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Co-designing a virtual reality exposure therapy with students experiencing school anxiety: a proof-of-concept study

Published online by Cambridge University Press:  18 September 2024

D. Boyle*
Affiliation:
Kerry Rehabilitation and Recovery Mental Health Team, Killarney, Co. Kerry. Ireland
N. Morrin
Affiliation:
Galway, CAMHS, HSE West, Merlin Park Regional Hospital, Galway, Ireland
J. Scargill
Affiliation:
Healthcare & Government Advisory Team, PwC 1 North Wall Quay, North Dock, Dublin, Ireland
F. Mulvey
Affiliation:
Roscommon, CAMHS,, Castlecourt House, Co Roscommon, Ireland
C. Heavin
Affiliation:
Business Information Systems, Cork University Business School, University College Cork, Cork, Ireland
E. Flanagan
Affiliation:
Research MUH/HRB CRF UCC, University College Cork/ Mercy University Hospital, Cork, Ireland
B. McMahon
Affiliation:
School of Medicine, Children’s Health Ireland, Herberton, Rialto, Ireland
H. O’Connell
Affiliation:
University of Limerick, Laois-Offaly Mental Health Services, St. Fintan’s Hospital, Portlaoise, Co. Laois. Ireland
*
Corresponding author: D. Boyle; Email: [email protected]

Abstract

Background and Objectives:

Anxiety related school avoidance can affect up to 5% of a country’s students each year. VRET (Virtual Reality Exposure Therapy) is a novel therapy proven to be as effective as conventional approaches for treating many anxiety disorders. The aim of this research is to co-design and evaluate a VRET intervention for students experiencing school related anxiety.

Method:

Eighteen adolescents participated in design thinking workshops where they developed a script and storyboard for the VRET. Using an iterative approach, a VRET prototype was developed based on this work. Eighteen teenagers were subsequently recruited to engage with the VRET for one session each and provide feedback on their experience via a structured questionnaire (supervised by a study coordinator) particularly focusing on the ability of the VR experience to reduce school related anxiety.

Results:

Exposure therapy needs to produce an anxiety response to be effective. The VRET was effective in producing an anxiety response in 89% of participants. Results demonstrated that 93% of participants found the simulations immersive, 94% found the scenarios believable, and 83% could relate to ‘Dala’, the avatar in the videos. 100% of participants believed that VRET would help with school anxiety.

Conclusion:

This proof-of-concept study demonstrates favourable face validity indicating promise for this mode of intervention for delivering targeted support to anxious students. VRET could be used as a scalable, cost effective early intervention to reduce the severity of anxiety associated with school avoidance.

Type
Original Research
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of College of Psychiatrists of Ireland

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References

Achilles, MR, Anderson, M, Li, SH, Subotic-Kerry, M, Parker, B, O’Dea, B (2020). Adherence to e-mental health among youth: considerations for intervention development and research design. Digital Health 6, 2055207620926064. doi:10.1177/2055207620926064.CrossRefGoogle ScholarPubMed
Bioulac, S, de Sevin, E, Sagaspe, P, Claret, A, Philip, P, Micoulaud-Franchi, JA, Bouvard, MP (2018). [What do virtual reality tools bring to child and adolescent psychiatry?]. L’Encephale 44, 280285. doi:10.1016/j.encep.2017.06.005.CrossRefGoogle ScholarPubMed
Braun, V, Clarke, V (2006). Using thematic analysis in psychology. Qualitative Research in Psychology 3, 77101. doi:10.1191/1478088706qp063oa.CrossRefGoogle Scholar
Carl, E, Stein, AT, Levihn-Coon, A, Pogue, JR, Rothbaum, B, Emmelkamp, P, Asmundson, GJG, Carlbring, P, Powers, MB (2019). Virtual reality exposure therapy for anxiety and related disorders: a meta-analysis of randomized controlled trials. Journal of Anxiety Disorders 61, 2736. doi:10.1016/j.janxdis.2018.08.003.CrossRefGoogle ScholarPubMed
de Beurs, D, van Bruinessen, I, Noordman, J, Friele, R, van Dulmen, S (2017). Active involvement of end users when developing web-based mental health interventions. Frontiers in Psychiatry 8, 72. doi:10.3389/fpsyt.2017.00072.CrossRefGoogle ScholarPubMed
Department of Education. (2021). Statistical Bulletin - July 2021. https://www.gov.ie/en/publication/055810-education-statistics/#latest-statistical-reports. Accessed 19/09/2022.Google Scholar
Geraets, CNW, van der Stouwe, ECD, Pot-Kolder, R, Veling, W (2021). Advances in immersive virtual reality interventions for mental disorders: a new reality? Current Opinion in Psychology, Psychopathology 41, 4045. doi:10.1016/j.copsyc.2021.02.004.CrossRefGoogle ScholarPubMed
Halldorsson, B, Hill, C, Waite, P, Partridge, K, Freeman, D, Creswell, C (2021). Annual research review: immersive virtual reality and digital applied gaming interventions for the treatment of mental health problems in children and young people: the need for rigorous treatment development and clinical evaluation. Journal of Child Psychology and Psychiatry, and Allied Disciplines 62(5), 584605. doi: 10.1111/jcpp.13400.CrossRefGoogle Scholar
Heyne, D, King, NJ, Tonge, BJ, Cooper, H (2001). School refusal: epidemiology and management. Paediatric Drugs 3, 719732. doi:10.2165/00128072-200103100-00002.CrossRefGoogle Scholar
Kothgassner, OD, Felnhofer, A (2021). Lack of research on efficacy of virtual reality exposure therapy (VRET) for anxiety disorders in children and adolescents: a systematic review. Neuropsychiatrie: Klinik, Diagnostik, Therapie Und Rehabilitation: Organ Der Gesellschaft Osterreichischer Nervenarzte Und Psychiater 35(2), 6875. doi: 10.1007/s40211-020-00349-7.Google ScholarPubMed
Oing, T, Prescott, J (2018) Implementations of virtual reality for anxiety-related disorders: systematic review. JMIR Serious Games 6(4), e10965. doi: 10.2196/10965.CrossRefGoogle ScholarPubMed
Pot-Kolder, R, Veling, W, Geraets, C, Lokkerbol, J, Smit, F, Jongeneel, A, Ising, H, van der Gaag, M (2020). Cost-effectiveness of virtual reality cognitive behavioral therapy for psychosis: health-economic evaluation within a randomized controlled trial. Journal of Medical Internet Research 22, e17098. doi:10.2196/17098.CrossRefGoogle ScholarPubMed
Sewell, J (2008). School refusal. Australian Family Physician 37, 406408.Google ScholarPubMed
Shiban, Y (2018). [Virtual reality exposure therapy for anxiety disorders]. Der Nervenarzt 89, 12271231. doi:10.1007/s00115-018-0596-z.CrossRefGoogle ScholarPubMed