General VR Treatment Tips
The value of exposures is amplified when you support your patient’s ability to focus attention in the present moment throughout treatment sessions. The reason for this is twofold:
1. Exposures engage your patient most effectively when your patient experiences the treatment experience to be as similar as possible to their actual feared and avoided experiences.
2. Heightened anxiety is associated with shifting attention to negative memories, anticipating feared events and distorting ongoing perceptions, i.e. cognitive distortions.
Feeling present and learning how to intentionally shift attention into the present moment will cultivate your patient’s ability to reduce anxiety on demand. Follow the "EXPOSE to CALM" treatment structure below to provide great VR exposure therapy.
EXPOSE during sessions (therapist)
EX - Create an exposure hierarchy of progressively feared virtual environments. Consider supplementing your hierarchy with virtual guided relaxation environments to support new learning.
P - Prepare for each exposure by noting that experiencing the upcoming environment will help reduce anxiety and avoidance over time
O - Open your selected virtual environment
S - Provide skills training during and between each exposure including monitoring SUDS and supporting cognitive restructuring, relaxation training and diaphragmatic breathing
E - Elevate sequentially through your exposure hierarchy environments to increase anxiety tolerance and learning
CALM between sessions (patient)
C - Commit to a schedule of homework tasks
A - Always complete homework tasks on schedule
L - Log experiences and SUDS ratings after each homework task
M - Master anxiety by repeatedly confronting feared situations