While PTSD is a significant issue for many of those serving in the military and others who work in traumatic situations, it also affects huge numbers of ordinary people who experience traumatic events such as assaults or natural disasters. Nearly 24 million Americans suffer from PTSD at any given time, and women are twice as likely as men to develop the condition. PTSD can sometimes be overlooked and is reportedly underdiagnosed, but anxiety disorders still cost society approximately $40 billion per year in treatment costs and loss of productivity.
A relatively new option for PTSD therapy involves virtual reality, with the goal of creating multisensory, immersive environments and experiences to treat the condition. The technique can be controlled by a clinician to suit a patient’s needs, and the results so far are promising.
Medgadget had the opportunity to ask Todd Richmond, Director of the Mixed Reality Lab at the University of Southern California and IEEE Member, some questions about the concept of using VR for PTSD and how it has worked so far.
Conn Hastings, Medgadget: Can you tell us how you became interested and involved in this area?
Todd Richmond, University of Southern California: Early on in my chemistry faculty career I began using the web and other digital media in my teaching and research. That prompted me to resign my faculty position in 2000, upon which I dove head on into emerging tech. That led me to USC, where I’ve been ever since in a variety of positions – I’m now at the Institute for Creative Technologies (ICT), where I head the Mixed Reality Lab. I also serve as research faculty at the School for Cinematic Arts.
I’ve been working in various forms of digital media — mostly as applied to training and learning — for more than twenty years. The power of these platforms has increased significantly over the last decade or so, and extensions into day-to-day life across all sectors have evolved quickly. In the medical area, two colleagues of mine have been inspirational to work with. First is Dr. Skip Rizzo, who has pioneered the use of VR for treating PTSD at ICT. He is an expert in the field, and has been working with VR in clinical settings for decades.
Second is Dr. Leslie Saxon, who is a cardiologist with USC Keck School of Medicine, and who heads the USC Body Computing Center, which is co-located at ICT. I have worked with Leslie for a number of years now, and she is a force of nature, working towards better health outcomes through the use of body sensors, big data, Virtual, Augmented and Mixed Reality (VAMR), and other emerging technologies.
Medgadget: Beyond PTSD, what types of conditions is virtual reality helpful for?
Todd Richmond: A group at the University of Washington has seen encouraging results using VR for treating pain in burn patients (distraction therapy). VR holds the promise of treating a number of psychological issues such as acrophobia [fear of heights] (and in fact many phobias), anxiety, and depression, as well as Alzheimer’s and dementia.
Medgadget: Can you talk us through the technology as applied to PTSD? Does the patient wear a headset? What do they see and experience?
Todd Richmond: With Skip’s system, the Medical VR experience takes place in a clinical setting with a trained clinician (psychologist/therapist) present. The patient puts on a VR headset, and the clinician has a computer interface where they can choose the patient’s location (typically Iraq or Afghanistan, given the most recent conflicts), time of day, weather, and scenario. The clinician can then see what the patient sees on their screen.
As the patient describes the traumatic event, the clinician can recreate the scenario for the patient to “relive” and work through. The protocol follows established work in exposure therapy, and, of course, the clinician doesn’t just jump into an overpowering recreation – rather, the patient works up to the traumatic events over time, just as they would without the VR. VR exposure therapy provides two major benefits – the first is for the patient, as they can be more immersed in their past events, which helps them to confront and work through them.
The second, and perhaps more important, is for the clinician. As the patient describes the situation and the clinician visually/aurally recreates it, they can have a better understanding of what the patient experienced. As they say, a picture is worth a thousand words – and an immersive VR scenario might be worth even more words.
It is important to note that Medical VR is not a “doc in a box” fix. The system is designed for carefully controlled clinical settings with a mental healthcare professional.
Medgadget: How can a clinician tailor the treatment for a specific patient?
Todd Richmond: The clinician has a “clinician’s control center” of sorts, which allows them to “point-and-click” to create a wide variety of scenarios with different stimuli, situations, and more.
Medgadget: How has the system worked for PTSD patients so far?
Todd Richmond: Clinical studies have shown significant improvements in the majority of patients. While this is not a “silver bullet,” so to speak, VR exposure therapy is proving to be a powerful tool that healthcare professionals can use to help heal those who suffer from PTSD.