COMMENTS BY CLINICAL EDITOR: Therapeutic use of virtual reality to overcome real-world issues.
in therapeutic settings because, for some, it may be a more enjoyable option than others the therapist presents. Although VR cannot replace important, traditional aspects of therapy, such as relationship building, home contingencies, drawing, and creative ventilation, it may enhance these activities.
VR Characteristics and Affordances in
VR has been used in educational contexts with children as young as 4 years old, for a maximum of 10 minutes per session with a rest period of 30 minutes, and a maximum of two sessions per day. The amount of time for each session and rest between sessions increases or decreases, respectively, as a person gets older, up to a maximum use period for the VR headset of one hour for adults per VR therapy session. Currently there are few studies on the amount of time a child can engage with VR, and this research is ongoing. In a recent study of 2,442 children aged 7 to 11, Pujol et al. (2016) suggested that playing video games for nine or more hours per week was linked to conduct
Therapeutic Virtual Reality opportunities for collecting and understanding individual patient data and analytics (Mohr, Burns, Schueller, Clarke, & Klinkman, 2013). Therapeutic VR provides opportunities for a clinician to observe a child’s abilities to engage in prospective decision-making, to recall and make use of prior cues and knowledge, to engage in socially acceptable control, and to release aggression (Didehbani, Allen, Kandalaft, Krawczyk, & Chapman, 2016). In addition to VR’s cognitive a view of the child’s ability to cooperate and to coordinate activities. This is advantageous, because play is regarded as the most effective setting to assess cognitive, social, and behavioral characteristics for children in a controlled environment (Harris & Reid, 2005).
Therapeutic VR is becoming a new and rapidly growing approach due its lower cost and greater availability. With this rapid growth, it becomes important to characterize the aspects of VR that provide affordances or barriers to play therapy, including the use of neuroimaging to assist in the triangulation of underlying outcomes. As computer-based VR simulations develop, the immersive nature, interactivity, and customizability of the environments (i.e., the broad interactivity and the realism of action), will allow children and clinicians to examine phenomena at multiple levels and to make transitions as needed to promote therapy.
Two critical factors that link VR play to effective therapeutic approaches are the increased level of engagement and the opportunity to practice. Other factors include using VR systems to guide and facilitate play interactions and to include cooperation. Children will engage with VR
Play Therapy Within the VR context, both mental and sensory immersion need consideration, and each is an important feature for creating a successful personal experience. The visual, auditory, or haptic devices related to sensory immersion must change in response to user movement in the VR environment responsively and in an interpretable way (MacLean, 2008). Haptic devices allow the integration of physical contact and feedback between the computer-generated environment and the user. This integration usually occurs through input output devices, such as sensor-enabled gloves or other sensor-enabled clothing user. Responsiveness and feedback are particularly important in the context of VR-based play therapies. If these do not occur, users may experience vertigo or other dysphoric events, reducing the activities’ effectiveness (Ferrer-García & Gutiérrez-Maldonado, 2012). Dysphoric events will greatly inhibit the therapeutic process and potentially make a child unwilling to use the VR environment.
When used appropriately, VR environments built with therapeutic approaches and the end user in mind allow users to interpret visual, auditory, and haptic cues to gather information while using systems to navigate and control objects in the virtual environment. In contrast to sensory immersion, mental immersion refers to the “state of being deeply engaged” within a VR environment (Huang, Rauch, & Liaw, 2010, p. 1172). For example, if a VR world is designed for therapeutic use, client success in mental immersion is contingent upon how involved the user becomes with the environment (Hale & Stanney, 2014).
Technologies have intrinsic
properties and activate cognitive systems that help children to
engage in meaningful learning and to solve problems
A second important feature that separates VR from other therapeutic technologies is the real-time interactivity in a stereoscopic 3D environment. That is, a VR system is able to interpret gestures and respond to new activities with relatively few lags in environmental changes. This responsiveness results in more authentic and real world-like immersion. Interactivity, control, and VR’s ability to respond
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