Ong Triton, Wilczewski Hattie, Soni Hiral, Ivanova Julia, Barrera Janelle, Cummins Mollie, Welch Brandon, Bunnell Brian
Doxy.me Inc.
University of South Florida.
Res Sq. 2023 Jul 17:rs.3.rs-3161151. doi: 10.21203/rs.3.rs-3161151/v1.
Virtual reality (VR) can enhance mental health care. In particular, the effectiveness of VR-based exposure therapy (VRET) has been well-demonstrated for treatment of anxiety disorders. However, most applications of VRET remain localized to clinic spaces. We aimed to explore mental health therapists' perceptions of telehealth-based VRET (tele-VRET) by conducting semi-structured, qualitative interviews with 18 telemental health therapists between October and December 2022. Interview topics included telehealth experiences, exposure therapy over telehealth, perceptions of VR in therapy, and perspectives on tele-VRET. Therapists described how telehealth reduced barriers (88.9%, 16/18), enhanced therapy (61.1%, 11/18), and improved access to clients (38.9%, 7/18), but entailed problems with technology (61.1%, 11/18), uncontrolled settings (55.6%, 10/18), and communication di culties (50%, 9/18). Therapists adapted exposure therapy to telehealth by using online resources (66.7%, 12/18), preparing client expectations (55.6%, 10/18), and adjusting workflows (27.8%, 5/18). Most therapists had used VR before (72.2%, 13/18) and had positive impressions (55.6%, 10/18), but none had used VR clinically. In response to tele-VRET, therapists requested interactive session activities (77.8%, 14/18) and customizable interventions components (55.6%, 10/18). Concerns about tele-VRET included risks with certain clients (77.8%, 14/18), costs (50%, 9/18), side effects and privacy (22.2%, 4/18), and inappropriateness for specific forms of exposure therapy (16.7%, 3/18). These results show how designing for telehealth may extend VRET and can help inform collaborative development of health technologies.
虚拟现实（VR）可以改善心理健康护理。特别是，基于VR的暴露疗法（VRET）在治疗焦虑症方面的有效性已得到充分证明。然而，VRET的大多数应用仍局限于诊所空间。我们旨在通过在2022年10月至12月期间对18名远程心理健康治疗师进行半结构化的定性访谈，来探索心理健康治疗师对基于远程医疗的VRET（远程VRET）的看法。访谈主题包括远程医疗体验、通过远程医疗进行的暴露疗法、对治疗中VR的看法以及对远程VRET的看法。治疗师们描述了远程医疗如何减少障碍（88.9%，16/18）、增强治疗效果（61.1%，11/18）以及改善与客户的接触（38.9%，7/18），但也带来了技术问题（61.1%，11/18）、环境不可控（55.6%，10/18）和沟通困难（50%，9/18）。治疗师通过使用在线资源（66.7%，12/18）、让客户做好预期准备（55.6%，10/18）以及调整工作流程（27.8%，5/18），将暴露疗法应用于远程医疗。大多数治疗师以前使用过VR（72.2%，13/18），并且有积极的印象（55.6%，10/18），但没有人在临床中使用过VR。对于远程VRET，治疗师们要求提供互动式会话活动（77.8%，14/18）和可定制的干预组件（55.6%，10/18）。对远程VRET的担忧包括某些客户存在风险（77.8%，14/18）、成本（50%，9/18）、副作用和隐私（22.2%，4/18）以及不适用于特定形式的暴露疗法（16.7%，3/18）。这些结果表明，为远程医疗进行设计如何可以扩展VRET，并有助于为健康技术的合作开发提供信息。
