Research

After obtaining my doctorate, I worked for a number of years at the National Research Council Canada. I carried over my interests related to social interaction to human-computer interaction using artificial intelligence and virtual reality technology.

My current research interest has evolved from my latest work. I'm particularly interested in the application of virtual reality to psychology.

Virtual Environments and Psychotherapy

Introduction

Although virtual reality is still a new technology, many have suggested its potential effectiveness in helping to resolve various psychopathological disorders (Glantz et al. 1996; Glanz et al. 1997; Weiderhold et al. 1998). A number of papers already report the effectiveness of virtual environments applied to the treatment of phobias (North et al. 1996a,b; North, 1997). Virtual environments have been applied to the treatment of eating disorders (Riva, 1996) and autistic children (Strickland, 1996). In all cases, authors report encouraging results.

The effectiveness of the technology assisted treatment rests on the notion that learning is more easily transferred to the real world when the client actively participates to his/her treatment.

Numerous attributes of the technology seem to support its therapeutic potential. The technology is flexible and relatively easy to program. It allows the practitioner to present a large number of controlled variables (e.g. items related to the realism of the scene) and measure and observe a large number of the client's responses (e.g.muscular tension, pupil dilation, heart rate). The structure of the environment and its reactions to the user's behaviour can be tailored to the needs of a specific psychological disorder (e.g. a phobia of heights) and/or tailored to the needs of a specific individual. A scene may, for example, be more or less realistic (i.e more or less frightening) according to the desired effect (Parent et al., 1998).

The structure of the environment and its reactions to the user's behaviour can easily be modified either between sessions or during a given session.

Virtual reality allows the practitioner to accompany his client in the virtual world in which he/she is immersed. Although traditional approaches also allow the practitioner to accompany his client through a therapeutic process, the virtual environment allows him/her to directly experience the perception of the client and intervene at the most appropriate times.

Applications

At this time, the technology has mostly been applied to the treatment of various phobias. Anxiety disorders are indeed particularly well suited to the technology given the nature of their traditional treatments. In vivo and in vitro systematic desensitization require that the client expose himself/herself physically or through visualization to the sources of his/her anxiety. The technology makes concrete those elements of the environment which trigger the anxious behaviour. The technology allows one to: (1) configure a scene, (2) manipulate the intensity of the stimuli, (3) manipulate the degree of realism of the simulation and (4) modify the number of sensory modalities presented (e.g. visual, auditory and soon haptic). The environment may be used to block the effect of one modality (e.g. the sight of a threatening stimulus) with another modality (e.g. soothing music). Compared to in vivo, the technology assisted treatment may be less dangerous, less costly than the transportation of both client and therapist, and more easily ensure client anonymity. Compared to the in vitro treatment, the virtual environment is likely to be more complete than the scene visualized by the client and more easily allow the identification of the triggering elements of the environment.

According to Glanz (1997), technology assisted therapy can also serve the goals of cognitively oriented approaches in various ways. It can help a client make the distinction between a perception and a presumption.The deceptive quality of the technology can demonstrate the falsehood of certain perceptions helping the client to question preconceived ideas. The technology is said to lend itself well to therapeutic interventions that aim to confront a client's misconceptions by reasoning and by identifying the signs that appear to justify them.

Since 1995, the results of preliminary studies on the effectiveness of the virtual environments applied to pathological disorders are found in the literature. Two studies target the fear of heights (Hodges et al. 1995a; Lanson et Meisner, 1994; Rothbaum et al.1995a,b). Others involve the fear of closed spaces (North et al., 1995a,b; 1996a) and the fear of flying (North et al. 1996b). Authors report positive results in each case. However, no study has at this time compared the results of a traditional form of therapy with one using a virtual environment.

Other forms of phobia appear to be the disorders currently most likely to be helped by the technology. These include the fear of driving a car, public speaking, certain animals, of medical procedures and certain environmental conditions such as thunder and lightning.

Research Directions

Although the future of virtual environments applied to the resolution of psychological disorders appears promising, empirical studies are needed to to better understand its benefits and limitations. Studies need to define when and under what circumstances the technology better serves various therapeutic interests. Research is required to determine, among other things: 1) the inventory of disorders the technology can help, 2) the number and length of sessions required to resolve a disorder, 3) given a specific disorder, the elements of the environment and/or 4) the sensory, cognitive and ergonomic variables responsible for undesirable responses, 5) and those involved in their resolution, 6) cost/benefit assessments of a traditional form of therapy and one assisted by the technology, 7) the impact of technology assisted therapies on various populations, 8) the interest of integrating images, audio and video tapes of the client's life and also, 9) the dangers it may involve.

Related Publications

Glanz, K., Durlach, N.I. Barnett, R.C., Aviles, W.A. (1996). Virtual reality (VR) for psychotherapy: from the physical to the social environment. Psychotherapy, Vol. 33, No. 3, Fall, pp. 464-473.

Glanz K., Durlach, N.I. Barnett, R.C., Aviles, W.A. (1997). Virtual reality (VR) and psychotherapy: opportunities and challenges. Presence: Teleoperators and Virtual Environments, Vol.6, No. 1, February,
pp. 87-105.

Hodges, L.F., Rothbaum, B. O., Kooper, R., Opdyke, D., Meyer, T., North, M.M., de Graff, J. J., & Williford, J. (1995a). Virtual environments for treating the fear of heights. IEEE Computer, Vol. 28, No.7,
pp.27-34.

Johnson, J. (1997). The virtual endeavor experiment: a networked VR application. Proceedings on the Fourth International Conference on Hypermedia and Interactivity in Museums, September 3-5, France, 68-73.

Langlois, G. (1996). La science de l'illusion: la réalité virtuelle. Interface, 17(6), 40-49.

Lanson, R. (1994). Virtual therapy of anxiety disorders. CyberEdge Journal, 4(2), 6-8.

Lanson, R., Meisner, M. (1994). The effects of virtual reality immersion in the treatment of anxiety, panic and phobia of heights. Proceedings of the Second Annual Conference on Virtual Reality with Persons with Disabilities, California State College, Northbridge, pp.63-68.

North, M.M., North, S.M., & Coble, J.R. (1995a) An effective treatment for psychological disorders: Treating agoraphobia with virtual environment desensitization. CyberEdge Journal, Vol. 5, No. 3, pp.12-13.

North, M.M., North, S.M., & Coble, J.R. (1995b). The effectiveness of virtual environment desensitization in the treatment of agoraphobia. International Journal of Virtual Reality, Vol. 1, No. 2, pp.25-34.

North, M.M., North, S.M., & Coble, J.R. (1996a). Effectiveness of virtual environment desensitization in the treatment of agoraphobia. Presence: Teleoperators and Virtual Environments, Vol. 5, No. 3, pp. 346-352.

North, M.M., North, S.M., & Coble, J.R. (1996b). Virtual environments psychotherapy: A case study of fear of flying disorder. Presence: Teleoperators and Virtual Environments, Vol. 6, No. 1, pp. 87-105.

North, M.M., North, S.M., Coble, J.R. (1997). Virtual environments psychotherapy: a case study of fear of flying disorder. Presence: Teleoperators and Virtual Environments, Vol.6, No. 1, February, pp. 127-132.

Parent, A. & Thibault, G. (1998). A task analysis tool for psychotherapeutic virtual environments. CyberPsychology and Behavior, in press.

Riva, G. (1996). Virtual reality and body experience: a new approach to the study of eating disorders. International Journal of Virtual Reality, Vol.2, No. 2, Spring, pp. 9-16.

Roehl, R. (1997). Virtual archeology. Iris Universe, 40, Summer, 28-35.

Rothbaum,B.O., Hodges,L.F., Kooper, I.R., Opdyke, M.S., Williford, J.S., & North, M.S. (1995a). Effectiveness of computer generated (virtual reality) graded exposure in the treatment of acrophobia: a case report. Behavior Therapy, Vol. 26 No. 3, pp. 547-554.

Rothbaum,B.O., Hodges,L.F., Watson, B.A., Kessler, G. D., Opdyke, D. (1995b).Virtual reality exposure therapy in the treatment of fear of flying: a case report. Behavior Therapy, Vol. 34 No. 516, pp. 477-481.

Strickland, D. (1996). A virtual-reality application with autistic children. Presence: Teleoperators and Virtual Environments, Vol. 5, No. 3, pp. 319-329.

Weiderhold, B.K., Weiderhold, M.D. (1998). A review of virtual reality as a psychotherapeutic tool.CyberPsychology and Behavior, Vol. 1 No. 1, pp 45-52.

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