VR Is Revolutionizing Therapy. Why Aren’t More People Using It?

Sam Stokes, a New Zealand-based gross sales supervisor, is not normally an anxious particular person. But there’s one factor that, as he places it, scared the shit out of him: needles. 

His aversion was extreme sufficient to carry him again from getting routine exams. Stokes, now 40, recollects an occasion in his 20s when he merely could not convey himself to get a blood check. He as soon as even drove to the testing facility to get his blood drawn, however could not comply with via with it. His companion (now spouse) ultimately satisfied him to get the check, however he remembers it as one among “probably the most horrific” experiences he is had. 

“I form of handed out a little bit bit alongside the way in which, and was sweaty and clammy and all that kind of stuff,” he stated. “I simply completely hated the entire expertise.”

When the COVID-19 pandemic arrived, he knew he could not let his needle phobia maintain him again. Even watching the information turned troublesome, as stations commonly ran tales about vaccine developments.

“Every third story was a picture of a needle, and that simply freaked me out,” he stated.

But by the point Stokes turned eligible to get the vaccine, he did not really feel a pinch of tension. No clammy arms, no chilly sweats. Nothing.

Stokes overcame his phobia via digital actuality, a buzzy expertise that trade giants like Meta and Sony consider could possibly be the way forward for gaming and on-line socializing. With Apple anticipated to announce its first headset this yr, 2023 could possibly be a landmark second for the expertise. 

The concept of utilizing digital actuality to ease anxiousness and overcome phobias is not new; it has been studied because the Nineties. The arrival of contemporary VR headsets like the unique Oculus Rift and HTC Vive in 2016 reignited conversations about how the expertise may enhance psychological well being care. 

But in 2023, regardless of the pandemic shining a highlight on stress, anxiousness and burnout, it appears like we’re nonetheless speaking about VR’s potential versus its impression. We’re nonetheless removed from a world by which strapping on a VR headset to beat your concern of crowds is as frequent as calling your therapist earlier than a subway commute. And it isn’t due to technological shortcomings. Rather, excessive prices, VR’s sluggish adoption and a lack of understanding about VR remedy are in charge. 

“I truly thought we might be farther alongside by now,” stated Dr. Barbara Rothbaum, affiliate vice chair of medical analysis on the Emory University School of Medicine, who performed a examine revealed in 1995 inspecting how VR could possibly be utilized in psychotherapy. “I assumed that extra individuals could be utilizing it for therapeutic interventions.”

Stokes, for instance, solely tried it as a result of he noticed a TV information phase a couple of examine being performed by the University of Otago in Christchurch, New Zealand, and oVRcome, maker of the same-named VR app meant for addressing phobias.

“Unlike possibly another fears, I had an finish date,” Stokes stated. “I knew that I needed to get a COVID vaccination. So I knew that this was my likelihood.”

The evolution of VR

In 2023, you’ll be able to connect a Google Cardboard headset to your cell phone for lower than $20 to expertise VR. It actually wasn’t like that when Rothbaum and her colleagues had been engaged on their examine, which was revealed within the American Journal of Psychiatry in 1995. Researching whether or not VR could be an efficient option to deal with a concern of heights via publicity remedy required a $150,000 laptop and a headset that price round $16,000 again then, in line with Rothbaum. 

That laptop wanted to be arrange in a separate room not solely due to its dimension, but additionally so it could possibly be saved cool, she says. While the affected person wore a head-mounted show in a small room with Rothbaum, she’d use an intercom to speak with a graduate scholar working the pc.  

“It was a really large operation,” she stated.

Since discovering a digital actuality headset wasn’t simple within the Nineties, Rothbaum frightened that she would not be capable to proceed her analysis when one among her favourite fashions was discontinued. 

“I assumed, effectively, that is the tip,” she stated. “That’s the tip of our work.”  

Luckily, that did not occur. The market was small, however different headsets started to crop up, typically at decrease costs. Rothbaum has collected so many of those headsets over time that she has a museumlike show case in her residence workplace crammed with them. 

“It was primarily the decision,” stated Rothbaum, when requested why she most well-liked some headsets over others. “But additionally, if it was not snug for a affected person to put on for half-hour, then that was going to be exhausting to make use of.”

Today’s VR headsets nonetheless have usability problems with their very own, corresponding to quick battery life and restricted compatibility with prescription glasses. But there is no denying they’ve come a good distance from the system Rothbaum used within the ’90s. Facebook guardian firm Meta at the moment dominates the digital actuality area, with 81% of the market as of the fourth quarter of 2022, in line with Counterpoint Research. 

Its Quest 2 headset prices $400 and does not require an exterior computing system. That alone represents a big leap even from 2016-era headsets just like the first-generation Oculus Rift and HTC Vive, each of which needed to be tethered to highly effective computer systems to gasoline video games and apps. Sony additionally simply launched the $550 PlayStation VR 2, which boasts a vivid show, haptics and eye monitoring expertise however should be tethered to a PlayStation 5. 

An increase in demand for immersive at-home leisure in the course of the pandemic, mixed with the hype surrounding the metaverse, has resulted in additional consideration being paid to digital actuality.

“It’s nonetheless going to be in all probability a decade out earlier than we now have a totally realized metaverse,” stated Ramon Llamas, a analysis director for market analysis agency The International Data Corporation. “But within the meantime, we will have quite a lot of enjoyable and … fascinating improvements coming alongside for VR.”  

Trying VR remedy

Many research and analysis papers have been revealed since Rothbaum’s. A scoping overview from 2021 examined 19 research that used digital actuality publicity remedy to deal with particular phobias. Twelve reported that VR was efficient at lowering anxiousness.

It’s simple to grasp why, when you attempt it for your self. That’s why I requested Dr. Howard Gurr, a New York-based psychologist who presents digital actuality remedy, to show the software program he makes use of together with his shoppers, which is supplied by an organization referred to as Amelia Virtual Care.

After launching the app and inserting my cellphone within the VR headset, I used to be transported to what would normally be a really anxiety-inducing scenario for me: getting behind the wheel. I’ve been dwelling in New York City for greater than a decade, which suggests I additionally have not pushed a automobile in about 10 years. 

I’ve all the time been a nervous driver, so dwelling within the metropolis has felt liberating, since I can depend on public transportation and Uber to get round simply. But simply as Stokes needed to confront his phobia to get vaccinated in opposition to COVID-19, I’ll have to deal with mine if I need to purchase a home within the suburbs with my husband and begin a household. 

Hitting the street nearly isn’t any substitute for the actual factor; my simulation was animated, and I did not have a bodily steering wheel or gasoline pedal. There was no approach for me to speed up, brake or select when to merge into a special lane. I felt extra like I used to be alongside for the experience than in management, but it surely felt immersive sufficient to impress some nervous reactions.

For instance, I skilled that acquainted pang in my abdomen once I seen a truck approaching in my facet mirror. Even although I wasn’t in an actual automobile, I felt compelled to maintain my eyes fixated on the street in entrance of me.

I did not even see the opposite digital passengers within the again seat till a couple of minutes into the simulation, as a result of I used to be so targeted on the freeway. The pouring rain and sounds of vehicles and automobiles zipping by virtually made me overlook I used to be sitting in my workplace, although it did not fairly really feel like I used to be behind the wheel both.

My expertise with Gurr was administered remotely on a headset that prices lower than $20 and that used my smartphone because the engine. The aim behind a setup like that is to make the expertise as inexpensive and accessible as potential. 

But extra strong setups additionally exist, such because the one utilized by Dr. Joseph Hirsch, a New York-based psychologist who’s revealed analysis papers on digital actuality remedy within the American Journal of Clinical Hypnosis. He tells me he is used a vibrating platform with audio system to extra precisely simulate the sensation of turbulence when working with sufferers who’re afraid of flying.

Not simply phobias 

Treating phobias looks as if a pure utility for digital actuality. Boarding a digital airplane or staring down from the highest of a digital skyscraper is far more vivid than imagining it. Gurr says this stage of element and immersion hastens the method of overcoming a phobia.

“I may see sufferers [and after] seven, eight or 9 classes, they’re accomplished,” he stated. “You cannot try this in conventional remedy.”

And then there are instances the place digital actuality supplies a way of escapism or a brand new sort of consolation zone. Monet Goldman, a licensed marriage and household therapist primarily based in California who presents VR remedy, understands this higher than most. 

He remembers one session in early 2022 when digital actuality was significantly impactful. He was counseling a toddler over a video name who had fully shut down and was giving just one phrase solutions. But that modified as soon as Goldman and the kid started enjoying a sport in VR. Goldman says he was “fully totally different.”

“These are the issues he is the very best on this planet at, and now he will get to disclose that,” Goldman stated. “He will get to show me that, and I get to witness this. And it form of helps their self worth, their sense of feat.”

Even those that are well-versed in VR are discovering new methods to make use of it as a stress reliever. Anais Riley, higher identified by her alias Naysy, who’s garnered thousands and thousands of followers throughout TikTook, YouTube and Twitch, has used the favored VR dance sport Beat Saber to deal with work-related anxiousness. It supplied simply what Riley wanted to fight her stressors: bodily train, a way of accomplishment, escape from the actual world and the chance to faucet into her childhood pursuits of music and dance. 

“I actually was simply loving enjoying the sport and seeing myself get higher,” she stated. 

But digital actuality is not a magic wand for making anxiousness and phobias disappear. It’s merely one other useful resource therapists can use when offering publicity remedy, a way that helps individuals overcome fears by exposing them to phobia-inducing stimuli in a protected setting.  

Rothbaum likens it to utilizing an actual elevator to assist tackle a affected person’s concern of elevators. “I’m skilled in publicity remedy, and that elevator, I’m going to make use of it otherwise for each totally different affected person,” she stated. “So you recognize, it is only a instrument. It’s not elevator remedy.” 

VR remains to be ready for its breakout second

The greatest drawback is that folks merely aren’t utilizing VR regularly. If VR headsets had been practically as ubiquitous as smartphones, therapists would probably be lining as much as discover methods to include them into their follow. But proper now they’ve little incentive to study or put money into VR if their shoppers aren’t utilizing it.  

“The bottleneck has all the time been the price,” says Dr. Albert “Skip” Rizzo, analysis professor on the University of Southern California’s Department of Psychiatry and School of Gerontology.

Shipments of VR and AR headsets are estimated to have reached 9.7 million models globally in 2022, in line with statistics from IDC. To put that quantity in perspective, 300.3 million smartphones had been shipped worldwide within the fourth quarter of 2022 alone, in line with IDC, despite the fact that the market skilled its largest ever single quarter decline.

The arrival of Apple’s long-rumored headset, which may debut in June, in line with Bloomberg, could assist usher in that breakout second for VR. The head-mounted laptop will probably be costly; Bloomberg studies it may price round $3,000. But Apple’s historical past of popularizing new applied sciences just like the smartphone, pill and smartwatch have set the expectation that it may do the identical for digital actuality headsets.

“Apple has a approach of driving the tide that lifts all boats,” stated Llamas. “It brings consideration, and it brings legitimacy to lots of the markets that it enters. And I do not suppose VR will probably be totally different.”

It’s troublesome to inform what number of therapists and psychological well being professionals at the moment supply VR companies, however there’s some information that may present a clue. Amelia Virtual Care, which supplied the software program I used throughout my expertise, has been used to assist deal with greater than 20,000 sufferers, says founder Xavier Palomer. The software program is utilized by greater than 2,000 psychological well being professionals world wide, in line with an organization press launch.

Adam Hutchinson, founding father of oVRcome, which supplied the software program used within the medical trial Stokes participated in, says his packages have been utilized in greater than 30 nations. 

Gurr additionally maintains an off-the-cuff listing of therapists who supply VR companies. Roughly 60 practitioners are listed on his web site, nearly all of whom are positioned within the US, the place psychologists usually want to satisfy state-specific licensing necessities. The Association for Behavioral and Cognitive Therapies’ listing lists 40 VR-equipped therapists.

These numbers pale compared to the practically 700,000 behavioral well being specialists within the United States alone, in line with information from The George Washington University’s Behavioral Health Workforce Tracker. Of that complete, 539,714 are counselors and therapists. 

“Virtual actuality, despite the fact that it’s efficient, remains to be in its infancy,” stated Gurr. “And clinicians are form of reluctant to choose up a expertise that both they do not perceive or weren’t skilled in.”

Aside from VR being comparatively scarce, there’s additionally the educational curve subject. Mental well being professionals should take the time to grasp digital actuality and discover ways to apply it to their sufferers’ or shoppers’ wants. 

Even somebody like Goldman, who grew up enjoying video video games and fondly remembers his Gameboy, practices VR video games on his personal time in order that he can correctly have interaction together with his shoppers.

“[There’s] quite a lot of, I suppose you might say, coaching and training exterior of the sport itself,” Goldman stated.

The corporations making an attempt to make VR remedy extra well-liked

Hutchinson acknowledges that it may be fairly a while earlier than most people — together with therapists — adopts VR regularly. That’s why he started with the system most individuals already depend on every single day: the smartphone. Though oVRcome additionally supplies instruments that therapists can incorporate into their follow, the corporate began by distributing VR remedy packages developed by medical psychologists that anybody can use with no therapists’ supervision.  

“That was the aim with oVRcome, was to make remedy for these anxiousness problems utilizing digital actuality publicity remedy simpler to entry and way more inexpensive,” Hutchinson stated. 

Participants are uncovered to a low-anxiety digital setting when this system begins and steadily progress to extra direct circumstances. In Stokes’ case, for instance, one of many first levels put him exterior a digital vaccination tent, whereas the ultimate session had him sitting with a nurse able to administer an injection. 

“We actually needed to mannequin how publicity remedy was supplied within the clinic,” Hutchinson stated.

Amelia’s software program, which I used throughout my session with Gurr, is designed for use beneath the supervision of a psychological well being skilled. The firm’s choices embrace a VR equipment that comes with a headset and an electrodermal response sensor for measuring a affected person’s sweat response, a VR software program platform with entry to greater than 100 digital simulations and an app for administering VR remedy remotely. The firm additionally supplies coaching and assist supplies like an introduction course, tutorials, manuals and advertising guides. 

Xavier Palomer, the founding father of Amelia, got here up with the thought round 2013 as a result of his buddy was afraid of flying. The firm was based in 2014, however Palomer says it hit an inflection level round late 2016, early 2017 as VR {hardware} just like the Samsung Gear VR turned extra well-liked. The pandemic additionally generated extra consciousness round psychological well being and self care.

“We are extra open to speak about it,” stated Palomer. “To search for options, to really ask for assist.” 

According to Rothbaum, typical knowledge says it takes 20 years from when a examine comes out for that expertise to make its approach into public use. If that holds true, VR ought to’ve already hit that time. But Gurr sees issues a little bit in a different way. That timer did not begin in 1995 when Rothbaum and her colleagues revealed their examine. It started when trendy VR headsets turned cheaper and extra extensively accessible.

“Even although digital actuality has been round for a very long time, I’m beginning the clock at 2015,” he stated. “Which means we’re solely in there for seven or eight years.” 

Although Stokes was aware of VR, he by no means thought-about utilizing it to deal with his phobia of needles till he got here throughout the oVRcome examine. In reality, he wasn’t going to hunt assist for his phobia in any respect. But now the considered getting a vaccine or a blood check does not hassle him within the slightest. 

“If I had a needle sitting on my desk proper now, I’d be fully snug,” he stated. “It’s truly exceptional.”

Senior Editor | Lisa Eadicicco  

Senior Visual Designer | Robert Rodriguez  

Visual Designer | Zooey Liao 

Senior Project Manager | Danielle Ramirez

Creative Director | Brandon Douglas

Senior Director of Content | Mark Serrels