Reliving and overcoming trauma through virtual reality therapy
Created and developed at the University of Southern California Institute for Creative Technologies, the program was originally funded by the Department of Defense and was most recently supported by the SoldierStrong Foundation.
The virtual reality exposure is offered at 60 clinics nationwide, including VA hospitals, military bases and university centers. It uses a mixture of exposure therapy and guided therapy sessions to help confront traumatic memories.
What's different than the treatments mentioned in my piece is the use of their "Virtual Iraq/Afghanistan" exposure simulation, called Full Spectrum Warrior, on the Microsoft X-Box platform.
Through BRAVEMIND I was connected with Dr. Todd Adamson.
Dr. Adamson is a clinical psychologist based in Los Angeles. He has worked with military service members and veterans for over 10 years within both the Department of Veterans Affairs healthcare system and the nonprofit sector.
Dr. Adamson provides VR training and consultation for mental health providers and also offers low-fee VR therapy for OIF/OEF service members.
He maintains a clinic in West Los Angeles where he works with teens, families, and adults. We exchanged remarks over email.
The Iraq/Afghanistan virtual reality therapy approach has been shown to reduce PTS symptoms in combat veterans and first responders. With more troops returning home from Iraq and Afghanistan in the coming months, do you anticipate an uptick in the distribution of headsets to VA facilities and clinicians who work with veterans?
Yes, as more troops are returning home from service, we do anticipate an uptick in distribution of headsets to VA facilities and providers throughout the country. Soldier Strong is spearheading this distribution with Bravemind systems at over a dozen VA facilities in the United States. The goal is to get this form of trauma treatment to as many returning veterans as possible and also train as many mental health providers as we can on the Bravemind system to support this expected demand.
Prolonged exposure, on which the therapy is based, can be used for preparedness and training. Rather than retroactively addressing mental health after service tours, are there plans to use in anticipation of deployment?
While traditionally, Prolonged exposure or PE, has been used to address and treat symptoms associated with PTS, there are aspects that can be used in specific ways to help prepare and train military service members for active duty. My colleague, Skip Rizzo, at the USC Institute for Creative Technology, has developed a program called STRIVE (Stress Resilience in Virtual Environments) to help address the emotional coping skills to support service members as they prepare for deployment and stress of combat.
I think we should note that VR therapy is used in conjunction with gold standard treatment such as Cognitive Behavioral Therapy. With that said, what are some of the most common reasons a service member would be reluctant to try traditional therapy? And how does VR fit into that treatment?
Therapy is hard and getting in there and doing the work is something I think most of us would rather avoid doing. It’s often after a period of family problems, work-related issues, or personal struggles that we realize we can’t do it alone and need help. The notion of talking to someone about these topics can be overwhelming and this is especially true for service members, who as part of their service and the culture of the military, are implicitly and sometimes explicitly dissuaded from seeking external help or support to talk about emotions, pain, and fear.
The specific forms of therapy for treating PTS zero in on the symptoms of re-experiencing, avoidance, and hyper-arousal in a way that general talk therapy does not, and as a result trauma therapy is very specific, systematic, and contained. All forms of therapy incorporate some element of exposure, simply going to a therapist's office or logging into Zoom are forms of exposure to the situation where I am going to share and talk about thoughts and feelings.
When we do exposure therapy, it involves having the service member recall the experience from memory and retell it in the present. For many, this can be challenging due to the avoidant nature of PTS or an inability to “see” an image in one’s mind. This is where VR can step in and help to facilitate that aspect by providing a visual context and environment for the service member so that they can begin to revisit their traumatic experience in a safe way and process emotions and thoughts that have been long avoided. In doing so, they begin to regain control over the memories and develop a different relationship to the past.