Low-cost VR to support imaginal exposure in PTSD treatment: a case report
Exposuretherapie voor PTSS vertrouwt doorgaans op imaginaïre technieken, maar het handhaven van levendigheid kan een uitdaging zijn. Dit casusverslag beschrijft het gebruik van goedkope, kant-en-klare virtual reality als ondersteuningsinstrument binnen een bestaand PTSS-behandelingsprotocol in een ambulante geestelijke gezondheidszorgsetting. Het biedt een concreet, clinicusvriendelijk verslag van hoe VR kan worden geïntroduceerd zonder gespecialiseerde apparatuur of grote budgetten.
Samenvatting
Revisiting what happened during (or after) a traumatic event is an important part of the treatment process in trauma-focused cognitive therapy (TF-CT). However, clinicians may have difficulty helping patients to intentionally retrieve these memories in order to engage with their content. As such, clinical tools to support the access and delivery of imaginal exposure content within treatment may prove to be particularly useful for therapists. This case report introduces work undertaken with Mr. A, a 38-year-old male, who 2 years prior had experienced a city centre assault. Initial assessment revealed a PCL-5 score of 64 and he met DSM-5 criteria for posttraumatic stress disorder (PTSD). Mr. A received 10 sessions of TF-CT wherein the traditional imaginal exposure components were implemented via a newly developed virtual reality (VR) development workflow called “VR Photoscan.” After 10 sessions, results showed PCL-5 scores decreased from 64 to 19 and Mr. A no longer met DSM-5 PTSD criteria. VR Photoscan was used during 4/10 sessions and included (1) reliving, (2) memory updating, and (3) stimulus discrimination activities. Mr. A also reported VR Photoscan as helpful regarding preparation for site visits. In conclusion, VR Photoscan technology provided a more visceral exposure experience which supported Mr. A to revisit the trauma memory. He reported high levels of satisfaction with the quality of the virtual environment and no issues using the VR technology. Produced with lower costs and shorter development times than typical computer-generated environments, VR Photoscan may be more easily implemented within routine care, although further research is required.
Trefwoorden: virtual reality, PTSD, exposure therapy, imaginal exposure, case report, community mental health
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Referentie
Best, P., Kupeli-Holt, S., Elliot, A., Duffy, M., D’Arcy, J., & Van Daele, T. (2024). Low-Cost Virtual Reality to support imaginal exposure within PTSD treatment: A case report study within a community mental healthcare setting. Cognitive and Behavioral Practice, 31(4), 577–594. https://doi.org/10.1016/j.cbpra.2023.03.003