In one fully automated VR therapy program, a virtual
therapist helps users overcome their fear of heights by
guiding them through a tall building with ledges overlooking an atrium.
therapist offers instructions and encouragement.
“I’m not sure if anyone ripped the headset
off, but a lot of people definitely started crying,”
says Philip Lindner, a clinical psychologist at
Stockholm University. One patient who was vir-
tually sitting in a living room with a lot of spiders
crawling around on the floor “physically put up
her legs and sat like that for, like, 15 minutes.”
Researchers tested this system on 97 arachno-
phobia patients and described the results last
November in San Diego at the Annual Association
for Behavioral and Cognitive Therapies Conven-
tion. Half of the volunteers were randomly assigned
to receive VR therapy and then encouraged to try
approaching spiders in the real world. The other
half completed a three-hour session of normal
exposure therapy, where participants worked up
from catching spiders in cups to holding a spider
in each hand.
Before treatment, both sets of participants generally wouldn’t go near a spider in a clear container,
Lindner says. After treatment, VR participants
could stand next to or even put their hands inside
the container, and real-world exposure patients
could touch the spider. One year later, though,
some VR patients could touch the spider too.
Lindner suspects that the VR experience
reduced patients’ fears enough for them to try
real-world exposure on their own, so they caught
up with the normal exposure group.
Despite the early successes for specific phobias,
it’s unclear whether therapist-free VR therapy for
more complex disorders could be used at home.
In simulated social interactions, therapists
carefully control virtual avatars’ responses to
address each patient’s idiosyncratic anxieties.
Computer-generated therapists aren’t yet so
versatile that they can have conversations with
patients that go in any direction, Bouchard says.
He does believe, however, that virtual humans will
eventually reach that level of sophistication. Even
if virtual therapists are up to the job, many
patients may not be driven enough to complete
treatment on their own, Lindner says. “There was
a lot of hype about [smartphone] mental health
apps, and very few of them saw any kind of extensive real-world use.”
Motivation isn’t the only barrier to self-help.
In some cases, self-led therapy may simply be
too stressful. For patients using the personified-
hallucinations program, “it’s really difficult to do
at the beginning, because you’re hearing really bad
things, like, ‘You’re an asshole, go kill yourself,’ ”
Dumais says. “I don’t think a person can manage
But developers shouldn’t discount poten-
tial stand-alone treatments before they’ve been
tested, Reger says. These systems may make ther-
apy, at least for some disorders, accessible to many
patients who can’t or don’t want to see a human
therapist. If automated treatments for complex
disorders like P TSD were found safe and effective,
he says, “I would certainly be a fan.” s
s Albert “Skip” Rizzo and Sebastian T. Koenig.
“Is clinical virtual reality ready for primetime?”
Neuropsychology. November 2017.
More to come
Scientists are testing VR programs to help
with a broadening list of challenges, such as:
Young cancer patients at South Carolina’s
Clemson University are testing VR to relieve
treatment-related pain and anxiety.
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