“We can learn from the gam­ing in­dus­try in terms of mak­ing men­tal health treat­ment more ap­peal­ing”

Could vir­tual re­al­ity be use­ful in treat­ing anx­i­ety dis­or­ders? Psy­chol­o­gists led by Prof Daniel Free­man of Ox­ford Uni­ver­sity are us­ing VR to help peo­ple over­come their fear of heights

Focus-Science and Technology - - DISCOVERIES -

What causes a fear of heights?

Some peo­ple re­ally over­es­ti­mate the dan­ger: they think they’re go­ing to fall, throw them­selves off (‘the call of the void’) or that a build­ing might col­lapse. That causes anx­i­ety, it causes peo­ple to avoid heights and it can im­pact on day-to-day life: they can’t walk or drive across bridges, or go to meet­ings high-up in of­fice blocks. About 1 in 20 peo­ple have it at the level of pho­bia, when you’ve had it for at least six months. Ver­tigo is some­thing dif­fer­ent, a balance is­sue.

Why treat it with vir­tual re­al­ity?

There are some good psy­cho­log­i­cal treatments for men­tal health prob­lems and if you see a skilled ther­a­pist, you can do re­ally well. But it can be hard to find a ther­a­pist, so we’re try­ing to help peo­ple via au­to­mated vir­tual re­al­ity. The fear of heights pro­gramme was our first test.

What did the treat­ment in­volve?

Peo­ple came to the of­fices of [uni­ver­sity spinout com­pany] Ox­ford VR. We screened them for at least a mod­er­ate fear of heights and had 49 ran­domised to the VR treat­ment and 51 to the con­trol con­di­tion. They re­ceived the treat­ment, which con­sisted of about five VR ses­sions of 30 min­utes each, over the course of two weeks.

In the VR pack­age we’ve been us­ing, you meet the ther­a­pist, who’s called Nick, in a vir­tual of­fice. She ex­plains what causes a fear of heights and how to over­come it, then takes you into the atrium of an of­fice block and asks, “Which of the 10 floors do you want to start off with?”. You go up to whichever floor you se­lected and carry out a range of tasks: it might be just stand­ing by the edge, res­cu­ing a cat from a tree, or travers­ing a rick­ety walk­way. In this way you can learn that your fears are in­ac­cu­rate and mis­guid­ing your be­hav­iour, be­cause ac­tu­ally noth­ing bad hap­pens.

How did you mea­sure im­prove­ment?

It’s a se­ries of ques­tions on clin­i­cal as­sess­ments – all these ques­tion­naires are val­i­dated against per­for­mance at real heights. Peo­ple’s fears came down on av­er­age by two-thirds, and 69 per cent no longer met the trial en­try cri­te­ria. It’s not a di­rect com­par­i­son, but com­pared to other tri­als that use face-to-face therapy, the ef­fects are al­most dou­ble. I was sur­prised the re­sults were even bet­ter than ex­pected. There’s no rea­son why it shouldn’t help peo­ple with a milder fear of heights.

One of the beautiful things about VR is you know it’s not real, so you try things you would never do. Then when you come up against much more mun­dane heights in day-to-day life, you have the con­fi­dence that you can deal with it.

When will VR treatments be available?

Over the next cou­ple of months, we’re pi­lot­ing this treat­ment in NHS psy­cho­log­i­cal ser­vices, put­ting the VR kit into clin­ics. In fu­ture years, peo­ple could do the treatments at home, but at the mo­ment they don’t have the equip­ment.

Ox­ford VR is em­ploy­ing peo­ple from the games in­dus­try to make these sorts of treatments much more fun and en­gag­ing. We think we can learn a lot from the com­puter games in­dus­try in terms of mak­ing men­tal health treat­ment much more ap­peal­ing to peo­ple.

ABOVE: Fear of heights is com­mon, and can im­pact on peo­ple’s lives if it de­vel­ops into a pho­bia

BE­LOW: Ox­ford Uni­ver­sity’s vir­tual re­al­ity ap­pli­ca­tion lets peo­ple carry out a range of tasks at dif­fer­ent heights, with­out any risk

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