VR Therapy for PTSD

VR DELIVERS IMMERSIVE GRADED EXPOSURE

VR Simulations are showing promising results at treating a variety of Post-Traumatic Stress Disorders. The virtual world immerses the patient in a dynamic simulation where he can confront his most fearful memories. Based on a therapeutic approach called graded exposure, the VR system enables therapist to customize the intensity of the experience on-the-fly to match the needs of the individual patient. VR Therapy is being used with a growing range of PTSD including cases of domestic violence, civilian survivors of terrorist attacks and intense battlefield stress in war veterans.

Delivering effective graded exposure requires the virtual world to be emotionally compelling in order inspire the patient's recall of the associated memories. Care is required to build appropriate simulation and hardware controls for the therapist to finely control the dynamic range of the patient's experience. Firsthand has extensive experience building worlds and delivery systems which are aesthetically and emotionally engaging to deliver effective therapy. We work closely with therapists and researchers throughout the design and development process to insure the final product meets patients' needs and system performace criteria. Below are some examples of Firsthand PTSD therapy worlds.

Middle East World: Baghdad Patrol simulation for PTSD
created for Pacific Telehealth & Technology Hui and the ONR. © U.S. DoD, image © 2006 Firsthand

Treating Battlefield PTSD: IraqWorld

Many soldiers are returning from the battlefields of Iraq with various stages of battlefield PTSD. Dr. Sarah Miyahira and Dr. Ray Folen (Pacific Telehealth & Technology Hui, Hawaii) and Dr. Hunter Hoffman (U. of Washington) are leading a clinical research effort using VR therapy with traumatized veterans. As a member of this team, Firsthand has provided design expertise and VR development services to create IraqWorld.

Patients don a VR helmet with an Ascension Flock of Birds 6DOF position tracker transporting them right back in the action of a humvee patrol on the streets of an Iraqi city. Children walk the street with their mothers. We pass soldiers on patrol and engaged in their daily duties. Then, an attack. An IED planted in the road explodes, but at a harmless distance. The next time, it may be closer and have more intensity. The humvee may become disabled, which will bring on a hail of automatic gunfire.

The therapist is careful not to flood the patient with too much at once. Healing comes through the gradual confrontation of fears and the emotional recounting of his or her personal experiences.

Bus bombing simulation for Dr. Tamar (Haifa, Israel)
©2005, Firsthand Technology, Inc.

Surviving Terrorist Attack: BusBomb

Dr. Tamar Weiss of the University of Haifa, has been pioneering the use of VR Therapy to help traumatized survivors of terrorist bus bombings in Israel. She came to Firsthand to create a realistic simulation geared to the special needs of her patients. BusBomb starts the patient off in a peaceful cafe scene, with a clearly visible bus stop across the street. Though this may seem inocuous to most people, the mere sight of a bus stop may be sufficient enough to cause significant stress in a survivor.

According to the patient's progress, the therapist can cue the sound of a bus approaching, or show the patient a bus pulling up to the bus stop, but with no sound. Cue the bus to silently explode. Then the patient hears screams. More intense screams. Sirens, Body parts. As the patient progresses, the therapist gradually increases the intensity as a means to help the patient relive and confront their deepest fears.

Links to Research

Soldier Attitudes about Technology-Based Approaches to Mental Health Care
Jaime A. B. Wilson, Kristin Onorati, Matt Mishkind, Mark A. Reger, Gregory A. Gahm. CyberPsychology & Behavior. ahead of print. doi:10.1089/cpb.2008.0071.

BusWorld: An Analog Pilot Test of a Virtual Environment Designed to Treat Posttraumatic Stress Disorder Originating from a Terrorist Suicide Bomb Attack.
Naomi Josman, Ayelet Reisberg, Patrice L. Weiss, Azucena Garcia-Palacios, Hunter G. Hoffman. CyberPsychology & Behavior. doi:10.1089/cpb.2008.0048.