Psious Inc. is creating virtual reality experiences to help people overcome their fears using the principle of exposure therapy. Exposure therapy allows people to incrementally experience a stimulus that can cause anxiety or fears. Psious is collaborating with mental health professionals by providing them with a set of self-contained mobile VR experiences designed to help expose people to small doses of a variety of different phobias including fear of flying, fear of needles, agoraphobia, acrophobia (fear of heights), fear of small animals, fear of public speaking, fear of driving.
Xavier Palomer Ripoll is the co-founder and CEO of Psious says that they originally got started in order to help one of the other co-founders get over his fear of flying. They were able to create an experience that successfully helped him overcome his fear of flying, and so they decided to build a company around this therapeutic application of these immersive technologies.
Psious already has over 90 mental health professionals who are using their bundled solution to work with patients suffering from a variety of different anxiety disorders. They’re starting to hear success stories and anecdotes from patients including one man who was able to ride the subway for the first time in six years after using their VR exposure therapy solution.
Xavier says that it may take traditional 10-15 sessions of traditional exposure therapy, and only an average of 6-8 sessions when it’s supplemented with a 15-minute VR exposure therapy experience. They usually start the VR portion in the therapy on either the second or third session, and they’re proud to hear the feedback that the patients really respond to and request these types of VR experiences in all of their sessions.
Here’s a number of research studies and meta-analyses that Psious has posted on their site that indicate that VR exposure therapy is really effective:
- Virtual reality exposure therapy for anxiety disorders: A meta-analysis
- Virtual reality exposure therapy in anxiety disorders: a quantitative meta-analysis
- Affective outcomes of virtual reality exposure therapy for anxiety and specific phobias: A meta-analysis
- Virtual reality exposure therapy in anxiety disorders: a systematic review of process-and-outcome studies
Psious also points to a number of research studies that indicate that the success rate of exposure therapy is a lot higher, and that you can get results faster if you use VR in combination with cognitive behavioral therapies. It also reduces the number of dropouts during the therapy.
- Redefining therapeutic success with virtual reality exposure therapy
- Comparing Acceptance and Refusal Rates of Virtual Reality Exposure vs. In Vivo Exposure by Patients with Specific Phobias
- Cognitive-behavioral treatment and antidepressants combined with virtual reality exposure for patients with chronic agoraphobia
Psious has a lot more information about their product and research to back it up listed in there product guide here. It’s exciting to hear about some of these therapeutic applications of virtual reality because it helps convince me that there are a lot of pragmatic applications of VR that are going to just become more and more common as the technology becomes more affordable and accessible for these types of applications.
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Rough Transcript
[00:00:05.412] Kent Bye: The Voices of VR Podcast.
[00:00:12.039] Xavier Palomer Ripoll: I'm Xavier, I'm CEO of PsyOS, and PsyOS we do virtual reality for mental health care. It's a technology for exposure therapy. The therapy consists on exposing a patient that suffers some kind of anxiety-related disorder, exposing the patient to that situation that makes them feel afraid, so they can get used to that situation and reduce the anxiety level whenever they face this situation.
[00:00:37.385] Kent Bye: And so, yeah, the exposure therapy, just the idea of slowly exposing people to a stimuli and they get less and less anxious when they're looking at it. So when looking at the actual research into exposure therapy, how do you determine that level of increasing intensity along different scales? And so how do you kind of break that down in a specific experience, for example?
[00:01:00.892] Xavier Palomer Ripoll: Yeah, ours is a professional solution, so it can be used only under professional supervision, which allows us to give all this breaking, the gradual exposure, this is up to the therapist. They decide what they expose the patient to, so ours right now is just a technology, and all this gradual exposure is made by the therapist themselves.
[00:01:24.783] Kent Bye: I see. So in terms of gradual increasing of intensity, do you just create a solid sort of intense experience or are you slowly making it more and more intense?
[00:01:36.857] Xavier Palomer Ripoll: Both of them. So from one side, the therapist has a control panel where they control the VR experience that the patient is going through. so they can change, for example, a plane going through turbulences like a big storm or different events they can launch, but also there are different automatic events that increase the exposure, the intensity, automatically.
[00:01:59.752] Kent Bye: And so yeah, maybe you could describe some of the scenes that you have built within VR in order to give people exposure therapy.
[00:02:06.740] Xavier Palomer Ripoll: So we have eight VR environments for different treatments, like we have fear of flying, fear of needles, agoraphobia, acrophobia, which is fear of heights, fear of small animals. fear of public speaking, fear of driving, and fear of driving, plus a relaxation tool, which is a VR environment to teach patients how to get relaxed so they can face these anxiety situations in a more relaxed way.
[00:02:34.164] Kent Bye: And so have you been able to actually use any of these experiences in a clinical situation yet?
[00:02:40.384] Xavier Palomer Ripoll: Yeah, definitely. The product is already in the market with 90 plus professionals and top institutions using it. And yeah, we have several people. For example, they have this guy. He's a teenager from Spain. He took the subway for the first time in six years, thanks to the tool we have built. So yeah, the product is already helping people and changing people's lives.
[00:03:02.150] Kent Bye: Wow, so how did you start to get into this field of exposure therapy and virtual reality then?
[00:03:07.611] Xavier Palomer Ripoll: Yeah, that was my co-founder, Danny. He was afraid of flying and we decided to help him and we started looking for solutions and it turns out that current solutions are not as cool as VR and not as effective as VR and we decided to develop a solution for exposure therapy using VR.
[00:03:26.475] Kent Bye: And so can he fly now after going through these VR experiences?
[00:03:29.798] Xavier Palomer Ripoll: Yeah, he can fly without any pills or drugs or alcohol or any typical solution that people use when they're exposed to these situations. So no, he can fly without anything else.
[00:03:43.230] Kent Bye: Is there kind of like an average standard number of experiences that people would have to go through in order to experience it in real life for the first time?
[00:03:52.089] Xavier Palomer Ripoll: Yeah. Using traditional therapies, they have to go through between 10 and 15 sessions. And using virtual reality, the average is between 6 and 8. So it's almost half of the traditional exposure therapy.
[00:04:04.273] Kent Bye: I see. But they still have to perhaps go through therapy, talk therapy, or what other thing is supplementing it? Because it's not just throwing people in VR experiences, but it sounds like there's trained professionals there as well. So maybe talk a bit about it's in conjunction with what?
[00:04:20.913] Xavier Palomer Ripoll: That's difficult to answer. Why? Because in mental health care, every single professional has its own way to treat people. Going closer to the CBT or Cognitive Behavioral Therapy, virtual reality is used in 80% of the sessions. What that means is, at the beginning they do a session where they evaluate the patient, they diagnose the patient. Next session will be typically like a session saying this is what we are gonna do. They explain the treatment they maybe they jump into a Imagination exposure therapy and then they start using virtual reality. That's a typical treatment But as I said mental health care, it's every single professional has its own way So there are millions and millions of ways of treating it
[00:05:04.635] Kent Bye: Yeah, and I would imagine that they just don't come in and they slap it in VR and then, you know, call it done. But at the same time, how long would they go through kind of the traditional either cognitive behavioral therapy or talk therapy before they actually start to dive into the VR? Is it within the first session sometimes or is it usually, you know, a little bit later?
[00:05:24.650] Xavier Palomer Ripoll: Typically it's between the second and the third session. And the VR sessions usually last for like 15 minutes, 20 minutes at max. That's the typical VR session is 15 minutes.
[00:05:35.937] Kent Bye: Yeah, and I noticed that you're developing on the Gear VR, which is a little bit more, I guess, mobile friendly, perhaps easier to use. And talk about that decision of, you know, going for Gear VR versus something that may be a little bit more complicated for these people to use.
[00:05:51.867] Xavier Palomer Ripoll: From the first day, we started developing with a mobile-based solution, always. Now we are jumping into the Samsung Gear because big partners, they ask for this, like health care institutions or health care networks. They want to bring the best of the technology with their patients. And that's why we have started developing for Samsung Gear. But until now, we were mobile-based, using affordable solutions like Homido.
[00:06:20.012] Kent Bye: Great. And what kind of institutions are you collaborating with in terms of, you know, getting help from advisors or, you know, kind of feedback from the actual on-the-ground therapist and academics in this way?
[00:06:34.173] Xavier Palomer Ripoll: Yeah, one of our top advisors, or the top advisor we have is Walter Greenleaf from Stanford. So we get good feedback from that. But also we collaborate with different other institutions in the US, but also in Spain. We are from Spain and we collaborate with top universities and healthcare institutions from Spain as well.
[00:06:54.244] Kent Bye: And have you been able to see this live in therapeutic situations with people, or is this something that you, it's kind of a black box once you send it out into the world?
[00:07:03.091] Xavier Palomer Ripoll: Personally, I couldn't be in one of these therapies because for confidential reasons, people are not willing to share their fears, especially with, I'm a physicist, I'm not a psychologist, I'm not a mental health professional. so they are not willing to share this with me, but we have a psychologist in the company and they've been in a situation like that.
[00:07:26.425] Kent Bye: I see. So you have people that are on the ground. They're kind of the trained professionals that are able to kind of witness it. And what have they observed in terms of the feedback that has kind of gone back into what was working, what wasn't working?
[00:07:38.790] Xavier Palomer Ripoll: More than what was working or what wasn't working, what we are most proud of is when the patients try our solution, they get super engaged. And they ask for this. Typically, at the end, they do a session. The last session is usually without VR. And when the patient goes to the therapist's office and they don't get a VR exposure session, they say, hey, why not? What's going on? Something wrong there? So that's what we are most proud of. When the patients try our solution, they always ask for it. So that's one of our biggest achievements.
[00:08:14.681] Kent Bye: And so if someone was creating a VR experience for exposure therapy, what would be one of the top one or two things that you'd say you'd absolutely need to do?
[00:08:22.506] Xavier Palomer Ripoll: Yeah, listen to patients. We come from a technical side, so we wanted to develop the most coolest, the best technology out there in the VR world. But we realized that the patient don't want that. Patient want what is useful for them to overcome the anxiety. That's not always the coolest technology. So that's focus on the patient.
[00:08:45.788] Kent Bye: And so I know within VR horror applications, or just VR in general, there's the concept of a jump scare where something sort of suddenly surprises you. And so I know there's been a number of VR experiences where a spider drops on your face. And I'd imagine that would be a really bad approach to doing exposure therapy, is to kind of take a shock and awe approach of just trying to really do something that would be probably too much, too overwhelming. And so, when dealing something with like fear of spiders, for example, what type of experience would someone experience in order to kind of deal with this fear?
[00:09:16.398] Xavier Palomer Ripoll: Yeah, the idea is a gradual exposure. So not getting in front of the worst spider in the world, no. The idea is to have a gradual exposure. For example, they can use like a getting close to the spider. So you can use our software to get close to that spider. So, for example, you can see the first time the spider on the other side of the room, not moving at all. Then getting closer to that spider, then not just one spider, but like 10 spiders in the room moving super fast that you cannot control them. You cannot really see all of them because they are moving too fast. So that's a gradual exposure. That's the key of the therapy. Great, so what's next for PSIAS? Yeah, now we have a solution for specific phobias. Our idea is to start developing for more complex diseases, such as PTSD, OCD, other diseases that exposure therapy is used on. And that's our next goal, yeah.
[00:10:14.007] Kent Bye: So with PTSD, I'd imagine that it's a pretty broad range of things that maybe triggers for people. So how do you go about deciding the most common PTSD triggers?
[00:10:26.112] Xavier Palomer Ripoll: We ask our therapists, we ask our customers what problems they are facing and we are going to develop according to their needs.
[00:10:35.905] Kent Bye: Great. And finally, what do you see as the ultimate potential for virtual reality and what it might be able to enable?
[00:10:42.447] Xavier Palomer Ripoll: I mean, virtual reality is game-changing. It's been here for a while. I mean, we all heard about virtual reality before, and it was always like, is that really a realistic technology it's going to get somewhere? And I think now is the time for that. It's going to change healthcare, education, entertainment, and it's here to stay here. It's going to change a lot, a lot of things. So what? I don't know. Hopefully healthcare, definitely. But it's going to change a lot of different industries, definitely, yeah.
[00:11:15.989] Kent Bye: Awesome. Well, thank you so much. Thank you. And thank you for listening. If you'd like to support the Voices of VR podcast, then please consider becoming a patron at patreon.com slash Voices of VR.
