HIGHLIGHTS FROM AMHCA ’ S 2023 ANNUAL CONFERENCE
CUTTING-EDGE SESSION Using VR to Enhance Your Therapy Practice
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the effect size of VR exposure , which , in turn , would be greater than the effect sizes of imaginal and interoceptive exposure .
I was wrong . To date , I have not found a single meta-analysis that concluded that in vivo exposure was more effective than VR exposure . To this day , this perplexes me , but it is a testimony to just how effective VR therapy can be — exposing our clients to aversive stimuli through VR appears no less effective than exposing them to aversive stimuli in “ the real world .”
Don ’ t take my word on this . Visit scholar . google . com ; type keywords such as “ meta-analysis ,” “ virtual reality ,” and “ exposure therapy ”; and check out the conclusions of various studies for yourself . in-person ) are filled with clients who struggle to implement and maintain an exercise regimen .
I have found that many clients who struggle with initiating and maintaining physical exercise find it much easier to do so when using VR applications . When an object is flying through space and looks like it is about to hit you in the face , your natural tendency is to physically react . I use apps related to boxing , kung fu , baseball , and other physical activities to “ trick ” my brain into thinking that my body must react to avoid pending doom , and so have many of my clients . I can easily ( or not so easily ) burn 500 calories in 30 minutes using such apps , and these activities are often much more rewarding than running on a treadmill in a room while going nowhere .
Here are a few examples of VR exposure activities involving clients that I have incorporated into sessions :
• A client diagnosed with prolonged grief disorder and agoraphobia involving her son ’ s death by suicide and related avoidance used VR to repeatedly “ travel to ” and “ stand at ” places she was avoiding in her community because of troubling memories involving her son . Once her level of distress abated , she then started going out “ in real life .”
• A client who wanted to discuss his traumatic experiences in his home country of Cuba was able to do so after using a VR headset to walk me through familiar places in his old neighborhood .
• A client with amaxophobia ( i . e ., fear of driving ) “ drove ” using VR through multiple environments with varying difficulty levels .
• A client who was too anxious to get a vaccination was able to do so after multiple rehearsals using a VR headset .
• A client who was claustrophobic and avoiding an MRI scan was able to “ attend ” her MRI appointment in virtual reality and then did so in vivo .
3 . VR for Behavioral Activation
According to the Society of Clinical Psychology , behavioral activation is an evidence-based approach to the treatment of depression that yields a strong level of efficacy and “ seeks to increase the patient ’ s contact with sources of reward by helping them get more active and , in so doing , improve one ’ s life context .”
There is no shortage of research on the impact of exercise on psychological well-being , and therapy rooms ( whether virtual or
4 . VR for Building Social Skills and Support
In April 2020 , my county was on lockdown due to the COVID-19 pandemic . I put on my VR headset , and I opened an app that allows users to access virtual movie theaters . Scrolling through the list of theaters , I saw a “ Star Trek Theater .” I ’ m a fan of the show , so I clicked on it . Within seconds , I found myself transported to a movie theater on a spaceship traveling rapidly through space .
Looking ahead , I saw a giant screen projecting Lt . Commander Data and Captain Jean-Luc Picard interacting during a scene from an episode of “ Star Trek : The Next Generation .” I turned to my right , and I saw the avatar of a woman , who turned to me and waved . We introduced ourselves , and I discovered that she was in South Africa . We enjoyed watching the show together . Neither of us felt alone that night .
Many individuals with mental disorders struggle to connect in healthy ways with other people . VR headsets provide a medium in which they can meet and interact with people all over the world with common interests . I have assigned clients to meeting and interacting with people through their VR headset , or even joining groups in which they collaborate on a common goal , such as maneuvering through an escape room .
5 . Psychoeducation
Well-intentioned therapists sometimes suggest to clients that they read a book or a website on a problem they ’ re struggling with or an approach that could be helpful . Many
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16 The Advocate Magazine 2023 , Issue # 2 American Mental Health Counselors Association ( AMHCA ) www . amhca . org