Virtual reality worlds could soon be available on prescription

Strapping on a headset and playing a game may not sound like the best way to tackle depression. In normal circumstances retreating to your room and immersing yourself in a fictional world might seem downright unhelpful. But actually virtual reality (VR) is increasingly being seen as an effective way to treat a range of mental illnesses.

For over a decade, US soldiers suffering from PTSD have been able to relive and re-contextualise their experiences in a ‘virtual Iraq’.

Supported by clinical experts, soldiers are thrust into a lifelike version of a desert war zone, working through traumatic experiences time and time again. Clinical studies suggest it helps soldiers adjust to normal life.

The idea is that it acts as a form of immersion therapy, gradually breaking down fear and anxiety through increasing exposure to the cause of psychological discomfort.

Now, in a new study published in the British Journal of Psychiatry Open, researchers from University College London have discovered that immersion therapy — or Virtual Reality Exposure Therapy (VRET) — can also have an impact in tackling depression.

During the study patients with a history of depression were placed in a digital world where they could view a virtual version of themselves in a mirror. Watching this virtual body move in the mirror creates an illusion called ‘embodiment’ — tricking the brain into believing that the virtual you is the real you.

Patients in the study were confronted with a tearful child who they comforted. The patients then found themselves in the child’s body, receiving their own supportive words.

At the end of the study nine patients reported encouraging signs of progress, with four reporting a ‘clinically significant’ reduction in depression.

It may be small scale, but it’s one of a growing number of studies making the case for virtual reality therapy.

Christopher Wilson, a behavioural psychologist at Teesside University, says its success is down to a phenomenon called ‘presence’. ‘The person feels like they are “doing” something, rather than “watching” something,’ he explains. ‘As such their emotional and behavioural responses have been found to closely resemble what one might experience in a real-life situation.’

One virtual reality therapy already being trialled in a number of London hospitals is a game called Pesky gNATs (the NAT stands for negative automatic thoughts). The game helps nine- to 12-year-olds cope with obsessive compulsive disorder and anxiety. Let loose on a desert island, players confront their own negative thoughts.

The game is based on the principles of cognitive behavioural therapy (CTB). It helps children tackle their anxiety by breaking the problem down into thoughts, feelings and actions. The child and therapist play the game together, putting into practice CBT-based coping strategies.

The NHS offers other digital therapies, too, such as online CBT courses for those with minor depression or anxiety which can be completed at home. The driving force here is money, with the cash-strapped mental health sector keen to explore anything that can help reduce costs.

While NICE — the body responsible for sanctioning treatments and drugs for use in England — has yet to approve any form of VR as a treatment, organisations within the NHS are trialling it, adding to the evidence base which could change policy in the future.

So will we be seeing virtual reality on prescription? ‘Right now the use of VR is in its early stages,’ says Wilson. ‘Further research would be needed before it was rolled out on a wide-scale basis.’