Futuristic virtual reality therapy shows promise

Royal College Staff
March 8, 2019 | Author: Royal College Staff

Imagine facing your demons head-on. For some patients, that’s quite literally what a new form of virtual reality therapy is empowering them to do.

The man behind this new approach, Alexandre Dumais, MD, FRCPC, is a researcher and psychiatrist at the Institut Philippe-Pinel of Montreal. Dr. Dumais is using virtual reality to help patients living with treatment-resistant schizophrenia. Over a series of about nine sessions, he mixes classical cognitive behavioral therapy (CBT) strategies for psychosis with a new form of avatar therapy.

Dr. Alexandre Dumais

Dr. Alexandre Dumais

Patients who participate have not responded well to anti-psychotic medications. This new treatment allows them to confront their persecutor head-on in the form of an avatar, modelled after the voice(s) they hear. Using virtual reality goggles, the patient will interact with Dr. Dumais in character as their avatar — usually a demon. The dialogue is based on patient-reported hallucinations.

“We are building coping skills with the avatar but the approach is really different because it’s experiential. The patient is inside the emotion; they live it right away. The avatar is saying ‘you’re an idiot.’ The person is saying ‘I feel like an idiot. I’m worth nothing.’ And we work on that on the spot.”

The software used to create the avatars (photo courtesy of Dr. Alexandre Dumais)

The software used to create the avatars (photo courtesy of Dr. Alexandre Dumais)

Dr. Dumais was inspired by London-based psychiatrist, Dr. Julian Leff, who has pioneered treating patients with refractory hallucinations using virtual reality. Dr. Dumais adapted the therapy from a two-dimensional screen to a 3D environment so that patients are completely immersed.

At the beginning, it was not easy to get funding and approval because it’s really different from what people are used to doing in Psychiatry,” said Dr. Dumais.

The therapy took about five years to develop. Treatment of the first patient began in 2015. The results of that first phase have been published in Schizophrenia Research. The second phase of this pilot will be complete by the end of the year. The third and final phase, a single blind randomized trial funded by a Canadian Institutes of Health Research grant, will begin in the New Year.

Dr. Dumais is testing the hypothesis that avatar therapy is superior to traditional approaches to treatment-resistant schizophrenia. While he concedes that this therapy is not the right fit for everyone, it has been transformative for some.

“We had really good results with some patients who before were not working, and now they’ve gone back to school and found jobs. It can change lives. One of my colleagues said that the avatar therapy will be the next generation CBT. It’s only the beginning.”

A patient in the therapy room (photo courtesy of Dr. Alexandre Dumais)

A patient in the therapy room (photo courtesy of Dr. Alexandre Dumais)

Read more about this pioneering therapy