Impressive advances have made treatment of PTSD possible and efficient in the past decade on CBT (cognitive behavioral therapy). (Goncalves, 2012) The CBT therapy involves a variety of treatment programs. The programs include cognitive restructuring procedures, exposure procedures, anxiety management programs and their combinations. Reviewing the existing literature materials on the treatment of PTSD is very positive in respect to CBT.Objective
To evaluate the effectiveness of the Virtual Reality Therapy in the treatment of PTSD
To analyze the adequacy of the psychological treatment programs that uses VR-EBT to treat the PTSD
TO investigate the acceptability of the VR-EBT to the society
Study of the Virtual Reality Program
Between 2001 and 2006, the terrorist attacks in Israel reach a peak with about 1139 death and 6700 wounded civilians. The number of terrorist-related attacks in 2001 was three times that of the previous year. These attacks made the government to conduct a phone-based survey of a sample of adults across the whole country. Then the survey was conducted again after 44months. The first study showed 16.4% of the respondent had direct exposure to terrorist attack, and 37.3% had indirect exposure to the attacks. 9% of the affected people manifested the PTSD. (Motraghi, 2014)
Due to too many bus-related attacks in Israel from 2001, the government came up with a unique environment known as the Bus World. In the Bus World, the participant wears a virtual reality helmet and is immersed in a virtual world. In this case, the participant is visual illumined to be in a city in Israel with a bus stop across the road. The participant is subjected d to different levels of graded exposure that the therapist regulates through the keyboard. At the first stage, the bus does not appear at the bus stop. The second stage the bus advances from around the corner and stops at the bus stop without any incident occurring. The third level the bus emerges and then explodes with no accompanying sound effects. (Rothbaum, 2010) The additional levels add visual and sound effects to the explosion. The effects are raging fire, police siren, and flashlights of ambulance and police cars, screaming, and crying sounds of the victims. The bus world was developed using the information gathered during the interviews and the attacks scene with Israel PTSD patients. The Virtual Reality therapy also made use of the texture maps developed from digital images taken in Israel.
Case Study: Bus World
On July 2, 2008, in the busy town of Jerusalem, a Palestinian construction worker decided to attack an Israel woman and her child in a car with a bulldozer. He killed the woman and crushing over her car. He also flipped two fully loaded buses trapping the passengers inside. Several other cars were damaged before the assailant was cornered and shot dead by the Jerusalem police. . At least three peoples were killed among them two women and dozens of other people were injured in that attack. Josman, Weiss, and other colleagues conducted a case study of a patient, R, who survived and later sought psychological treatment following the incident. The R patient was diagnosed with PTSD and Obsessive-compulsive disorder (OCD). The R was taken through a series of 12 session’s oaf VR treatment program using Bus World. The treatment involved prolonged exposure to other serious traumatic incidents. The patient was immersed in a computer generated virtual world guided by the therapist and returned to the scene of the horrifying event to help him gain access to his memories of that incident and lower his emotional intensity. The program helps the patient change his unhealthy thought pattern and pathological memories. The horrifying occurrence of the bulldozer attack was treated by imaginal exposure while the patient was in the VR bus world environment. The R showed large post-treatment reductions in PTSD symptoms. The clinician admitted that the PTSD scale scores of R drastically reduced to zero from 79 pre-treatment. The scores were still zero even after six months. (Gerardi, 2008)
The patient said the virtual reality treatment helped him remember and habituate to his memories and stop to shun trauma related occurrences. He endorsed the Bus World treatment and appreciated the improvement that he got after that therapy program although his traumatic incident was a bulldozer attack. About that case, it can be suggested that virtual reality treatment effectively facilitates the extinction of traumatic memories.
The virtual reality treatment program offers an experience of the participant and therapist that is not practical anywhere else. For instance, it is practically impossible to bring clinicians on the battlefield with combat PTSD patients. Although it is not possible to share all PTSD, patients’ imagined events. (Kramer, 2013)
The VR has an extension range of options that are available to clinicians that gives an opportunity for exposures to situations that are very difficult, costly or time-consuming in real life situations. For example, the therapist may use the virtual airplane to expose the patient to the airport, spend time taking off and flying in turbulent and smooth weather conditions and landing without leaving the office. VR provides a sensory-rich and therapeutic environment that are often helpful to patients who find it difficult to recall traumatic memories are not good enough at remembering the situation. Another good thing about the VR is that it is easy to control the exact dose of exposure to a specific stimulus and guarantee each participant to receive same exposure to the same stimulus.
The difficult question that remains in many minds of the people is whether VRE is less or mere effective than PE (prolonged exposure) in the treatment of PTSD. There are many studies that are ongoing hence the question remain unanswered. The direct comparison shows comparable outcomes across various cognitive-behavioral treatment protocols. Other studies doing the comparison of individual and combined treatment protocols found related outcomes for combined and individual treatments.
Virtual reality treatment program has shown that it is effective in reducing the anxiety disorder such as PTSD. The VR experience is controllable, acceptable and vivid to most people. Generally, in the area of mental health, the VR future is ever expanding, and this conclude the method is effective.