Low Cost Virtual Reality Tool to Treat PTSD

• Research type

  Research Study

• Full title

  Low-Cost Virtual Reality as a Tool to Support the Treatment of Post Traumatic Stress Disorder: A Proof of Concept Study

• IRAS ID

  307702

• Contact name

  Paul Best

• Contact email

  p.best@qub.ac.uk

• Sponsor organisation

  Queen's University Belfast

• Clinicaltrials.gov Identifier

  N/A, N/A

• Duration of Study in the UK

  2 years, 0 months, 0 days

• Research summary

  ‘Research ‘Summary’
  Posttraumatic stress disorder (PTSD) is one of the most debilitating mental health problems that significantly impact individuals, families, and health and social care services. Therapies such as Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) are recommended as one of the most effective treatments according to NICE guidelines (2011).

  TF-CBT treatments require exposing clients to trauma-related memories, environments, and other feared stimuli via imaginal (where clients close their eyes and try to recall trauma memories) and in vivo (real-life–visiting trauma location) exposure. This allows one to process trauma-related memories. However, not everyone benefits from imaginal exposure or would like to go back to trauma locations—especially a public space. Also, people diagnosed with PTSD are highly avoidant and emotionally distant from trauma memories. Subsequently, they find it challenging to engage with the exposure process leading to high dropout rates (Rauch & Rothbaum; 2016), Lewis et al., 2019).

  The solution has been found to address these issues using Virtual Reality (VR) based tools within exposure and TF-CBT treatments. VR is a well-established, safe, and successful therapeutic tool among a variety of patient populations, e.g., psychosis (Bisso et al. 2020), eating disorders (Gadsby, 2019), and PTSD (Rizzo & Koenig, 2017). Nonetheless, VR technology is yet to be used in routine care where services are provided for the general public. This is due to the high cost of the technology. Especially for PTSD, VR environments have to be customised to individual’s specific traumatic memories. Subsequently, in addition to this issue, the acceptability of the technology among health and social care professionals is also not fully understood.

  We are proposing to create low-cost VR environments via 360 immersive photo scanning technology, which will allow this beneficial tool to be used within routine clinical settings, e.g., Northern Health and Social Care Trust (NHSCT) to treat PTSD clients eligible to receive TF-CBT.

  ‘Summary of Results’
  We used Virtual Reality technology to create virtual environments with four participants tailored for Trauma-Focused Cognitive Behavioural Therapy (TF-CBT). The primary outcome measure was the PCL-5 (trauma/PTSD score) and was administered pre and post intervention. Interviews were conducted with therapists (n=4), the service manager (n= 1), the software developer (n= 1), and clients who took part (n= 2) to evaluate the initial acceptability and potential value of the VR intervention in supporting trauma therapy.

  Summary of quantitative data

  The mean PCL-5 score at baseline was 51.0 (SD= 13.2), with scores dropping to 25.7 (SD= 26.1) postvention.

  The mean CORE-10 score at baseline was 14.75 (SD= 3.9), with scores dropping to 9.75 (SD= 11.3) postvention.

  Three of the four 4 participants showed improvement in trauma/PTSD symptoms with one participant withdrawing from therapy in session six. In interpreting these results, it is important to acknowledge the high standard deviations, particularly in post-intervention scores, which reflect significant variability among participants. While some individuals may have experienced substantial improvements, others have shown more modest changes, underscoring the need for further research with larger sample sizes to draw more definitive conclusions about the intervention's effectiveness.

  Summary of quantitative data

  Participant Acceptability

  • Participants generally found the VR component engaging and immersive, with initial curiosity about the technology
  • Participants appreciated the immersive experience that helped them revisit traumatic events in a controlled manner, making the process less overwhelming
  • One participant reported that VR helped piece together fragmented memories, enabling a more comprehensive emotional processing of the traumatic event.

  Therapist Perceptions

  • Therapists noted the flexibility of VR in therapy, allowing them to tailor sessions based on the client's needs
  • VR was seen as a valuable tool for exposure therapy, accelerating the resolution of trauma in a controlled and safe manner
  • The ease of transitioning between virtual environments and traditional therapy was viewed as beneficial, enhancing the client’s experience

  Improvements and Suggestions:

  • Participants suggested improvements, such as adding more specific stimuli (e.g., tools or people) to better replicate the traumatic environment, which could increase immersion and therapeutic value
  • Therapists identified that VR environments do not need to be perfect recreations of the trauma site, as the overall immersive experience was more important for therapeutic success
  • Suggestions for improving the technology included creating a library of pre-built environments and incorporating AI-driven avatars to better simulate real-world interactions during trauma

• REC name

  Wales REC 7

• REC reference

  21/WA/0397

• Date of REC Opinion

  20 Dec 2021

• REC opinion

  Favourable Opinion