The Future of Virtual Reality Therapy

May 31

The social media giant Facebook made headlines in late 2021 by changing the company’s name to “Meta.” Although cynics saw this as an attempt to rebrand themselves out of bad publicity, there was more to the name change. The company’s new name represents its commitment to the future of virtual and augmented reality. These technologies will have far-reaching impacts on all areas of life, including on how therapy is delivered.

A metaverse of possibilities

The name “Meta” is a reference to “the metaverse,” a concept previously relegated to science fiction stories. “The metaverse” is a vision for a network of virtual worlds traversed with the click of a button, allowing users access a breadth of 3D spaces for productivity, entertainment, communication, education, and more. Since purchasing the pioneering virtual reality headset company Oculus for approximately two billion dollars in 2014, company head Mark Zuckerberg has made it clear that he believes that VR is the future. Meta’s promotional video outlining its vision for the metaverse depicts people meeting up in virtual reality to play board games, surf virtual waves, and even attend real-life events as a digital avatar. It is clear that Mark Zuckerberg and the rest of the folks at Meta believe that their investments in virtual reality will garner major dividends, as they help to create a new way of experiencing life that is less bound by the strictures of physical location.

Come together, right now (virtually)

The COVID 19 pandemic has changed the way we think about sharing physical spaces with other people. Some who might have never considered attending a webinar prior to the pandemic might find that they have become accustomed to Zoom meetings as a matter of course. Meta (then Facebook) launched their relatively-low-priced Quest 2 virtual reality headset during the height of the pandemic in 2020. Although official figures have not been released, the Quest 2 appears to be selling well based on reports of app sales from the Quest content store. Every new headset sold represents a new citizen of the metaverse.

Many of these new users will have been drawn to virtual reality by the promise of new dimensions for gaming and entertainment. However, it will also revolutionize the way we communicate with one another and receive personal services. This includes healthcare, and, more specifically, counseling and therapy.

Therapy from the comfort of your own couch

At the beginning of the COVID-19 pandemic, many psychotherapy sessions transitioned from being held in-person to being conducted online using video-conferencing software. Studies have shown that online therapy is as effective as in-person therapy, and many therapy clients and practitioners have come to appreciate the convenience and accessibility of video sessions. Therapy sessions held within virtual reality would offer many of the same benefits of traditional online therapy, with the potential for an added dimension of “presence.”

Presence of mind (and body)

In the world of virtual reality, the word “presence” is used to describe the degree to which someone wearing a virtual-reality headset feels immersed in the virtual experience. With a high enough degree of presence, a user should feel as though they have really stepped into another reality. If two users are both experiencing a high degree of presence as they share a virtual encounter, they should feel as though they are occupying the same physical space.

This opportunity for a shared sense of physical presence will, in my opinion, be a boon for online therapy. Clinicians and clients may feel a sense of togetherness that is beyond what traditional video-conferencing can offer.

This increased sense of presence has the potential to have a positive impact on online therapy in general. In addition, virtual reality is already showing promise for use in particular therapeutic applications.

Wounded warriors

One specific application of virtual reality therapy that has been researched is with veterans suffering from Post Traumatic Stress Disorder. In this experimental therapy, virtual reality technology has been used to reproduce the sights, sounds, and even smells of wartime in an intense and convincing way. This reproduction of the sensory circumstances of the battlefield allow veterans to confront the sources of their trauma in a direct and visceral way. It is the hope that in recreating these traumatic experiences in a therapeutic context, those suffering from PTSD might eventually be less disturbed by intrusive memories associated with them.

Social anxiety

Another potentially therapeutic application of Virtual Reality that has been discussed is using it as a tool to build social skills and lessen social anxiety. Some VR users have stated that they’ve found it helpful to use virtual reality as a means of interacting with others when entering into a real-life social situation with strangers might be too overwhelming. This anecdotal evidence has been supported by preliminary research. If the stereotype of a video game player is an anti-social one, it is interesting to think of virtual reality as a means of potentially drawing people out of their shells.

Play therapy for all

Virtual reality offers users the opportunity to embody different “avatars,” or digital representations. These avatars might resemble the user somewhat (at this point cartoonish representations are the closest to real-life that the technology can provide), or might be completely different. Users can choose or design avatars of different artistic styles (think anime) or even different species.

There is much that can be gained therapeutically from discussing an avatar that someone might choose to represent themselves. Why did they choose it? How do they feel they are similar to their avatar representation, and how do they feel they are different? How do they feel when they embody their avatar? Making space to explore a client’s imagination is a hallmark of child therapy. It is also an important piece of depth psychotherapy with adults. Virtual reality might give clinicians the opportunity to not only inquire about a client’s imagined worlds, but experience them together.

The end of the beginning

It is undeniable that virtual reality has made huge headway since the groundbreaking Oculus Rift headset was released in March of 2016. A technology that had spent decades as a distant fantasy has proven to have real-world potential. Despite these gains, virtual reality technology still has a very long way to go before it can be widely used in the context of therapy.

The biggest barrier to widespread use of virtual reality in therapy is cost. Even with Meta selling their headsets at a loss in order to popularize the technology, VR headsets still cost hundreds of dollars. In addition, the most graphic-intensive VR experiences require that a headset be connected to an expensive gaming PC. These costs will need to come down if we are to have equitable access for all to virtual reality.

Another benchmark that will need to be reached before we will see widespread adoption of virtual reality in therapy is the ability to render near-photorealistic avatars, as well as the ability to track facial expressions and full-body movements. As I mentioned before, there is much that can be learned in a therapeutic context from a client’s fantasy avatar. However, it is also important that the real-world appearance of the therapist as well as the client is able to be reproduced convincingly within virtual reality. This will allow for an appropriate degree of professionalism when called for, and contribute to a heightened sense of presence. When headsets are able to use cameras to track facial expressions, clinicians and clients will be able to read each others’ faces as they would in person or over video conferencing. The ability to read facial expressions is essential to the therapist’s ability to ascertain the client’s experience, and to the client’s feeling that they are being heard and understood by the therapist. Although this kind of technology might seem far-off, it was teased in a very convincing way in a demonstration from Meta’s latest Connect event, when a video of a man speaking was revealed to be a digital reconstruction. To supplement the importance of near-photorealistic avatars and facial tracking to a sense of the client and clinician really being together, full-body tracking would allow clinicians to monitor the body language of their clients.

A final consideration that will need to be addressed is that of privacy. Meta and other companies that make software for the metaverse will need to ensure that HIPAA- compliant communication options exist within VR so that the confidentiality of virtual reality therapy sessions could be assured.

A brave new (virtual) world

Mark Zuckerberg is right to believe that virtual reality and the metaverse will change the fabric of our lives substantially. In addition to providing new dimensions to entertainment, these fledgling technologies will change how we interact and spend time with each other. Healthcare will be one of the many industries that are transformed as the metaverse grows. For those who are open to exploring it, virtual reality therapy may represent a new frontier of personal growth and healing.

Andrew Conner