Opioid addicts and others battling compulsion around drugs or alcohol are using a new high-tech, low-risk method to practice saying no—through virtual reality.
Their virtual reality avatars, accompanied by Vanderbilt University clinical psychology graduate student Noah Robinson, walk into a virtual bar, turn down alcoholic drinks offered by a stranger, and ask for water instead. A different VR world allows them the drug-free relaxation of interacting with colorful, free-floating spheres while listening to uplifting music.
“If you design the virtual environment to be therapeutic, you can allow them to escape a real environment, which has tons of cues that are encouraging addicts to use drugs or alcohol,” said Robinson. “We can use virtual reality as a way to immerse people into therapy and have them be able to be connected with social support.”
Robinson’s research is under the direction of Steve Hollon, Gertrude Conaway Vanderbilt Professor of Psychology.
Partnering with patients
A partnership between Robinson and a Nashville-area rehabilitation center promises to expand the use of VR in addiction therapy, from initial intake through post-treatment.
During his practicum at Journey Pure, Robinson said he’s noticed that new patients often arrive in an agitated state. He suggested trying VR to help calm them.
“VR can help regulate their emotions as a substance might, but it’s not physically addictive,” Robinson said. “It releases neurotransmitters to counteract negative emotions. If they wake up at 3 a.m. and want to use, they can put on a headset instead.”
Promising early results
Of the 30 patients who initially tried the system, 29 reported it improved their mental outlook, Robinson said.
“What we’re seeing is that if you deliver therapy when someone is in a state of relief, the therapy seems to be sinking in more effectively than if you were trying to do therapy with someone while they’re experiencing all these negative emotions,” said Robinson.
Brian Wind, Journey Pure’s chief of clinical operations and an adjunct instructor in Vanderbilt’s psychology department, said it’s difficult to hypothesize why VR works on a neurological level, but its potential is clear.
“You can literally pluck patients from the environment where they’re feeling upset or dysregulation and place them into a soothing and calming environment away from all the chaos,” he said. “Unearthing all the old adverse experiences and trauma can cause the upset. Put them into VR seems to regulate that.”
Robinson is seeking Institutional Review Board approval for a formal experiment with detox patients. He stresses that this is all experimental and it’s not an established therapy.
Robinson says the long-term goal is to get these headsets in the homes of patients or have VR therapy centers easily available.
“If you can create an intervention that is as accessible for the addict as the drug, perhaps they can choose the intervention over the drug,” said Robinson. “So instead of having to wait until the next day to go to a meeting or wait until the next week to see their therapist, they can immediately put on the headset be removed from all the cues related to what’s prompting them to want to use the drug and get some of the support that they’re seeking.”
Robinson notes that people with addiction also generally lack healthy relationships in the real world.
“What if we could develop healthy relationships in the virtual world, and teach people in a safe environment how to develop the skills they need to regulate their emotions without drugs?”
This semester Robinson also launched a research study at Journey Pure to quantify the effects of VR on mood. He recruited eight undergraduate research assistants, who are spending a total of 52 hours per week running patients in virtual reality games and applications.
“These are all self-contained environments, as opposed to the social ones I use for therapy, as it’s a preliminary study to show how VR can increase positive affect and decrease negative affect,” said Robinson.
Computer engineering help
Two computer science undergraduates are also teaming with Robinson at Vanderbilt’s innovation center, The Wond’ry, to build a virtual room where patients learn about cognitive behavioral therapy and another with a game where they sort emotions into boxes.
The team uses a platform called VRChat, co-founded by Vanderbilt alumnus Graham Gaylor, BS’14.