Quebec university pioneering treatment of some mental illnesses with virtual reality

From The Canadian Press:

MONTREAL — A Quebec university has made virtual therapy a reality by using computer wizardry to treat phobias, depression and addiction while forging Canada's reputation as a world leader in the emerging field of cyberpsychology.

The Universite du Quebec en Outaouais lab first began using virtual reality to study and treat simple phobias. A decade into the venture, its researchers are now targeting pathological gambling, eating disorders, schizophrenia, agoraphobia, sex offender treatment and, soon, post-traumatic stress disorder in Canadian soldiers returning from Afghanistan.

They're collaborating with therapists, clinics and hospitals across Canada and internationally and they say their lab boasts the only fully immersive virtual reality vault dedicated solely to clinical psychology.

"This is a truly unique network," said Martin Drapeau, a clinical psychologist with Montreal's McGill University, whose psychotherapy research group is partnered with the lab. "There's nothing like this in the world. Stephane Bouchard is one of the leaders in this area."

Bouchard is the whiz behind the lab and is an award-winning psychologist who holds the Canada research chair in clinical cyberpsychology.

He's witnessed its evolution first hand.

Virtual reality is proving practical for treating more disorders than researchers had ever thought possible, he says, including schizophrenia, generalized anxiety disorder and phantom-limb pain - sensations appearing to come from where an amputated limb used to be.

"And there's been key changes in both the quality and the cost of the technology," Bouchard added. "The environments are more realistic and easier to work with."

The lab's pride - the vault nicknamed Psyche after the Greek goddess who represents the soul - works with the lab's own software and creates a stronger sense of presence than the older model VR helmets they still use.

Patients step into the room wearing 3-D glasses and stand in the centre while computer-generated images are projected on its six walls.

"The person is completely surrounded by the images and it gives a really strong feeling of reality," said Bouchard. "They're completely immersed."

Virtual reality technology allows the therapist to control the patient's experience and avoid the curve balls present in conventional therapy.

"These are basically video games that we use," explained Drapeau. "We work with these templates, we create the environment where people can walk right in. With virtual reality, you have it right there with the click of a button. The (patient) knows you can step in and out, they can take off the headset if they want to."

It was that lack of control that was the inherent disadvantage of the most effective treatment for phobias - exposure therapy, in which the patient must face their fear, be it heights, spiders or snakes, head on.

A therapist taking a patient with a fear of flying on a plane, for example, has no control over the flight conditions.

All that changes in a virtual environment.

"We can choose if there's turbulence, good weather, if we do takeoffs and landings, and so on," Bouchard said.

It also improves patient confidentiality and reduces the embarrassment people sometimes feel in seeking treatment, although Bouchard cautions it's important to see the technology as a tool and not a replacement for the therapeutic process.

"It doesn't change much in the gist of the therapy but it does change a key element," he says.

Mark Wiederhold, president of the San Diego-based Virtual Reality Medical Center and editor of the Cyberpsychology and Behaviour Journal, says patients have been quick to embrace the high-tech treatment.

"It makes sense to people. It's a very effective, very powerful tool," he said, adding that Bouchard is doing a great job validating the technology's use for treating anxiety disorders. "He understands how to apply the tools. We know how it works, why it works, and where it works."

Wiederhold's private clinic has been treating Iraq war veterans suffering from post-traumatic stress disorder for more than three years, an illness Bouchard hopes to begin working with in the coming months.

"A lot of the issues have to do with cues," Wiederhold said. "You can sensitize (veterans) to cues. A car backfiring can sound like gunfire. A crowded street scene might remind them of a crowded village (in Iraq). We can desensitize them."

But Drapeau notes this new tool isn't a magic bullet and with many forms of therapy available, patients should seek the treatment that suits them best.

"It's not for everyone," he said. "We need diversity in terms of treatments."

Still, both Drapeau and Bouchard say private clinics like Wiederhold's are the future of treatments for mental illness.

"More complex disorders will bring in private clients," Bouchard predicted. "And we'll see virtual reality moving from research centres into public health centres."

Drapeau says the full benefits of using virtual reality to treat mental illness have yet to be tapped.

"It's giving the psychologist and patient new opportunities," he said. "It has tremendous, huge potential."