Virtual Environments for Use in the Treatment of Anxiety Disorders

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Window
Therapist
Elevator


Since 1993 Dr. Hodges and his students in the Virtual Environments Group have been developing and testing virtual environments that can be used by clinicians in the treatment of different anxeity disorders.  Many of these environments are now available commercially through Virtually Better.

The Virtual Airplane places the patient in the window seat of the passenger cabin of a commercial airplane. With a few simple keystrokes, the therapist can expose the patient to the different aspects of a complete flying experience such as sitting in the plane with the engines on or off, taxiing on the runway, takeoff, flying in either smooth or turbulent weather, and landing. The sights and sound mimic those found in actual flight. Patients experience anxiety as if they were actually on a real plane. The patient's experience is augmented with the use of somato-sensory feedback provided by a chair with a specially designed speaker underneath. Thus, one can "feel the turbulence outside and other mechanical bumps often associated with flying.

 The Large and Small Audience Environments allow a client to face an audience that the therapist can control. These are not Avatars! Virtually Better uses its patented approach to put 'real' people in the audiences. Keyboard commands allow the behavioral responses of the audience to the speaker (applause, bored audience, interested audience, mixed reaction audience and others) to be controlled by the therapist. Prepared text (outline, notes, etc.) can be loaded in the environment as a text file and scrolled along the top of the podium so that it may be seen in VR. Prepared slides can be shown on the screens behind the speaker. The Cyber Puck® from IIS allows the user to control the text and the slides. A curtain that the therapist controls is designed to facilitate work with anticipatory anxiety. A scripting language allows the environments to be pre-programmed to specific sequences of time and audience reactions. As with all other Virtually Better environments, the therapist speaks through a microphone into the environment to help maintain immersion. Virtually Better's Audiences are the clear leaders in exposure environments for speaking.

The Height Environments include a glass elevator and a ser ies of bridges. The elevator is modeled as an open elevator (no walls or ceiling) located on the inside of a 46 story hotel. The client uses a joystick to move the elevator up and down, at their own pace. The bridge environment presents a canyon with bridges of different heights spanning the canyon from one side to the other. A river runs through the bottom of the canyon. The bridges vary not only in height but also in apparent steadiness. The lowest two bridges (seven and fifty meters) appear safe and solid. The highest bridge (eighty meters) is a rope bridge with widely spaced wooden slats. The wind sound effects increase as one goes higher and higher. The therapist transports the client from a boat in the river to the bridges with the press of a button. The client can remain on a bridge as long as necessary during exposure sessions.

The Storm Environment seats the participant in a chair in a room with a large window. The the weather can be varied from a calm sunny day with birds singing outside the window to severe storm conditions. Simple keyboard commands control rain intensity, wind intensity, lightning/thunder, and power failures. Local maps can be displayed on teh television to enhance adaptability to your situation.

The Vietnam Environments provide various experiences consistent with thos e described by Vietnam war veterans. Included are a Huey helicopter ride over various Vietnam terrain, including rice paddies, river, jungle, and landing and taking off from an open field. A separate environment simulates the experience of walking exposed in the middle of an open field surrounded by jungle. Extensive audio effects are incorporated into the environment that are controlled by keyboard commands by the therapist. For example, the open field environment audio can vary from simple jungle noises to a full battle including mine explosions, mortar fire, rockets small arms fire, men yelling, B52 strikes and helicopters coming in to land. These environments have been created specifically for treatment of Vietnam war veterans with Post Traumatic Stress Disorder (PTSD).

 

Last Updated: 10/30/2002, lfhodges@uncc.edu