Virtual reality students explore phobia treatment

Many people suffer intense fears of darkness, noises or creepy crawly things. Two engineering undergraduate students at the University of Santa Clara, Paul Thurston and Bryce Mariano, devoted their last semester of college in Spring 2015 to treat acrophobia, the fear of heights, with technology using virtual reality goggles to simulate the sensation of being at high altitude during therapy.

“We had to create a project that had a social benefit as well, and we were looking at virtual reality as a general field to work in,” said Thurston, a recent computer science engineering graduate.

Millions of Americans suffer from anxiety disorders, a family of psychological conditions including post-traumatic stress disorder (PTSD), obsessive-compulsive disorder and
specific phobias such as a fear of flying or spiders. The National Institute of Mental Health estimates that 12.5 percent of U.S. adults suffer from a phobia at some time of life, but only a minority of them are treated. Treatment may include medication, cognitive-behavioral therapy or controlled exposure to the thing most feared.

“Finding and downloading the program we used, Unity, was easy and free and we figured if we were able to do this well, then that many more people would be able to receive treatment with the help of trained [therapist],” said Mariano.

Originally, the 23-year-old Thurston and his partner, 22-year-old web design and engineering graduate Mariano, wanted to use the concept to treat PTSD. But Professor of Clinical Psychology and Department Chair Kieran Sullivan advised the pair to switch to something safer.

“[Sullivan] told us the disorder was complex and volatile. If it wasn’t managed properly, it could actually make the PTSD worse, so we started looking into phobias,” said Mariano in a telephone interview.

Their next idea was to research the top five most common phobias through the creation of a hybrid phobia simulation. Time restraints forced them to focus on one fear. With guidance from Maria Pantoja, an instructor with video game design experience, the two were able to download the free Unity software to bring the task to fruition.

“I’d seen a presentation centered around therapeutic video games last year by a cognitive neuroscientist named Adam Gazzaley and his team, and I thought it was amazing,” said Pantoja, an adjunct lecturer in the computer engineering department. “I wanted the task to combine game design with ‘Giving back,’ which is one of the school’s missions.” (Gazzaley is founding director of the Neuroscience Imaging Center and professor of Neurology, Physiology, and Psychiatry at the UC San Francisco.)

Pantoja helped the duo acquire the virtual reality hardware system they needed for the task, said Thurston, who worked on the design while Mariano focused on linking the hardware to a computer tablet. The team used a virtual reality system made by Oculus Rift, a VR developer in Irvine that is now owned by Facebook Inc., of Menlo Park.

“We took the software and formatted it to work for our project, which was focusing on creating an immersive experience for the people who suffer from acrophobia,” said Thurston. “It’ll feel like they’re actually there as the therapist adjusts the degree of the patient’s exposure.”

Mariano and Thurston envision that a certified therapist and a patient would use the goggles together. The patient would view the three-dimensional world from a simulated perspective on top of a building, while the therapist would adjust the levels and exposure amount based on emotional and physical cues.

While the former students didn’t subject their game to either medical testing or clinical trials because it was “outside the scope of a year one project,” Thurston said they did test the device on each other before finally showing the finished prototype to both Pantoja and Sullivan.

Pantoja said her excitement toward the assignment increased once she saw the end result.

Fusing psychology and technology isn’t a purely new concept, she added.

“It’s been happening in neuropsychology, for MRIs [and] as apps for smart phones to explore mental illnesses,” said Pantoja “The therapeutic relationships between the two might be new but I can see it catching on.”

Melinda White, a certified cognitive behavioral therapist in Berkeley who wasn’t affiliated with the Santa Clara team, liked the sound of the device and said its success rate and the patient’s safety would depend on the individual’s medical history, proper procedural instructions and therapist qualifications. White also thought the tool introduction was timely considering the growing numbers of people who incorporate technology into their daily lives.

“The device itself isn’t unusual, especially since more people are using apps to help themselves,” said White, a founding fellow of the Academy of Cognitive Therapy, “It sounds like a good alternative for people who won’t have access to primary behavioral therapy.”

After grappling with technical glitches such as a tendency to cause motion sickness, virtual reality in general is now experiencing a resurgence, which Thurston and Mariano said they see as a great thing for a variety of uses.

“Both the concept and videogames are untapped, powerful tools to help kids read, do math, and help with homework — even help with health care — so why can’t it be used for effective and affordable phobia treatment?” asked Thurston.

Thurston and Mariano said they have given their project to the school complete with an outline suggesting the ways they’d like to see it continued in case others want to “pick up where we left off.”

Psychiatrists and phobia sufferers will have to wait for this project to become available, as it still requires more tweaks and testing — but Pantoja said progress was well underway.

“A group of students will continue to develop the simulation,” said Pantoja, adding that any such device used in mental health treatment faces clinical testing, and regulatory review by the U.S. Food and Drug Administration to be qualified for therapeutic use.

Thurston now is continuing his studies at Santa Clara by working on a Master’s Degree in Computer Science and Engineering. Meanwhile, Mariano is working at a mobile and virtual reality applications startup called Fusion.Tech. Eventually the two plan to work in the videogame industry — and get over their respective fears.

“Sharks,” Mariano said.

“Snakes,” said Thurston.

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