Although standard cognitive and behavior therapy principles and practices are followed during the course of treatment, special emphasis is placed on individual reactions to the virtual environment, she explained. Using physiological measures as a guide during VR therapy appears to be an important factor in treatment, Wiederhold said. Those who received physiological feedback moved through the various scenarios of the VR program based on their physiology stabilizing. It is necessary to have some objective measurement rather than just asking a patient what is going on. While VR therapies and technologies are becoming more affordable and accessible, Mark Wiederhold, M.D., Ph.D., of Science Applications International Corp. did raise ethical concerns.
Many patients describe extremely powerful, meaningful and vivid reactions to simulated environments.
Because computer simulation allows for a seemingly unlimited number of creative and interactive environments, questions concerning appropriate choices and safe, effective and ethical use of these environments should be a priority. Specific issues cited by Wiederhold included patient privacy and confidentiality, practitioner competence, deception in research, misuse of the technology, informed consent, and human subject protection. A major concern of internal review board committees, he explained, is the failure to provide the safeguards required for the protection of all subjects and the failure of investigators to assess risks accurately in the consent forms that are commonly seen. Wiederhold urged investigators and presenters at the symposium to form an ad hoc committee and create a set of ethical guidelines for virtual reality therapy. An Innovative Paradigm.