CleVRET worlds

CleVRET

The CleVRET system can be used to treat people with fear of heights and fear of flying. This system is based on a treatment technique called Virtual Reality Exposure Therapy (VRET), which combines the effectiveness of exposure therapy with the accessibility of a virtual environment. With the CleVRET system a complete flight, starting from check-in too landing, can be simulated. Real-time adjustments to the scenario can easily be made to create a tailored experience. The system also allows therapists to create custom scenario’s using the advance scenario editor. For the fear of heights treatment a virtual environment of a shopping mall with seven floor levels, partially glass floors, can be simulated. The sixth floor include a section without a safety railing for maximum exposure with a high level of anxiety.

VRET has been scientifically proven to be effective by the University of Amsterdam (UvA) and the Delft University of Technology (TU Delft) after a decade of research; and many other international research groups. The University of Amsterdam has currently used the CleVRET system for a research into the effects of VRET with the addition of medicine.

Treatment with the CleVRET system is now available at the following partners GGZ Delfland (http://hulpbijvliegangst.nl) and PsyQ.

More about CleVRET

Psychosis and Social Phobias

CleVR collaborates in a new research project for the treatment of Psychosis. A new Virtual Reality (VR) solution has already been developed by CleVR for the psychosis project, where psychotic people with symptoms of paranoia and social anxiety are virtually exposed to several social situations. CleVR created a software platform for the pilot and Randomized Controlled Trial (RCT) of this Psychosis project. The research focuses mainly on how VR could be used in order to treat Psychosis more efficiently and effectively.

The pilot has been successful and the results were very promising. The virtual (social) environment produced similar effects on paranoid people as if they were exposed to real life social situations. These positive results offer the possibility to create a new and more efficient and effective treatment method for this target group. The RCT is currently in progress and first results are expected around the end of 2015.

Four virtual worlds are used during the RCT where patients get the impression of walking along a busy shopping street, travelling by bus, shopping in a supermarket or visiting a bar. Within the various virtual worlds the therapist has the possibility to alter the virtual environment. The therapist is able to change the expressions on the faces of the avatars (virtual characters with dynamic emotions) and to modify their behaviour, make them friendly or hostile and even dictate what they say. The ethnicity, the number of avatars and the number of male and female avatars can also be altered. The patients are being exposed to a controlled (virtual) social environment. The complexity of the environment and the level of exposure within a social (virtual) environment can gradually be increased or decreased by the therapist. The idea is that patients will become less anxious, learn to cope with their feelings of paranoia and will ultimately stop feeling the need to avoid social situations. These VR treatments are performed within the safety of a therapy room, so privacy should not be an issue. The therapist is able to observe in what circumstances certain behavioural patterns develop, so a more effective treatment will be possible.

The researchers are convinced that VR will be complementary to existing forms of cognitive behavioural therapy, in which people learn to change negative thoughts and practise with situations that cause anxiety. ‘Cognitive behavioural therapy is difficult for psychotic patients, who are often very suspicious. They may perceive eye contact with a stranger as a threat, and assume that they are the subject of other people’s conversations. In extreme cases, they may even think that people are conspiring against them or that they are being followed. It is not easy to persuade these people to venture out onto the street to practice. Using VR, they can gradually get used to a safe environment. The therapist is in a better position to treat the patient as he/she gains a better understanding of how much the patient can take. In this way, Virtual Reality Exposure Therapy can complement behavioural therapy.’ (Dr. Wim Veling)

It is hoped that the RCT will provide insight into the impact of environmental factors on psychotic patients, which can now be studied in depth using VR. This project is a collaboration of CleVR with several mental healthcare organisations. These organisations are the Parnassia, Dijk en Duin, Bavo Europoort, GGZ Noord-Holland-Noord), GGZ Delfland, GGZ Pro Persona, and UMC Groningen. The main researchers are Prof. Dr. Mark van der Gaag, Dr. Wim Veling, Drs. Roos Pot-Kolder.

Generalized (Social) Anxiety Disorder (GAD)

Recently funding was granted to start a pilot research to see if the use of Virtual Reality (VR) has benefits during the treatment of Generalized (Social) Anxiety Disorder (GAD). This study was initiated by Altrecht Academisch Angstcentrum in close collaboration with CleVR.

Patients with serious forms of GAD very often halt their treatment before completion or do not want to start the treatment at all. Virtual Reality Exposure Therapy (VRET) could be the solution for this problem by giving the patients the opportunity to visit the social situations virtually instead of in real life; this could make the first step a lot easier. So people are more willing to start or continue their treatment.

Another goal of this study is to compare the psychopathological processes of serious forms of GAD with those of psychosis. The results of this pilot study will also be part of the larger research project of psychosis, which is described in the previous section. This project is done in collaboration with researchers of the psychosis project.

Running projects:

Burn Center - Reducing pain of burn patients during wound care

The Burn Center of the Martini Hospital in Groningen received funding for the development of an interactive Virtual Reality (VR) world that will be used during the treatment of burn patients. The software will be developed by CleVR. VR will be used to reduce the pain during wound care and rehabilitation for children and adolescents, so less or even no medication is needed.

Earlier research has shown that the use of VR during the treatment results in a significant lower level of pain and anxiety. The research was based on the immersive VR pain distraction. Pain perception has a strong psychological component, where each pain signal can be interpreted as a painful feeling or not. Pain requires conscious attention and when the VR world can interfere with this attention, less attention will be available to process the pain signals.

Other Burn Centers in the Netherlands will also receive these VR systems after successful introduction of VR within the Burn Center of Groningen.

CATCH project (Computer Support for Anxiety Disorder Treatment at Home)

CATCH is a new project focusing on phobia treatment at home using virtual reality, providing the therapy right in the living room of the client while being remotely monitored by a therapist. This project, in which CleVR is one of the partners, is supervised by the Delft University of Technology and the University of Amsterdam. In order to make remote therapy possible many features need to be automated, such as client monitoring, anxiety level adjustments, session scenarios and the interaction between the virtual world and the client at home. The RCT is currently in progress and first results are expected around the end of 2015.

D-Escalator

For the D-Escalator project CleVR collaborates with several partners in developing a training simulator for employees dealing with aggressive people. The main purpose of this system is training people to take appropriate action during escalating situations. The training simulator enables them to experience such situations in a safe and controlled environment without the need to hire actors. Training sessions can therefore take place more often.

D-Escalator will focus on verbal aggression and enables the trainee to talk to the computer-simulated aggressor. The avatar will show both verbal and non-verbal aggression (facial expressions and body gestures). The avatar's emotional state will change dynamically in response to the trainee's actions.

This video shows a number of scenarios in a virtual cafe that threaten to escalate, to give an impression of what is possible with dynamic emotional avatars.

This project is a collaboration of CleVR with several organisations. These organisations are the Delft University of Technology, PBLQ ROI / PBLQ HEC, Trigion and the Politieacademie.

Future

Recently funding was granted to develop a Virtual Reality Aggression Regulation Training for reducing victimization in forensic clinics. First contacts with several Mental Health Care Centers already took place about how VRET can be used in order to treat people with forms of Autism and people with a Mild Intellectual Disability (MID). VRET can possibly be used to train several (social) skills, so these people will be able to cope independently with their (social) surroundings and taught how to be more independent and how to stand up for themselves in a more effective way. Our goal is to custom-built VRET software in order to make the Health Care and Well-Being sector more accessible, flexible, safe and efficient.

Summarizing, CleVR specializes in creating a bridge between psychology and technology, where problems are translated into solutions with Virtual Reality. A complete Virtual Reality solution within a ready-to-use package will be provided to our partners and customers, and developed in close collaboration with them. Our core business is the development of Highly Interactive Virtual Reality software. CleVR is mainly active within the Netherlands but also interested to have new international collaborations.