Kip Hanneke, Kelders Saskia M, Weerink Kirby, Kuiper Ankie, Brüninghoff Ines, Bouman Yvonne H A, Dijkslag Dirk, van Gemert-Pijnen Lisette J E W C
Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands.
Department of Research, Stichting Transfore, Deventer, Netherlands.
Front Psychol. 2019 Feb 27;10:406. doi: 10.3389/fpsyg.2019.00406. eCollection 2019.
Although literature and practice underline the potential of virtual reality (VR) for forensic mental healthcare, studies that explore why and in what way VR can be of added value for treatment of forensic psychiatric patients is lacking. This study aimed to identify (1) points of improvements in existing forensic mental health treatment of in- and outpatients, (2) possible ways of using VR that can improve current treatment, and (3) positive and negative aspects of the use of VR for the current treatment according to patients and therapists. Two scenario-based methods were used. First, semi-structured interviews were conducted with eight therapists and three patients to elicit scenarios from them. Based on these results, six scenarios about possibilities for using VR in treatment were created and presented to 89 therapists and 19 patients in an online questionnaire. The qualitative data from both methods were coded independently by two researchers, using the method of constant comparison. In the interviews, six main codes with accompanying sub codes emerged. Ideas for improvement of treatment were grouped around the unique characteristics of the forensic setting, characteristics of the complex patient population, and characteristics of the type of treatment. For possibilities of VR, main codes were skills training with interaction, observation of situations or stimuli without interaction, and creating insight for others into the patient. The questionnaire resulted in a broad range of insights into potential positive and negative aspects of VR related to the current treatment, the patient, the content of a VR application, and practical matters. VR offers a broad range of possibilities for forensic mental health. Examples are offering training of behavioral and cognitive skills in a realistic context to bridge the gap between a therapy room and the real world, increasing treatment motivation, being able to adapt a VR application to individual patients, and providing therapists with new insights into a patient. These findings can be used to ground the development of new VR applications. Nevertheless, we should remain critical of when in the treatment process and for whom VR could be of added value.
尽管文献和实践都强调了虚拟现实（VR）在法医精神卫生保健方面的潜力，但探索VR为何以及如何能为法医精神病患者的治疗增添价值的研究却很缺乏。本研究旨在确定：（1）现有住院和门诊法医精神卫生治疗中的改进点；（2）使用VR改善当前治疗的可能方式；（3）患者和治疗师认为VR用于当前治疗的积极和消极方面。使用了两种基于场景的方法。首先，对8名治疗师和3名患者进行了半结构化访谈，以引出他们提出的场景。基于这些结果，创建了6个关于VR在治疗中应用可能性的场景，并通过在线问卷呈现给89名治疗师和19名患者。两位研究人员使用持续比较法对两种方法的定性数据进行了独立编码。在访谈中，出现了6个主要代码及相应的子代码。围绕法医环境的独特特征、复杂患者群体的特征以及治疗类型的特征，对治疗改进的想法进行了分组。对于VR的可能性，主要代码包括互动式技能训练、无互动地观察情境或刺激以及让他人深入了解患者。问卷得出了关于VR与当前治疗、患者、VR应用内容以及实际问题相关的潜在积极和消极方面的广泛见解。VR为法医精神卫生提供了广泛的可能性。例如，在现实情境中提供行为和认知技能培训，以弥合治疗室与现实世界之间的差距；提高治疗动机；能够根据个体患者调整VR应用；并为治疗师提供对患者新见解等。这些发现可用于为新VR应用的开发奠定基础。尽管如此，我们仍应谨慎考虑在治疗过程中的何时以及对谁而言VR能增添价值。
