MHConcierge has posted several articles in the last year about using virtual reality (VR) for therapy. It is evident that VR is a “thing,” and therapists need to know enough about VR to make an informed decision about whether to incorporate it into their practice.
This will be the first of several MHConcierge posts about VR. We will start with a brief overview of VR and VR headsets. Future posts will discuss more specific use of VR with certain disorders, mainly anxiety disorders including social anxiety, phobias, and PTSD, but also pain disorders. And, it can be potentially helpful for relaxation training and guided meditation.
First, a few disclaimers: I bought my own VR headset, an Oculus Quest 2, so I have no financial ties to the manufacturer. Second, I am not a tech expert; I hope that my research and experiences as a retired therapist interested in VR technology will speak to your own needs – perhaps more effectively than would be done by a tech geek.
VR technology creates a computer-generated, three-dimensional digital experience through a headset, hand-held controllers and, potentially, other devices. The headset runs programs, such as games and immersive environments, developed for VR. The headset and other devices have sophisticated sensors that track head and hand movements and feed this data to the program. The program responds to the user’s movements and other inputs, and the digital environment is altered in ways that create a much more immersive experience than typical two-dimensional programs.
The VR experience can be powerfully vivid and “real.” In fact, some programs have ratings for “comfort” or “intensity,” and may even include warnings about the risk of motion sickness, disorientation. and other potentially problematic psychological “side effects” for some people. Most people, however, experience VR as a highly engaging and entertaining experience. In fact, the most common risk for buying a VR headset is it can be “addictive.”
VR has interesting potential for therapy. It allows the therapist to provide a controlled and psychologically intense environment that can allow work on selected psychological problems. It is particularly well-suited to exposure therapy.1 It enables precise control of the intensity and pace of exposure, and the experience can be repeated. It also has potential benefits for research because the VR experience can be “consistently replicated, tested, and modified within a safe environment….”1
VR Hardware – the Oculus Quest 2
There are, in general, three types of VR headsets: “stand-alone” headsets that use your WI-FI network; computer headsets that are connected to a computer and are primary designed for gaming; and headsets that connect to a smartphone. The smartphone versions are much cheaper, with Google offering one made out of cardboard (!) (the user provides the smartphone which provides the visual and auditory action) for $10 and many others that connect with a smartphone for $30 to $50. These headphones, however, are being phased out – the other VR systems are much more powerful, have better resolution and therefore a better visual experience, and have more complex programs.
Before buying, I read reviews of VR headsets from two reliable online tech resources, CNET2 and PC Maagazine3. Both reviewers highly recommended the Oculus, for several reasons: it is an updated version of the Oculus Quest and the Oculus Rift headsets, with significant improvements, but based on reliable hardware and programs; it is very easy to set up using your WI-FI network; it provides both stand-alone and computer functions; it has all of the functions that most VR users would need; there are many programs available; and the price is actually lower than the previous generation.
Oculus is owned by Facebook, and Facebook reportedly views it as “the future of social networking”3 Facebook is subsidizing the Oculus Quest 2 to reduce the price and investing in VR games and social apps that can be used by multiple people to expand usage of VR. The reviewers commented that customers who do not like Facebook may not be comfortable buying an Oculus. On the other hand, they suggest that having your Facebook privacy settings in order probably will enable you to use the Oculus without your data being shared and your privacy violated.
The 64GB Oculus is $299 and the 256GB is $399. Other options include: Sony PlayStation VR ($349-485); HTC Vive Cosmos Eliste) ($899)750.80); HTC Vive Pro VR System) ($1,199); Valve Index ($999)
The Oculus reviews stated that the 64GB has enough capacity for most entry-level VR uses, so that is what I bought. I found it to have a mostly solid build, except for the head strap, which seems flimsy – and the reviewers agreed. I found that the headset felt unbalanced and a bit wobbly. Oculus offers the “Elite Strap” for $49, which seems like a lot for what you get – a strap like the original, with an “ergonomic” attachment that looks like it must cost about $0.50. Reviewers recommend it for people who use their VR headset for extended periods, such as gaming. There are cheaper alternatives from other companies, such as this one for $24.
I am lucky because a friend with a 3D printer made an attachment that works very well. The headset is much more comfortable and stable – I cannot imagine using my Oculus for more than about 15 minutes without it.
So, I connected my new Oculus to my WI-FI network, registered it with Facebook, downloaded some free introductory programs, and took it for a spin. It was quite an experience!
Up next: the VR experience
1“The use of virtual reality technology in the treatment of anxiety and other psychiatric disorders,” Maple-Keller, Bunnell, Kim and Rothbaum, 2018.
2CNET review of VR headsets – includes an extremely helpful 20-minute video review.
3PC Magazine’s review of the best VR headsets for 2021.