Following a therapy session at home using Virtual Reality. How effective is that? That is one of the questions of the collaborative project Follow the Dot to Beat Your Anxiety. The project focuses on children aged 8 to 17 who follow EMDR therapy because of anxiety or trauma symptoms. They continue the therapy at home by using Virtual Reality glasses. Janniek Bragt-de Jong (Medical and Clinical Psychology, Tilburg University) is PhD researcher on the project and tells TESC all about the ins and outs of the project.
Sometimes children must deal with fear or trauma. For example, if they have needle fear, fear of failure, or post-traumatic stress disorder (PTSS). A treatment often used for children (but also for adults) with complaints that arise from these is EMDR therapy. EMDR stands for Eye Movement Desensitization and Reprocessing. In EMDR therapy, the child repeats the fearful event in his or her mind together with a therapist. This happens in combination with a distracting stimulus, such as watching the therapist’s moving fingers or following a light bar with your eyes. The child and the therapist reflect on the thoughts and feelings this evokes. “A proven effective treatment in the short term,” says Janniek. “But sometimes you still see residual symptoms or a relapse after treatment. For example, the child learns to face his or her fear together with the therapists but then, when the child has to deal with it alone in his or her own environment, treatment doesn’t always work well enough, and symptoms return.”
The project team investigates the effect of continuing the therapy at home using Virtual Reality (VR). Virtual reality glasses take children into a virtual therapy session and allow them to imagine and relive a bad situation in a positive way, at home and independently without a therapist but always in a safe home situation with proximity to parents or caregivers. Janniek brought a pair of VR glasses, developed with partner Psylaris, and shows us how it works. The glasses take you into a virtual treatment room, and a quiet voice leads you through the therapy session. Using a pointer, you click through the parts and determine the pace of the treatment yourself. As a distraction stimulus, a dot is used in the room, which you follow with your eyes and click on with the pointer. “With the application, we hope to enhance the effectiveness of EMDR, require fewer treatments, reduce relapse, and ultimately, we hope to increase the quality of life for these children,” says Janniek.
The Future Me
The application is called The Future Me because children positively imagine what they can do. This is also called EMDR’s Mental Video Check. Janniek explains: “We have specifically chosen to use this part of EMDR therapy in the VR application since it focuses on viewing yourself in the feared situation in the future in a positive light, which can be practiced at home and independently by the children and adolescents themselves. The combination of focusing on the future in a positive way, the intensified, independent practice in their own environment without extra sessions with the therapists seems worthwhile to test for effectiveness of reducing short- and long-term symptoms and increasing quality of life.”
The use of Experience Sampling
Through hospitals and mental healthcare institutions (GGZ), the project team would like to recruit 215 children who want to participate in the study. “We want to know how effective the treatment is, for whom the treatment is effective, and what happens to emotions during and after the treatment,” says Janniek. To do this, the project team uses the Experience Sampling research method, an intensive data collection method. “We use Experience Sampling to ask about emotions, to find out how the child deals with emotions and what the context is. We send out a short questionnaire using the M-Path app four times a day for four weeks: one week before the treatment, one week during the standard EMDR sessions, one week during the sessions with the VR glasses at home, and one week after the treatment. In this way we gain insight into the process of what happens to emotions during the treatment with the VR headsets and hope to see an improvement that lasts”.
The project involves broad cooperation in a research consortium. Janniek Bragt-de Jong (PhD) is working with her supervisors Esther Hartman, Annemiek Karreman, and Tom Smeets of the Department of Medical and Clinical Psychology at the Tilburg School of Social and Behavioral Sciences. They are conducting the research in collaboration with (so far) eight hospitals and mental healthcare institutions (GGZ). The application in the virtual reality glasses was developed together with partner Psylaris. The project is made possible with a PPS grant from Health~Holland. Click here for more information about the project on the website of Health~Holland.