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Creating Virtual Environments for Phobia Treatment

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Creating Virtual Environments for Phobia Treatment Open Comput. Sci. 2016; 6:138–147 Review Article Open Access Dana Horváthová* and Vladimír Siládi Creating virtual environments for phobia treatment DOI 10.1515/comp-2016-0012 ysis of following resources as considerable success has Received Apr 30, 2016; accepted Jul 30, 2016 been achieved by using VR for distraction from pain or for panic disorder and agoraphobia [1]. In recent years, Abstract: In this paper, we try to present the problems of Virtual Reality Exposure Therapy (VRET) has become an the modern approach to treating various phobias. Virtual interesting alternative for the treatment of anxiety disor- environments created by virtual reality (VR) tools can help ders and several phobias [2–5]. Also Virtual Reality Cogni- to make the treatment of certain types of phobias more ef- tive Behavior Therapy (VRCBT) is an effective technology ficient. Attention to this form of phobia treatment with the with promising results [6, 7]. Treating simple phobias with help of VR is on the rise in the world, so we are also moni- VR techniques, clinical outcomes, cost effectiveness and toring its development, as well. Our paper introduces the possible side effects of this treatment are described in[8]. necessary hardware and software that has been piloted in VR therapy enables the patient to experience a realistic our department, but also methods of creating virtual en- yet carefully controlled exposure to an anxiety-provoking vironments, models and application designed for medical scenario in the therapist’s own office. While VR environ- therapies of patients. In our work we have searched for and ments were initially quite costly and demanded powerful tested the following methods for creating virtual environ- computers, lately their price has decreased, making this ments: A) modelling using computer graphics, B) mode- form of treatment an intriguing option for therapists [9]. lling animation using animation programs, C) taking pic- There is also direct comparison of In-Vivo Exposure Thera- tures of static objects and scenes, D) filming moving ob- py (IVET) and VRET using the same subjects and proce- jects and scenes using classic video or special scanning ∘ dures in studies differing in experimental settings, data techniques to create 360 panoramas or E) any combina- reduction procedures, and study populations [10]. Some tion of these methods. researches focus on various social phobias. In [11–13] the Keywords: Virtual reality; virtual environments; treatment fear of public-speaking that utilizes VR as a tool for ex- of phobias posure therapy is described. Re-exposure to memories of traumatic events via imaginably exposure therapy, which can lead to a reduction of Post-traumatic Stress Disor- 1 Introduction í der (PTSD) symptoms is analysed in [14]. Articles [15–18] are dealing with specific phobias such as arachnopho- bia [19, 20], talk about Aviaphobia, numerous spatial pho- Technical inventions are nowadays quickly penetrating bias are discussed in [21, 22] and lastly [23] is based on into all aspects of our lives. No wonder they are affecting treatment of phobias by computer games. The research re- also the area of medicine and psychotherapy. Thanks to sults from these mentioned references gave us reasonable virtual therapy, various types of phobias can be treated. outputs and good examples on how to use VR to treat pho- This is the true progress for patients suffering from pho- bias. bias. Although our task at this moment is not to treat pho- Many studies describe their experience with using bias, the fact that hundreds of patients leave the clinics VR in psychotherapy. Our research was based on anal- around the world treated, gives us hope for the future. At the Department of Informatics, Faculty of Natural Sciences, Matej Bel University in Banská Bystrica we have *Corresponding Author: Dana Horváthová: Department of Com- devoted our third year to issues of phobia treatment via puter Science, Faculty of Natural Sciences, Matej Bel University, VR. The definition of the problem that we have decided to Banská Bystrica, 974 01, Slovakia; Email: [email protected] deal with was to find the most efficient method of creation Vladimír Siládi: Department of Computer Science, Faculty of Natu- of environments, situations and objects for a certain kind ral Sciences, Matej Bel University, Banská Bystrica, 974 01, Slovakia; Email: [email protected] of phobia. Our main goal was to prepare materials used © 2016 D. Horváthová and V. Siládi, published by De Gruyter Open. This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 License. Creating virtual environments for phobia treatment Ë 139 by psychotherapists to help treat various kinds of pho- A third group of phobias are so called specific phobias, bias, such as for example fear of spiders (Arachnophobia), also known as isolated phobias. Fear of certain objects and fear of reptiles (Herpetophobia), fear of heights, depth situations fall into this category. A good example is fear of (Hypsophobia, Akrophobia) or open spaces (Agoraphobia) spiders, bacteria, snakes, blood, lightning, dark etc. [27]. and so on. For the use of phobia treatment, we are creat- Categorization of some types of phobia could differ ∘ ing pictures, objects, 3D models, videos, 360 panoramas considering the above-mentioned source [26], as well as and sounds, to create realistic environments and situa- subject of the phobia could fall into several groups. For ex- tions easing the treatment process for psychotherapist and ample, someone feels serious anxiousness when crossing speeding up the inducement of the desired state for the pa- through the town square. With one’s feet trembling, one tient. can have difficulties with breathing and is unable to think rationally, escaping the place in panic. The described si- tuation can be typical for agoraphobia, if caused by fear 2 Phobias and their treatment of large and open spaces while moving away from safety of one’s home. At the same time, the situation could be a type of social phobia, if being the centre of attention and Clinical psychology describes phobias as anxiety disorder, in the presence of too many people caused the panic. characterized by intense irrational fear of specific objects Nowadays there are several ways of treating phobia, or situations. This excessive amount of fear does not corre- some of them used in combination with others. The most spond to the potential amount of danger of stimulus. De- commonly used treatment method is pharmacotherapy to- spite the fact, people suffering from phobias experience in- gether with psychotherapy, where dominating approaches tensive psychic symptoms (anxiety, loss of control, fear) are cognitive-behavioural, psychosocial methods and re- and vegetative symptoms (increased heartbeat, fainting, laxation procedures [27]. sweating, problems with breathing). The content of pho- Many practical techniques were developed to over- bias has a compulsive characteristic – concern that the come pathological fear. The core of these techniques is feared object could also occur outside the real time and to provide patient with correction experience, which in- place which might lead to anticipated fear and evasive be- cludes confrontation with the item or situation of fear in haviour [24, 25]. safe environment. Here, the psychotherapist creates spe- Generally, phobias could be divided into three main cific conditions, which helps to overcome the fear of be- categories: agoraphobias, social phobias, and specific ing exposed to concerned item or that makes the situation phobias [26]. easier. Exemplary technique is systematic desensibilisa- Agoraphobias are characterized by fear of places or tion composed of three parts: 1. Evoking a suitable and situations, i.e. large overcrowded spaces, or on the con- comfortable state; 2. Creating of a set of situations, gradu- trary, fear of closed and confined places. In the case of ally evolving in strength and content (from completely these types of phobia, patients are often concerned that harmless up to a stimulation creating maximal phobic re- by necessity, there will not be immediate help available. sponse); 3. Getting gradually more accustomed to these More serious cases of this disorder lead to complete isola- situations and enduring them in the pleasant state. Join- tion from the outside world, where patients do not leave ing the dreaded situation with emotional state, which ex- their homes [27]. cludes fear, takes place in real situations - “in vivo” or Another group is described as social phobias, which situations most vividly imagined by patients - “in vitro” are usually connected with low self-confidence, fear of in laboratory. Excessive fear is thus being suppressed by critique, fear of people, overcrowded places or fear of deliberate and repeated imagination of ideas. Situations travelling in various kinds of transport. Social phobias that produce fear, combined with muscle and mental re- might also be induced by performing publicly or some- laxation, to the contrary of fear in mental, are motoric and times just by general communication with an individual. autonomic [28, 29]. All these situations lead to avoiding social contact. Some- In psychotherapy there are many other methods; im- times the social phobia does not necessarily have to be plementation of which can be interconnected with newer caused by fear from other people, but rather from the pa- types of treatment - therapy through VR [30–33]. Due to the tient themselves. This can stem from
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