Derek Price, Chief Executive Officer, Desert Hope Treatment Center
Derek Price is the CEO of Desert Hope Treatment Center, an American Addiction Centers facility. Price has dedicated most of his career to helping people get better, a passion spurred by his own health challenges. A neck injury forced him to retire from the NFL after two seasons with the Detroit Lions. It was during his recovery that Price decided to pursue a healthcare career and obtain a Doctor of Chiropractic degree from Life University in Atlanta.
Over the past 20 years, Price has owned and operated more than a dozen multidisciplinary clinics, an anesthesiology practice, a billing company, and several CrossFit gyms. He has also served as a business consultant, showing healthcare companies how to operate more efficiently.
In the following discussion, Price states an account about VR in rehabilitation and treatment of addiction.
When the first virtual reality (VR) headsets went into wide release in 2016, most people saw them as a curiosity best suited to video games and simulated travel experiences. Few predicted that the “journeys” people took could place them on the road to personal recovery—or that the “games” they played could help them cope with the biggest challenges they face in life. The use of VR is still in its infancy—but despite the imaginary worlds it creates, so far, the evidence indicates that for patients, its benefits are genuine indeed.
"Continual innovation is hallmark of enlightened healthcare, as is the willingness and courage required to apply new technology. It is through innovation that we have an opportunity to take patient care to a new level and give patients the best possible outcome"
VR technology has recently emerged as one of the most innovative therapeutic tools to come along in many years, especially in the fields of addiction recovery and mental health. For some time, PTSD treatment has benefitted from VR; but now chronic pain, anxiety, eating disorders, phobias, depression, and addictions are all being addressed. VR is also being used to diagnose conditions such as ADHD, schizophrenia, and early-stage Alzheimer’s disease.
Immersive virtual reality devices create safe environments in which patients can confront and learn to deal with any number of afflictions or disorders. Repeated exposure to situations and stimuli, without concern for real-world repercussions, reduces anxiety progressively, creating an environment where healing can occur.
VR is surprisingly well suited to the clinical environment, especially where group care is involved. It can be challenging to customize the treatment experience for one patient in a group setting. When a single therapist leads several patients, it’s difficult to instigate a level of treatment per a person’s individual components, i.e., their situational or emotional triggers. In many patients, there is a high comorbidity of substance use and mental health concerns, making individual solutions both complex and unique.
Yet if a group therapist can program therapeutic scenarios that are specific to each individual, efficacy rises significantly. One therapist can guide ten individuals through tailored journeys, watching and directing each person throughout the entirety of the program. Using virtual environments—for example, a tavern containing triggers like whiskey bottles or aggressive individuals—patients are taught how to manage such situations without fear of real-world consequences.
The therapeutic scenarios are endless. Patients can be placed in a bedroom, a workplace, a busy urban setting, or alone in a dark alley. The software allows technicians to create specific storylines based on dozens of templates, which then can be tailored using hundreds of variables. The patient is given two handheld controllers equipped with buttons that enable them to choose between options. If a session becomes too intense or the patient becomes agitated, it can be quickly ended by the therapist.
Given the peculiarities of the clinical environment, customization is important. Whether the setting is a Residential Treatment Center (RTC), an Intensive Outpatient Program (IOP) or a Partial Hospitalization Program (PHP), patients are admitted daily who are assessed and then placed in some level of group care. In that group, individuals are already on their own chapters of recovery; the first day for one person may be the fifth, or tenth, or thirtieth for another.
VR helps the group therapist answer this challenge. It lets each patient start from zero, with care tailored to his or her initial needs. VR establishes a course of treatment that is both unique and yet supportive of the group dynamic. The likelihood of a healthy outcome is significantly increased.
Proper Application Vital
While VR can provide an infinite number of therapeutic situations, its use must reflect the reason for care. In addiction treatment, for example, the first step is always detoxification. Then, therapies can be applied to help the person learn how not to re-engage in the practices that led them to their particular plight.
The benefit of individualized conditioning cannot be overstated. VR is unmatched in how it can be tweaked to address a patient’s special issues, weaknesses, or traumas. Once immersed in a therapeutic scenario, the clinician can track the patient’s response via biomarkers such as heart rate and respiration; it can even monitor brain waves and electrical conductance on the skin.
Therapists can witness in real-time what happens when the person is confronted with a trigger or situation—where the person’s eyes go, how their pulse changes, and what choices they make. The therapist can see what the patient sees by watching the situation unfold on a monitor, with sessions recorded for later analysis.
As the patient improves, technicians can create new and more challenging scenarios—just like “leveling up” in a video game. Based on assessment and understanding of the patient’s mental health, their life experiences, and discoveries made during counseling and interview sessions, therapists can choose to apply different triggers or variables at appropriate times. They control the input, moving from benchmarks to new settings that meet the patient at his or her improving level of care.
Not a Panacea
For all the potential of VR, it should be considered one tool among many. Just as real physical fitness is produced by numerous regimens, including cardiovascular, progressive resistance, and flexibility exercises, VR will undoubtedly complement, rather than replace, existing therapeutic techniques.
As an emerging alternative, however, VR holds incredible promise. In addition to behavioral modification, it can be used for meditation or other paths to positive reinforcement. Mitigating a desire to pick up an alcoholic drink, for example, could lead the patient to a peaceful and serene setting, reinforcing the notion of better emotional outcomes.
As an industry, we’re still in our infancy of understanding the true depth and breadth of what VR can do. Artificial intelligence (AI) is only now being integrated to track responses and “learn” how to adapt new VR situations for maximum benefit, and new refinements to VR devices and software are on their way.
Some would question the use of technology more closely associated with entertainment to healthcare applications. But if VR can be effectively applied to mental health and substance use therapy, we should embrace it. Continual innovation is the hallmark of enlightened healthcare, as is the willingness and courage required to apply new technology. It is through innovation that we have an opportunity to take patient care to a new level and give patients the best possible outcome.