Silvia Fisas: "Virtual reality helps to control the therapy process".

Psychologist Silvia Fisas gives us the keys to understanding virtual reality used in therapy.

As new technological resources are being developed, the world of mental health is adapting to this progress by relying on the tools that appear in its path.

A clear example of this can be found in the virtual reality used in many psychotherapy sessions.. Its proposal consists of exposing the patient to very realistic situations that are generated in a virtual world modeled in three dimensions, so that, from these fictitious spaces, it is possible to work on the management of emotions by controlling all the necessary variables.

The person we interviewed today, psychologist Silvia Fisas, is an expert in this type of therapy.. Here she will explain the keys to the use of virtual reality in the consultation.

Interview with Silvia Fisas: using virtual reality in psychotherapy.

Silvia Fisas is a psychologist with a practice in Palma, and part of her work consists of taking advantage of the potential of virtual reality when treating her patients. In this interview she explains how this process works, and why this therapeutic resource is useful.

Technically, what is meant by virtual reality?

Virtual reality (VR) is a technique based on 3D graphics projected with equipment consisting of glasses and a headset, as well as a sensor to measure biorhythms.

The helmet and headset isolate the person from external stimuli and transport him/her to a suitable and different environment, from which the stimuli corresponding to the necessary therapeutic procedure are applied according to the specific characteristics.

What made you become interested in taking advantage of the potential of virtual reality in therapy?

Well, as we know, new technologies facilitate processes of all kinds. In psychotherapy, having VR helps the therapist to control the therapy process much more. It makes possible a personalization according to the characteristics and needs of the person throughout the therapeutic intervention, in a simple, fast, non-invasive way and with the security of being in consultation.

As a psychologist, have you noticed that some patients are wary of this type of technology, simply because they are unfamiliar with it or have never used it before? Does it take some getting used to?

The unknown can always create a bit of insecurity, but the truth is that in general everyone accepts it very well, at least to try it and then they love it. People get used to the process easily, and the session can be stopped at any time if necessary.

It is true that perhaps people less in contact with new technologies may be more reticent at first, but for this reason there is always a first special session to explain the technique, to show the equipment, small tests, to understand how it works, etc... what would be a first contact.

From then on, before starting each session, we explain to the person what is going to be done that day, with what objective, and we remind the basic operation in case there are any doubts.

At the end of each session, a brief report is given, explaining graphically the improvements obtained in terms of the person's reactions.

What are the main psychological problems that you address through virtual reality sessions?

The truth is that VR is very useful for the treatment of a lot of disorders and situations that people experience on a daily basis. Perhaps I could say that for me it is the queen of anxiety problems, from generalized anxiety to specific anxieties (social, exams, public speaking, etc.), as well as phobias, panic attacks, agoraphobia, etc.

But we must not forget that it is a tool that facilitates the work of the psychotherapist to address the possible problems of people.

So, by modifying stimuli, times, scenes, VR can be used also for OCD, PTSD, attentional disorders, eating disorders, Pain management, and many others. Many studies over the last 25 years support better therapeutic results than with classical imagery therapies.

What advantages of this therapeutic resource would you highlight compared to similar interventions that do not make use of virtual reality?

If we do not use VR in psychotherapy, we are left with only 2 options, exposure in imagination or live exposure. The advantages of VR over these other 2 classic techniques are many. It allows a totally personalized design of the exposure hierarchies, graduating the different steps to follow at each moment.

As for the major advantage of VR over exposure in imagination, it is important to highlight the avoidance of problems associated with the difficulties of imagination of some people, as well as the therapist's capacity for description and detail to help in the imagination of the scene or situation to be worked on therapeutically.

As far as the advantages of VR over live exposure are concerned, we can highlight greater privacy; lower cost; absolute control of the stimuli; being able to use settings that are difficult to access in real life (airplane take-offs and landings, storms, heights, medical procedures...); as well as creating situations beyond reality (recreating 10 take-offs in a row, going up in an elevator without stopping for 5 minutes, etc.).

In addition, it facilitates self-training and over-learning, since we do not need to wait for something to happen, but the therapist can produce whenever necessary and as many times as needed.

And very important for me, it is an activity in which the person adopts an active and participating role, in this way it can encourage re-learning and behavior modification, which is the ultimate goal.

How can the improvements obtained through virtual reality therapy be generalized to the patients' daily life?

This is one of the best parts, since it is not necessary to do practically nothing to generalize the improvements obtained in consultation, because they have not been obtained artificially, in an environment different from the one that the person then faces or in an imaginary way, but the learning has been carried out in the situation/s "feared" or that create anxiety or discomfort in the person through VR.

Therefore, the generalization of the learned skills and their transfer to real life is much simpler, faster and almost automatic. When the person does well in consultation with VR, they will do well in real life, because the person was already doing it, even if it was through 3D glasses, their brain thought they were doing it in the real situation, so when they encounter that situation again, they will simply continue to act as they did in consultation, with the skills and resources learned and without a problem.