Supporting Patients and Therapists in Virtual Reality Exposure Therapy

Abstract:  This thesis explores challenges for the design of Virtual Reality Exposure Therapy (VRET) systems. Exposure therapy is the established method for treatment of anxiety disorders and is typically delivered in-vivo, i.e. exposure to phobic stimulus in real environments. Virtual reality (VR), instead, offers the potential to conduct exposure therapy at the clinic. This approach has several benefits in terms of efficiency, customization and control, amount of exposure, and as an transition phase to real situations. However, currently many systems are limited in scope and are designed for research purposes without informing the design from therapist's practices. My research aims to contribute towards the understanding of current practices in exposure therapy and investigates challenges for the design of these systems for the two main user groups, patients and therapists. Three different focus areas have been prevalent. First, we have studied therapist in real sessions to inform the design and development of VRET-systems. Second, we have evaluated two different VRET implementations supporting therapists to interact with patients. Third, on the patient's side, we have studied presence on healthy participants focusing on the influence of virtual bodies and patient movement in VR.This thesis summarises and discusses these studies. Overall, the studies emphasize the complexity of exposure therapy and the need for individualized patient conditions. This poses multiple challenges for the design of VRET-systems such as, first, the systems must offer flexibility to the therapists to orchestrate individualized therapy. Second, the systems must enable rich therapists-patient interaction. Third, the complexity of individualization of scenarios and sessions must be addressed in the design of the therapist's interface. Fourth, for patients, body avatars influences presence differently depending on the scenario and locomotion is challenging as offices are typically small.