Virtual Reality vs. Very Real Problems

By Marisa Ramirez

The room is empty except for the woman sitting in a chair. On her head is something that looks like a motorcycle helmet. Though her eyes are concealed, her head slowly moves to survey the room. She grabs at the air and examines what she’s grasped. She does not see an empty room. She sees a party, a pool, beer and cigarettes. She’s walking through a virtual environment.

Directed by Professor Patrick Bordnick, the Virtual Reality Clinical Lab is a place to study behaviors and addictions and find interventions. The custom-made virtual environments become innovative tools to observe and safe places to practice coping skills. The lab is housed in the Graduate College of Social Work. Study participants enter the virtual worlds by wearing the virtual reality (VR) helmet, while the environments are uploaded by computers in an adjacent room.

What are the limitations of traditional therapy that can be resolved through VR?

Virtual reality brings the real world into a clinical or controlled laboratory setting. Traditional approaches to assessing and treating addictions or phobias consist of therapists conducting sessions in an office, using role playing to teach skills, but this method lacks context. For example, the best treatment for a smoker is to accompany them to places that trigger their smoking and teach them skills not to smoke. But that’s impractical. Virtual reality bridges the gap. Different environments are available at the click of a mouse, and coping skills learned in these environments carry over to the real world.

How old is your lab and what kinds of research projects have you directed?

I launched the Virtual Reality Clinical Lab in 2008 when I first joined the faculty. We have conducted projects ranging from food addictions to heroin addiction. All of our projects are supported by both private and federal grants. Some projects to date have explored:

Nicotine Addiction – This project assessed craving for cigarettes in various virtual reality smoking settings. In the virtual world, patients could actually grab a pack of virtual cigarettes and beer as we explored ways to assess and treat their addiction.

Alcohol Dependence – We developed 10-12 virtual environments with alcohol drinking contexts. For example a sports bar, a party, an airport lounge, a home. Then we tested these as part of a treatment designed to teach coping skills and relapse prevention strategies.

Heroin – This project is currently underway and will assess craving responses for injecting and non-injecting users. We’ll also explore methods to decrease craving and relapse.

How do you work with animators to create a virtual environment?

The process is a lot like making a movie. We start out with a story board and move up to full scale 3D models. The software we use relies on video game advances and technology. Though these are usually used to create games, our goal is to create the real world in the virtual space.

What is the most innovative environment you’ve created?

The most technically advanced environments we’ve created are two heroin houses for an NIH–funded study. One environment is a row house in an urban setting designed to replicate a shooting gallery (house where injection drug use occurs). The other is a part y where people are drinking and snorting heroin in a bathroom. Each virtual environment consists of high-definition avatars that are state-of-the art and resemble real humans. All elements in the environments are true to life and go well beyond the fantasy level of a video game. Our goal is to recreate the real-world environment exactly; this is the key to our success in achieving realism.

What’s next for this technology and research?

The marriage of this technology with academics has driven new ways to research behaviors. Virtual reality can be used to provide interventions for public health crises, such as drug and alcohol abuse and HIV/AIDS, help returning soldiers with brain injuries or posttraumatic stress disorder adjust to civilian life, or help future clinicians learn diagnostic skills through simulated interactions with patients. Additionally, researchers can layer the VR sensory experience with smells (of alcohol or cigarettes) to further trigger cravings and practice coping skills. And future environments may not require the bulky helmet. Participants may enter the virtual environments by wearing special glasses to see 3D environments displayed on the walls, or download an app that replays coping skills whenever they near a place that triggers cravings. It’s very exciting, and UH will be on the cutting edge of this innovation.

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