What is it like to give a VR therapy? Monique Nederstigt tells her story

Since March 2017 I have been working as a practitioner for the DiSCoVR pilot study with two other psychologists from the University Centre for Psychiatry (UCP) at the psychosis outpatient clinic. As part of this research, I am giving the DiSCoVR treatment to clients of the UCP.

Setting goals

At the beginning of the training we set goals together with the participant. For example, they may want to become better at small talk or communicate more clearly and make their wishes better known. The challenge for me is to see, together with the participant, which (social-cognitive) skills are needed for this purpose and which strategies they can best use. For example, looking at someone’s body language, thinking about how you would feel yourself, asking someone how they would feel in a certain situation or asking if you understood the other person correctly.

Practicing with VR

These skills are practiced step by step in the assignments in the VR environment. Participants get VR glasses and see and hear the avatars (virtual people) in the program. The participant watches the avatars and has to determine which emotion is involved. They also see avatars in conversation with each other, the participant must then determine what these avatars think and feel and argue why they think this.

Role playing

There is plenty of room for personal input from the participants. During the training there is a lot of practice with role playing. Based on the goals, situations are chosen and ‘recreated’ in the virtual environment by the practitioner and the participant. The practitioner talks to the participant through the avatar and the practitioner’s voice is distorted by a microphone. In the beginning it is a strange experience for the participant to hear the avatar talking with, for example, a heavy male voice, while they know that this is the practitioner speaking to them. Fortunately, they quickly get used to this. In this way situations can be practiced and in the discussion after there is talk about what can be improved.

Experiences

Participants experience that they can make mistakes, learn from them and do it again to improve themselves. Because they practice with avatars and not directly with the therapist, the exercises are experienced as more ‘real’, even though participants know they are in a virtual environment. I also like this more as a therapist. If, for example, I have to criticise the participant in a role play, it is easier in VR. There is more emotional distance because the criticism is expressed through the avatar. It’s also clearer, the role-play takes place via the avatar and the evaluation, after the role- play, with the practitioner himself. In this way the different roles of the practitioner are not mixed up. VR therefore offers a safe environment in which practice situations can be tailored to suit the situation.

Enthusiastic participants and treatment!

Participants are enthusiastic to work with this training. They tell me that in between the sessions they also started working with their goals and the newly learned interventions. The VR helps them to take this step more easily. I myself am also very enthusiastic about this treatment method and I expect, given the rapid developments, that the VR possibilities will be expanded and more advanced and who knows, also easier to apply in everyone’s consulting room.