Is clinical virtual reality ready for primetime?


Rizzo, A. & Koenig, S.T. (2017).  Is clinical virtual reality ready for primetime?  Neuropsychology, 31 (8), 877-899.  doi:


The authors of this article sought to provide an overview of the utilization of Virtual Reality (VR) technology within clinical settings.  A brief history of VR techniques and how it came to be used in the fields of rehabilitation and psychology is provided.  Of note, the earliest clinical use of VR as a tool was used in exposure therapy to treat specific phobias.  The authors also explore the various uses of VR for assessment, treatment and research.  They discuss clinical VR’s use in training and/or assessing skills in everything from navigation in a wheelchair to preparing soup in a virtual kitchen; it’s use in providing options for reviewing feedback and results of a patient’s performance; and how the use of gamification of rehabilitation tasks can be used to increase engagement and motivation.  The growing body of literature supporting the positive use of VR in the rehabilitation setting is discussed, with some studies yielding reduced depression after using VR to experience “self-compassion”, and increased proficiency in training of wayfinding around the unit or other locations for patients with physical or visual challenges because they can complete more sessions in less time.  Importantly, the authors note that VR is meant to compliment services provided by clinical professions, not replace those providers.  The authors provided an interesting discussion on the belief that technology will create a barrier between clinician and patient, stating that “. . . the ability to pause (and later restart) a client’s simulated experience for a direct clinical intervention may actually serve to remove a key barrier—the lack of an immediate shared experience.”(p. 884) between patient and provider.  Added to that is an exploration of how clinical VR can be used to break down barriers to care by looking at seven different factors (awareness, anticipated benefits, access, availability of well-trained providers, acceptability for seeking treatment, adherence, and affordability) that keep people from seeking or accessing services.  Also included is a discussion of the limitations, including considerations such as operability and cost to individuals who may be using the VR treatment independently at home, as well as potentially creating a false sense of security with no real world hazards in the virtual world.  Likewise, other possible safety risks and ethical concerns one must consider when utilizing VR with any population are provided.  The authors provided the following future considerations: “A continued focus on research methodology, selection of outcome measures, quantification of training transfer to daily life, and the identification of “active ingredients” of clinical VR tools is needed to advance its thoughtful and scientifically valid use” (p. 889).

I CHOSE THIS ARTICLE BECAUSE, as a Psychology Trainee with the goal of working in a neurorehabilitation setting, I am always interested in opportunities available to improve assessment, treatment and research.  More importantly, the large role that VR does and will continue to play in the maximization of independence is a topic that needs to continue to be discussed regularly, as this is an ever-changing field. Given the advances our society is making in the use of technology as a whole, it seems only logical that the use of technology in the field of psychology will grow as well.  Keeping abreast of the developments being made can seem daunting, and I felt this article provided a comprehensive summary and overview of what is available in the realm of Virtual Reality technology.

THIS MONTH’S REHABILITATION SCIENCE SPOTLIGHT was provided by Molly B. Keith, MS, Third Year Psychology Trainee, Neuropsychology Concentration, Nova Southeastern University