (oup.com)

The Hippocampus in the Limbic System (thoughtco.com)

23 Amazing Virtual Reality Statistics [2022]: The Future Of VR + AR – Zippia

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.

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

Meet Dr. Asher Marks and Amanda Garbatini

Research Population and Measures

Results That Inspire Hope

The Power of VR

Conclusion

About Foretell

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