The Top Questions From Patients About VR in Therapy and How to Answer Them

Virtual reality is transforming the way therapists practice. Using VR in therapy enables therapists to craft richly immersive environments that can help people with a wide range of mental health issues. 

However, as with any new technology, patients may have questions about VR and how it’s used in therapy. 

Here, we list some of the most common questions that arise when discussing VR with patients and provide answers that can help put their minds at ease. 

By addressing these concerns upfront, you can feel confident your patient is comfortable with using VR during therapy and will get the most out of the experience.

The Most Frequently Asked Questions From Patients About Using VR in Therapy

“I thought VR was for gaming, how does it work in therapy?”

That’s correct. VR is commonly used for gaming, but what patients might not know is that years of research support the use of VR in mental health and numerous studies support the effectiveness of VR in treating a variety of conditions, such as PTSD, anxiety, and phobias.(1)

Being in a VR environment allows two key processes to occur—immersion and sense of presence. These two processes allow the brain to interact with stimuli in an environment. And it can generate thoughts, sensations, and emotions that are helpful to the therapeutic process. 

The VR environments used in therapy are not designed for gaming purposes, so they shouldn’t expect the experience to be like a video game. The environments used in therapy are specifically designed to allow the patient to work towards their goals.

“Does virtual reality have any side effects?”

Amelia can be used with patients of any age, including young children under 13 y.o. as long as they are under guardian supervision for remote practice. 

The following side effects are rare, acute, and tend to be mild: 

– Eye pain, dizziness, visual fatigue, or visual abnormalities. 

– Redness of the skin, eczema, swelling, irritation, or discomfort. 

– Excessive use may cause imbalance or motor incoordination.

 

Patients should not use VR if they are experiencing any of the following: 

– Tiredness or exhaustion

– Under the influence of substances (e.g., alcohol) or hungover

– Digestive distress

– Suffering from cold, flu, headache, migraine, vertigo, or earache. 

– Are pregnant, elderly, or suffering from physical, mental, visual, heart, or neurological conditions that may make them prone to seizures (consult with your doctor)

“Can I close my eyes when I watch a scene?”

No, patients should not close their eyes to avoid watching a certain part of the scene, no matter how unpleasant it may seem. 

Let your patient know that the way to get used to these challenging situations is to watch them repeatedly. If they do happen to close their eyes during a session, they need to inform you. 

“Can I take breaks during exposure sessions?”

We recommend that a session last between 30 and 45 minutes without pauses of any kind. You should try and end the session only after having completely finished a scene. 

Additionally, do not end a session when the patient’s level of discomfort is high. It’s best to continue the exposure session until the patient’s distress levels have decreased. 

“Can I wear prescription glasses under the headset?”

Yes, the Amelia Pico headset is designed to fit around most frames, with a fitting width of 6.3 inches (16 centimeters). 

“Can I access VR therapy remotely?”

Yes. If you, as the therapist, offer remote sessions, your patient can use their smartphone and purchase a Universal VR headset to access the VR sessions at home. With our Homework feature, you can also assign and track asynchronous VR sessions to your patient.

“Can I stand or walk while wearing the headset?”

Amelia’s VR environments are designed to be experienced while sitting. But if the patient prefers to stand, they can as long as they do not move around while wearing the headset, and they keep a physical point of reference (e.g., laying their hands on their side). To avoid accidents, they should not move while wearing the headset.

“Will I feel physical pain when using VR?” 

No, the patient will not feel any physical pain when using VR. The technology does not induce any kind of physical pain. 

If the headset causes discomfort, the straps should be adjusted to fit correctly. And the patient should generally stay seated to avoid any potential falls or injuries.

What To Do When Your Patient Says…

“I don’t feel immersed in the VR situation.”

It’s essential that the patient imagines that they are in the virtual reality environment. Encourage them to not look at the environment as if they were watching a movie. Instead, they should try to imagine that they are actually living it.

Some of the following guidelines can make the situation feel more realistic. Tell them to think about how they are dressed, where they are going, and who may be sitting next to them. You can have them close their eyes for a moment, to pay attention to the sounds coming through the headphones. These details can help them to feel more immersed in the environment. 

Also, ensure that there are no distractions in the room. If the patient cannot focus, stop the activity and resume at a more appropriate time. 

“This is not the same as reality.”

It is certainly not. But it is a powerful tool that can be used to help patients achieve their therapeutic goals. Various studies have shown that virtual reality can promote a sense of presence and trigger bodily responses similar to in vivo exposure.(2)

VR puts patients in a controlled environment, where exposure and habituation can take place safely. 

“The headset doesn’t fit well.”

Adjust all the fastening strips so they fit comfortably. Unfasten the velcro, tighten the strap around the head, and refasten it. Try not to tighten the strips too much, because they can get uncomfortable during long sessions. It is also important to center the headset at the average height of the patient’s eyes.

“This [scene/image/stimulus] causes me a lot of discomfort.”

Your patient may want to think about something else, remove the headset, get up, or leave. Let them know that if they experience significant discomfort when they see certain images or hear certain sounds, this means the exposure process is working. The only way to make the stimuli neutral is to let the discomfort reduce in their presence, and this will happen after repeatedly working on different scenes.

Use your clinical judgment and decide if the patient should stay in the same scene or move on.

“I’m tired…”

If your patient indicates they are too tired to engage with the VR environment, it is best to take a break. First, pause for five or ten minutes. If your patient still cannot get involved, finish the session and return to it when your patient feels more energized. 

“I’ll never be able to get through this whole scene.”

Encourage your patient to take things one step at a time, focusing on what has already been achieved rather than on the amount of work that still needs to be done. 

It is normal for the last few stages of their VR sessions to be more difficult than the initial ones. Have your patient experience the scene again as many times as necessary. Each time they experience it, the discomfort will reduce a little more. 

Have Any Questions About Using VR in Your Therapy Practice?

Virtual reality is a powerful tool you can use to support your patients’ therapeutic journey. 

However, it’s important to remember that this might be your patient’s first time experiencing VR, so they may have many questions. Addressing their concerns will help them become more comfortable with the process and help create an environment where patients feel supported and safe. 

Want to learn more about using VR to support your patients? 

Don’t hesitate to contact us. We’re here to answer all your questions too.

 

References:

  1. Maples-Keller, J. L., Bunnell, B. E., Kim, S. J., & Rothbaum, B. O. (2017). The Use of Virtual Reality Technology in the Treatment of Anxiety and Other Psychiatric Disorders. Harvard review of psychiatry, 25(3), 103–113. https://doi.org/10.1097/HRP.0000000000000138
  2. Slater, Mel & Sanchez-Vives, Maria. (2016). Enhancing Our Lives with Immersive Virtual Reality. Frontiers in Robotics and AI. 3. 10.3389/frobt.2016.00074.
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