Virtual Reality

My long time personal fascination with the potential of virtual reality was quickly transformed into a professional and clinical interest when I realized how this new technology could be used to study and treat pathological fear and anxiety.

The ability to quickly and convincingly alter specific aspects of a persons perceptual experience is a powerful tool for investigating the role of context and environment in behavior. Investigating the role of context in behavior can be quite difficult. Taking a participant to many different real environments is expensive, time consuming, and difficult for researchers to control the many different variables between locations. Alternatively, researchers can use VR to systematically design many environments as needed to vary on specific characteristics and only on those characteristics. This capability could be extremely useful in both investigating and implementing several strategies for maximizing inhibitory learning, such as multiple context exposure, stimulus variation, deepened extinction, and combinations of these strategies.

Using VR in behavioral research offers additional channels of potentially useful data available to researchers. For example, eye-tracking in three-dimensional space, movement around digital environments, and posture and body position data can be used to study avoidance behaviors. Virtual behavioral labs could even have participants engage in research remotely using their own systems.

Quickly declining costs for powerful consumer headsets (e.g. Oculus Quest 2) are making the out of office use of VR more and more feasible. In the era of Zoom and telehealth, VR could provide a more immersive and hi-fidelity medium for remote treatment options. This immersive and intuitive modality might also be useful for self-help applications like VR “workbooks” with experiential exercises and exposures. Keeping with this line of thought, VR is also a potentially promising way to assign between session homework or even post-treatment maintenance of extinction.

In acceptance and commitment therapy work, VR might be useful for bringing experiential exercises and metaphors to life. We could simulate a virtual bus for patients to drive, with virtual passengers tailored to specific thoughts and experiences. We could take text thoughts and make them HUGE in virtual space, or anchor them so they block the users field of view. The powerful and unique perspective taking and context modifying power of VR could be useful in illustrating self-as-context. Overall I think VR is an untapped as tool for experiential exercises in therapy and for packaging these therapeutic exercises as direct-to-consumer tools.

As you can see I am very excited by the potential of VR to expand and transform mental healthcare as this technology and our methods of applying it continue to evolve.

360° video

I have explored the use of 360° videos as an alternative to traditional VR as a means to deliver some of the benefits of VR in an even more affordable and accessible way. These videos are captured using cameras with lenses that can view a complete 360° perspective of the environment. When placed into an affordable head mounted display, contemporary smartphones can display these videos in a manner that immerses the user in a photorealistic digital environment. Tracking systems within smartphones are able to accurately process orientation in three-dimensional space, which allows changes in the user’s head position to correspond with changes in the video’s field of view. While 360° videos should not be considered VR due to the inability of users to interact dynamically with the stimuli, the sense of presence it engenders is similar to the VR experience.

While exploring technological approaches for treating stressor and anxiety-related disorders at the Emory Healthcare Veterans Program, I traveled all around Atlanta collecting 360° video footage for use in exposure therapy. These videos are hosted online in an open access 360° video library for use by clinicians and researchers. Dr. Sherrill and I currently have a paper in press at Translational Issues in Psychological Science (see preprint) which outlines the benefits, draw backs, uses, and future research areas of 360° videos for exposure therapy. This forthcoming paper also includes an appendix to help clinicians get started with the technology.

Here is an example, you can look around the environment by clicking and dragging your mouse in the video window to change perspective.