Many people who take antipsychotic medication for schizophrenia continue hearing voices,
says Alexandre Dumais, a psychiatrist at the
University of Montreal. Traditionally, therapists
advise patients to ignore these residual hallucinations, but recent research has shown that
engaging the voices in conversation may actually help reduce patients’ sense of helplessness.
So Dumais’ team built a VR system in which a
patient designs an avatar that embodies a bothersome hallucinatory voice. The therapist voices
this avatar using patient-suggested sentences and
gradually makes the avatar friendlier, encouraging
the patient to get more comfortable and assertive
in addressing the voice.
Dumais’ team tested this system, described in
July in Schizophrenia Research, on 19 patients
with schizophrenia. Four dropped out after the
first session because they either didn’t like the
program or found it too scary. The remaining
15 rated how scary they found each VR therapy
session from 0 to 10, with 10 being the most distressing. Scores dropped over six weekly sessions.
Moreover, at the end of treatment, the patients’
scores on a 0 to 20 scale measuring general
hallucination-related distress dropped from an
average of 16. 1 to 10. 9.
“We’re very much in the early days” of simulating impossible situations in VR for therapeutic
purposes, Freeman says. But as VR becomes more
pervasive, more researchers may have the opportunity to develop creative new treatments that
exploit virtual unreality.
Virtual avatars, good for filling simulated coffee
shops, may also serve as therapists, transforming
VR from a tool available only in a clinic to a new
type of self-help. This may be especially useful
for patients who are averse to visiting a therapist,
such as people with social anxiety or agoraphobia,
or for people living in remote areas without access
The first fully automated virtual reality therapy,
designed for fear of heights, was described in the
Lancet Psychiatry in August (SN: 8/4/18, p. 15).
In this program, an animated therapist guides
a patient up a 10-story office complex. The user
performs increasingly difficult tasks, from standing near a drop-off to going out on a platform
over a central atrium. The virtual therapist
periodically checks how the patient is feeling and
offers encouragement. Freeman and colleagues
tested this program on 100 patients: Forty-nine
were randomly assigned to two weeks of VR treatment; the other 51 got no treatment.
“I anticipated it was just going to be like a
game,” one VR participant said, but the program
“pushed the limits in terms of what I thought I
would be able to achieve.”
On a scale measuring fear of heights from 16 to
80, the scores of people who used the VR program
dropped, on average, about 25 points after treat-
ment. The no-treatment group kept about the
same scores as before. While results are encourag-
ing, researchers don’t yet know how this program
measures up to real-life therapy.
Another self-led treatment, this one to calm
fear of spiders, has been tested against face-to-face therapy. The three-hour VR program
involves various arachnids—a cartoonish,
slipper-wearing spider to a realistic tarantula.
The spiders approach the user while a virtual
One VR program treats arachnophobia by exposing users to spiders, working up from
a cute, cartoonish spider to a more realistic tarantula (shown).
Head games Schizophrenia patients who heard voices
and conversed with them in VR rated how scary and
anxiety-provoking six weekly therapy sessions were. Over
time, patients gradually found the VR experience less
stressful. SOURCE: O. PERCIE DU SER T ET AL/SCHIZOPHRENIA RESEARCH 2018
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Schizophrenia stress drops in VR therapy
Week of VR therapy