A (Virtual) Therapist's Dream

By Roland Piquepaille

A company named Virtually Better, based in Georgia, creates virtual environments mixing video images and computer-generated ones to help people deal with their fears and anxieties. In this article, the New York Times (free registration) writes this costs only 10 percent more than conventional therapy. The newspaper adds that therapists using this system claim a success rate exceeding 90 percent.

Here is how it works.

The red curtain opens to reveal an intimidating auditorium. A bored audience stares back at you. One person in the crowd seems to be falling asleep; another coughs loudly and stretches his neck. You notice that your palms are sweaty. Your stomach is fluttering. You wonder whether you will pass out.

But this is no ordinary panic attack: it is a virtual scene that was created to help people overcome anxiety about public speaking. This slice of virtual reality and other similarly stressful scenes are the work of a Georgia-based company called Virtually Better, which creates virtual environments with 3-D imaging software for use by psychologists, psychiatrists and researchers.

As this is often the case with this kind of technology, health experts have diverse views about the concept.

"It's a therapist's dream," said Albert Rizzo, a research assistant professor of engineering at the University of Southern California and a licensed psychologist who has created classroom and party scenes to treat attention deficit disorder and social anxieties. "To help people deal with their problems, you must get them exposed to what they fear most."

"There's not proof that any of this is working," said Joann Difede, an associate professor of psychiatry at Weill Medical College of Cornell University, who has helped create virtual therapeutic scenes. For example, there has been no large-scale study to test the effectiveness of virtual therapy, although some individual therapists, including Dr. Difede, claim a success rate exceeding 90 percent.

What kind of fears can be treated using these virtual environments?

Virtually Better has created scenes of a glass elevator and a bridge to address fear of height, an airplane cabin for those who fear flying and a thunderstorm to diminish fear of bad weather.

For example, here are two images from the virtual airplane environment (Credit: Virtually Better).

Virtual airplane during take-off	Virtual airplane in flight

The treatment of substance addiction, too, is being investigated. Several researchers are testing to see whether virtual exposure to drugs, alcohol and cigarettes can trigger cravings, and thus help patients learn to resist them. Virtually Better has created scenes of a virtual bar and crack house for that purpose.

To treat post-traumatic stress, Virtually Better has programmed a Vietnam scene to help veterans confront memories they may be blocking out. Dr. Difede and others at Weill Cornell, collaborating with researchers and engineers from the University of Washington, have created a re-enactment of the terrorist attacks on the World Trade Center to help those coping with their aftermath.

Finally, what are the costs?

Virtually Better leases its software to clinical therapists for $400 per month. This includes full technical support and upgrades. The company charges researchers a flat fee of $3,500 to $10,000 for the software. Headsets with trackers range from $2,000 to $20,000.

Dr. Robert Reiner, a Manhattan psychologist, and his staff at Behavioral Associates offer a sliding scale, charging patients $75 to $350 a visit -- about 10 percent more than for conventional therapy -- based on their ability to pay.

For more information and images, you can visit the current virtual environments developed by Virtually Better.

Source: Sam Lubell, The New York Times, February 19, 2004