VR for Good

Skip Rizzo at SIGGRAPH Asia 2020

What does a Virtual Reality headset have to do with trauma?  What is it like to build a 3D environment not for a video game but to save someone’s life? SIGGRAPH Asia 2020, the Virtual one, had a range of incredible speakers, with amazingly disparate backgrounds.  I spoke with Professor Skip Rizzo, Director of the University of Southern California Institute for Creative Technologies Medical VR Lab.  

Professor Rizzo has directed the Virtual Iraq/Afghanistan VR exposure therapy projects for combat-related Post-Traumatic-Stress-Disorder (PTSD) and has been involved in translating these simulation assets for PTSD assessment and prevention (stress resilience) since 2004. His lab (USC MedVR Lab) has also developed VR game-based applications to promote physical and cognitive rehabilitation in persons with CNS dysfunction (e.g., stroke and TBI).

Professor Skip Rizzo.

He is also a research professor in both the USC Dept. of Psychiatry and in the School of Gerontology, and is a Clinical and Neuro-Psychologist.  Skip Rizzo’s presentation is on Sunday, the last day of SIGGRAPH Asia 2020, and On Demand afterwards.

In 2010, Rizzo received the American Psychological Association (APA) Award for Outstanding Contributions to the Practice of Trauma Psychology for his R&D work on VR exposure therapy for PTS and in 2015 he received the Society for Brain Mapping and Therapeutics “Pioneer in Medicine” award. He recently received APA Society for Military Psychology (Division 19) Presidential Citation (2019) for his contributions to the study and treatment of PTSD using Virtual Reality and the International Society for Traumatic Stress Studies 2020 Innovation Award.

A little history

The development of VR can be traced back to 1957 when Morton Heilig, a cinematographer, suggested audiences would be more effectively drawn into stories if all senses were engaged at the same time. In 1960 Heilig built the ‘Sensorama’ which combined a stereoscopic colour display, fans to provide wind, odour emitters, stereo-sound system, even a moving chair to simulate motion.  Only a year later, the first head-mounted display (HMD) was developed by the Philco Corporation in 1961. The ‘Headsight’ combined a video screen and tracking system linked to a closed-circuit camera system. This system was intended for use in dangerous situations as the user could observe a real environment remotely. It was used in military training operations and by helicopter pilots to have a clear field of view while flying in the dark.

“In PTSD treatment, we use VR headsets to immerse patients in simulations of the context in which they experienced a traumatic event at a very gradual pace,” Skip Rizzo explains. “This evidence-based treatment strategy helps the patient to confront and re-process difficult emotional experiences in the simulation, while in the safety of the clinical office with a well-trained clinician’s guidance and support. This assists the client’s imagining of going to places where they have actively been trying to avoid, ever since the event happened. Controlled scientific research has shown this to be an efficacious treatment.”

Skip Rizzo describes this process as a way to promote ‘Extinction Learning’, putting people in simulations that are reminiscent of what they were traumatised by, but in a clinical setting where they can be safe, feel safe, and positively engaged with by professionals who help support the cognitive re-processing of the emotionally challenging experience.

The traditional prolonged exposure therapy approach that VR Exposure is based on, required the clinician to verbally guide the patient, and say, ‘close your eyes, imagine you are in the Humvee, etc, tell me what you’re seeing, tell me what happened’ all done exclusively in the hidden world of imagination. Rizzo says there was some initial pushback to the Clinical VR strategy, “but over the past 15 years, there are documented results with patients that validate this as an evidence-based approach, and initial findings suggest the same for addressing PTSD due to military sexual trauma.”

PTSD is just one area of psychology where this method has been shown to be of benefit to the client. It is a rich clinical and training tool for improving social skills with persons on the autism spectrum, promoting relapse prevention with addictive behaviours, relieving the fear in persons with phobias and in stroke and brain injury rehab, the list is exhaustive.

“War sucks.  But it does drive innovations in medical and mental healthcare and it certainly has had an impact on how we assess and treat PTSD. No doubt, this is hard medicine for a hard problem, but R&D in the military trauma domain, has provided a knowledge base that can now inform how we address trauma in the civilian sector.  Between the combat and sexual trauma related work with VR, going back to early work treating survivors of the 9-11 terrorist attack, we now see this approach as relevant for addressing the ubiquitous trauma we see in the modern world. Current efforts are planning to use this approach with first responders, survivors, and health care professionals stressed out on the frontlines of the COVID pandemic. Strategies are also being conceptualized for treating the enduring effects of adverse childhood experiences in young adults, but that area will require significant research to evolve VR’s use as a tool in that area.”

Rizzo predicts that standalone VR headsets (e.g., Oculus Quest, VIVE Focus, Pico Neo, etc.) will eventually be found in every home like every kitchen has a toaster today. They will be valuable tools for accessing VR for clinical care, education, training, and for use for social, medical and business interaction. Entertainment and virtual travel will be a new growth industry.  Today’s virtual conferences will be seen as the halfway point towards being even less face to face but far more interactive.

STRIVE and Bravemind are two forms of virtual reality approaches to preventing and treating post-traumatic stress in service members and veterans from the Iraq and Afghanistan wars. Developed at the USC Institute for Creative Technologies, Bravemind is a form of virtual reality exposure therapy and STRIVE is for pre-deployment resilience training.

The clinical health conditions that benefit from these applications include patients with Anxiety Disorders, Depression, PTSD, Acute/Chronic Pain, TBI, Autism, ADHD, Alzheimer’s disease, stroke, social skill challenges, and other clinical conditions.

If you or a loved one have had any past issues arise upon reading this story, please get in contact with your local health authority.

Related links:

USC Institute for Creative Technologies Medical VR Lab

Check out their work on YouTube

Virtual Reality for Psychological and Neurocognitive Interventions. 

SIGGRAPH Asia 2020

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