Ong Triton, Ivanova Julia, Soni Hiral, Wilczewski Hattie, Barrera Janelle, Cummins Mollie, Welch Brandon M, Bunnell Brian E
Doxy.Me Research, Doxy.Me Inc, Rochester, NY, USA.
Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
Virtual Real. 2024;28(2). doi: 10.1007/s10055-024-00956-7. Epub 2024 Mar 8.
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, previous experiences with VR, 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 difficulties (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 of VR (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 reveal how combining telehealth and VRET may expand therapeutic options for mental healthcare providers and can help inform collaborative development of immersive health technologies.
虚拟现实（VR）可以改善精神卫生保健。特别是，基于VR的暴露疗法（VRET）治疗焦虑症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，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、以前使用VR的经历以及对远程VRET的看法。治疗师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）、环境不受控制（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），使暴露疗法适用于远程医疗。大多数治疗师以前使用过VR（72.2%，13/18），并且对VR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）、副作用和隐私问题（22.2%，4/18）以及不适用于特定形式的暴露疗法（16.7%，3/18）。这些结果揭示了将远程医疗和VRET相结合如何可能为精神卫生保健提供者扩展治疗选择，并有助于为沉浸式健康技术的合作开发提供参考。
