Virtual reality may be the next frontier in remote mental health care

In recent years, experts have focused on finding better ways to improve remotely delivered mental health care.

Now, virtual reality (VR) may pave the way for myriad new opportunities.

Using VR for remote therapy involves conducting “face-to-face” sessions in a virtual environment. This mode of treatment could make counselling more accessible to those living and working remotely.

My colleagues and I published a paper exploring VR’s potential in providing counselling for people in regional areas.

While face-to-face therapy remains the optimal treatment method, we discovered VR-based therapy was more effective than Skype-based counselling.

Taking advantage of available tools

We compared the experiences of 30 participants aged 21 to 63, who participated in both VR-based and Skype-based mock counselling sessions.

To deliver the VR sessions, the participants and trained therapists used the Oculus Go head-mounted display and vTime social networking app. This provided them with a multisensory and interactive VR experience.

We used cartoon-like avatars to represent the two therapists, modelled closely to how they looked in real life.

We then compared participants’ responses in both settings to determine which type of therapy was more engaging, less stressful and preferred overall.

Results were compiled based on factors including a perceived level of “presence” (being there), “co-presence” (being together with the therapist), “social presence” (engaging with each other) and “realism”.

Virtual environments bring real results

On almost all accounts, participants responded greatly in favour of VR-based therapy sessions. The use of VR generated high levels of engagement between client and therapist, without causing stress or feelings of sickness.

Participants reported their virtual experience was consistent with what they might expect from a face-to-face experience. This heightened sense of realism made the interaction more meaningful.

Using a VR avatar also encouraged most participants (22 out of 30) to more freely express themselves without fear of judgement. This was observed in both introverted and extroverted participants.

Our results suggest VR-based telehealth sessions could greatly reduce dropout rates for clients and produce positive clinical outcomes.

Moving beyond standard practice

In Australia, around 7 million people live in rural and remote areas. Many either can’t access face-to-face counselling, or have to travel large distances for it.

Remote workers such as mining and construction workers are at greater risk of mental health problems, usually requiring ongoing counselling or psychotherapy.

These individuals often work long hours in harsh climates, and some have to live far from family for extended periods. Accessing quality mental health care can be particularly difficult under such circumstances.

Currently, it’s common to use mobiles and video conferencing to deliver telehealth sessions remotely using programs such as Skype, Zoom and Facetime.

However, one of the biggest challenges with this is that clients are often unmotivated to commit to the treatment.

A phone session using audio without video doesn’t convey important non-verbal cues.

Even with video, the physical distance between a therapist and client can prevent clients from being fully engaged. In this context, engagement refers to the client’s commitment to willingly disclose their thoughts, feelings, problems and history.

This is essential for successful psychological treatment, as past research has found clients displaying lower levels of engagement are more likely to discontinue treatment.

A successful program delivering VR-based mental health services to remote areas would have a far-reaching impact.

Further testing

So far in clinical psychology and psychiatry, the primary focus of VR has been its role in treating anxiety and stress-related disordersspecific phobiaspanic disorder, and post-traumatic stress disorder.

Soon, VR may be the next major avenue for remote mental health care delivery.

Moving forward with this technology, one important consideration will be assessing an avatar’s capacity to act and move in a believable manner.

In virtual environments, the use of hyper-realistic avatars can generate cold and eerie feelings (known as Uncanny Valley (UV) effects).

Similarly, avatars that are too unrealistic and cartoon-like could negatively impact a client’s experience.

In the next phase of our research, we will conduct clinical interviews via both VR and face-to-face methods, and measure participants’ physiological responses. This will include monitoring their heart rate, skin conductance (how much they sweat) and reported experiences.

We hope further trials will bring us closer to providing a world-leading VR-based therapy option for Australians living and working remotely.

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Virtual reality won’t make cows happier, but it might help us see them differently

Earlier this week, Russian farmers announced they are testing virtual reality (VR) for dairy cows.

Conducted at the RusMoloko farm near Moscow, the trials supposedly use specially adapted goggles to show the animals a view of a pleasant field in summer. The idea is to make the cows happier, which in turn could make them produce more milk.

Some have doubts over whether the tests are real, and it wouldn’t be the first time pictures of animals in VR headsets have been used to capture public attention. Similar images of CatVR and “virtual free range” chickens have appeared in the past.

But to take the idea seriously, at least for a moment: can animals perceive virtual reality the same way we do? And would it do them any good?

Virtual entertainment for animals

Unfortunately for the emerging VR industry, there is little to suggest that gazing on a virtual landscape will make cattle happier.

Visual stimulation may be beneficial to some species of animals, but the research relates mostly to primates. Horses in a stable do seem to benefit from a view of other horses and an open window. But the sounds, smells, breeze and associated temperature changes in the real world make for a far richer sensory experience than VR can offer.

Could virtual reality for animals ever be a good idea? Cognition researchers working with chimpanzees have given the animals access to a virtual maze environment to study their spatial cognition abilities.

In this research the chimps were given food rewards when they successfully located objects in the maze. There’s no evidence they enjoyed the VR experience for its own sake. And the chimps didn’t wear VR headsets; the virtual world was displayed on a computer screen and the animals navigated using a joystick.

A visual VR experience might be appealing to humans, but would likely have less inherent value for animals. Humans can understand symbolic imagery, complex language-based events, and the written word. So visual technologies such as television, smartphones and VR can provide us with long-lasting entertainment, intellectual stimulation, and social connection.

This is not so for other species. While some dogs might watch TV, their interest is usually short-lived unless it has a meaningful outcome, such as the opportunity to chase and bark at animals on the screen. Similarly, some cats play with iPads and digital toys for short periods, but usually only keep up the behaviour if they are intermittently given a reward when they catch the “prey”.

Real entertainment for cows

Despite evidence that cattle have the capacity for complex thoughts and feelings, an increasing number of cows are housed year-round in relatively boring and restrictive indoor environments.

At the same time, there is interest in providing cattle with “environmental enrichment”. This takes the form of objects and activities to provide physical and mental stimulation, in the same vein as toys and puzzles for pets and zoo animals. As well as improving the animals’ well-being, it seems to improve dairy production outcomes.

Good animal enrichment addresses the physical and behavioural needs of different species that are not already met in their existing environment. Good enrichment can also give animals more agency – more control over their lives and their environment. For cows, enrichment might look more like a sophisticated brush than a VR headset.

In our research, we have investigated approaches to designing technology-based enrichment that responds to animals’ real needs. In 2016 we trialled digital enrichment for orangutans at Melbourne Zoo, offering the animals a range of games and apps that could be made more complex as animals learn.

How tech for animals can change humans

There seems to be something inherently fascinating in seeing animals using technology that is “meant for humans”.

When we provided digital games for orangutans at Melbourne Zoo, we investigated the effect on visitors’ perceptions of the primates. We found that seeing the animals using technology influenced people’s empathy for the orangutans. Others have also proposed that digital games for pigs might encourage people to reflect on the needs of farm animals.

So while VR for cows may not directly improve their well-being, it just might encourage people to think more about what animals need.

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Augmented Reality – The Past, The Present and The Future

Augmented reality has come a long way from a science-fiction concept to a science-based reality. Until recently the costs of augmented reality were so substantial that designers could only dream of working on design projects that involved it – today things have changed and augmented reality is even available on the mobile handset. That means design for augmented reality is now an option for all shapes and sizes of UX designers.

Augmented reality is a view of the real, physical world in which elements are enhanced by computer-generated input. These inputs may range from sound to video, to graphics to GPS overlays and more. The first conception of augmented reality occurred in a novel by Frank L Baum written in 1901 in which a set of electronic glasses mapped data onto people; it was called a “character marker”. Today, augmented reality is a real thing and not a science-fiction concept.

A Brief History of Augmented Reality (The Past)

Augmented reality was first achieved, to some extent, by a cinematographer called Morton Heilig in 1957. He invented the Sensorama which delivered visuals, sounds, vibration and smell to the viewer. Of course, it wasn’t computer controlled but it was the first example of an attempt at adding additional data to an experience.

Then in 1968, Ivan Sutherland the American computer scientist and early Internet influence, invented the head-mounted display as a kind of window into a virtual world. The technology used at the time made the invention impractical for mass use.

In 1975, Myron Krueger, an American computer artist developed the first “virtual reality” interface in the form of “Videoplace” which allowed its users to manipulate and interact with virtual objects and to do so in real-time.

Steve Mann, a computational photography researcher, gave the world wearable computing in 1980.

Of course back then these weren’t “virtual reality” or “augmented reality” because virtual reality was coined by Jaron Lainer in 1989 and Thomas P Caudell of Boeing coined the phrase “augmented reality” in 1990.

The first properly functioning AR system was probably the one developed at USAF Armstrong’s Research Lab by Louis Rosenberg in 1992. This was called Virtual Fixtures and was an incredibly complex robotic system which was designed to compensate for the lack of high-speed 3D graphics processing power in the early 90s. It enabled the overlay of sensory information on a workspace to improve human productivity

There were many other breakthroughs in augmented reality between here and today; the most notable of which include:

  • Bruce Thomas developing an outdoor mobile AR game called ARQuake in 2000
  • ARToolkit (a design tool) being made available in Adobe Flash in 2009
  • Google announcing its open beta of Google Glass (a project with mixed successes) in 2013
  • Microsoft announcing augmented reality support and their augmented reality headset HoloLens in 2015

The Current State of Play in Augmented Reality (The Present)

Augmented reality is achieved through a variety of technological innovations; these can be implemented on their own or in conjunction with each other to create augmented reality. They include:

  • General hardware components – the processor, the display, the sensors and input devices. Typically a smartphone contains a processor, a display, accelerometers, GPS, camera, microphone etc. and contains all the hardware required to be a an AR device.
  • Displays – while a monitor is perfectly capable of displaying AR data there are other systems such as optical projection systems, head-mounted displays, eyeglasses, contact lenses, the HUD (heads up display), virtual retinal displays, EyeTap (a device which changes the rays of light captured from the environment and substitutes them with computer generated ones),Spatial Augmented Reality (SAR – which uses ordinary projection techniques as a substitute for a display of any kind) and handheld displays.
  • Sensors and input devices include – GPS, gyroscopes, accelerometers, compasses, RFID, wireless sensors, touch recognition, speech recognition, eye tracking and peripherals.
  • Software – the majority of development for AR will be in developing further software to take advantage of the hardware capabilities. There is already a an Augmented Reality Markup Language (ARML) which is being used to standardize XML grammar for virtual reality. There are several software development kits (SDK) which also offer simple environments for AR development.

There are apps available for or being researched for AR in nearly every industrial sector including:

  • Archaeology, Art, Architecture
  • Commerce, Office
  • Construction, Industrial Design
  • Education, Translation
  • Emergency Management, Disaster Recovery, Medical and Search and Rescue
  • Games, Sports, Entertainment, Tourism
  • Military
  • Navigation

The Future of Augmented Reality

Jessica Lowry, a UX Designer, writing for the Next Web says that AR is the future of design and we tend to agree. Already mobile phones are such an integral part of our lives that they might as well be extensions of our bodies; as technology can be further integrated into our lives without being intrusive (a la Google Glass) – it is a certainty that augmented reality provides opportunities to enhance user experiences beyond measure.

This will almost certainly see major advances in the much-hyped but still little seen; Internet of Things. UX designers in the AR field will need to seriously consider the questions of how traditional experiences can be improved through AR – just making your cooker capable of using computer enhancements is not enough; it needs to healthier eating or better cooked food for users to care.

The future will belong to AR when it improves task efficiency or the quality of the output of an experience for the user. This is the key challenge of the 21st century UX profession.

The Takeaway

AR or augmented reality has gone from pipe dream to reality in just over a century. There are many AR applications in use or under development today, however – the concept will only take off universally when UX designers think about how they can integrate AR with daily life to improve productivity, efficiency or quality of experiences. There is an unlimited potential for AR, the big question is – how will it be unlocked?

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