Virtual reality helps patients cope with stressful situations

Being with people who give you their undivided attention. For the average person, this is basically an everyday situation. For people suffering from social phobia, this is a very stressful moment. Thanks to the Ekhi project which is being worked on by physicians from the University Hospital Brno and experts from the Masaryk University in Brno in co-operation with the team led by Tomáš Švec from the Faculty of Information Technology of the Brno University of Technology, patients suffering from various mental disorders will soon be able to train various situations or revisit stressful experiences in the safety of virtual reality. They will be accompanied by a therapist who will be able to control the situation and adjust the patients' stress level.

Following the years of pandemic, the offices of psychologists, psychiatrists and therapists are beginning to fill with people suffering from post-traumatic stress disorder caused by hospitalisation or severe coronavirus infection. Situations that are difficult for professionals and their clients to return to in a regular office, and are therefore very time-consuming, could soon be happening again right in front of their eyes within a few seconds.

All the patient has to do is put on virtual reality headset and suddenly they can be back in the hospital ward, hear devices or coughs and move between medical staff in protective suits. The therapist will see exactly what the client sees but also will be able to monitor patient's physical reactions. When the situation becomes too stressful for the client, the therapist can immediately change the environment to a calming forest.

The Ekhi project created by a team led by Tomáš Švec aims to create a technological and procedural framework for virtual reality serving for diagnosing and treating mental disorders. "We are developing an application for virtual reality headsets, specifically for Oculus Quest, a web portal allowing therapist to control the application and, finally, the backend connecting these two parts together," described Švec. According to him, the entire system can be simply imagined as a hospital filing cabinet.

"You put some data in, other parts of the system then take these data, read them and work with them," explained Švec, adding that they consult the procedure with other colleagues from BUT, for example experts in the fields of artificial intelligence, machine learning or security. This allows them to create a system that is significantly more complex than those developed in the past. "The idea to use virtual reality in therapy is not new. However, the technology available in the past did not allow mass deployment and even now, the spread of virtual reality into therapists' offices is very slow. Therefore, most studies were carried out using a specific software developed for a specific issue. Researchers have found that the results of virtual reality are at least comparable to conventional exposure therapy. However, that was the end and nobody went further. We want to offer a set of tools that will be useful in a variety of different situations," added Švec.

Ekhi is not intended for self-diagnosis or self-treatment. "The entire system should work in co-operation with a therapist. The therapist has the opportunity to watch the patient's experience in real time, monitor their biosignals and use these signals, such as the heart rate or respiratory rate, when deciding on the next step," said Tomáš Švec. This specific type of therapy is called exposure therapy. "I liken it to going to the gym. Exposure therapy works in such a way that a person experiences the same situation over and over again and gradually, the situation is for example getting more detailed. The patient gets used to it and realises that there is no danger," said Švec. At the same time, the technology offers a wider range of options. In situations like quarantine or huge distance between the therapist and the client, headsets and software could enable therapy to take place remotely.

There are virtual reality scenarios for social phobia and post-traumatic stress disorder caused by stay in Covid wards. However, scenarios for other mental diseases should also be available in the future. "We want to make using the tool and developing new scenarios as easy as possible. We will be happy if some research groups find an application for our tool in the research of other mental diseases," added Švec. Apart from this, the authors are also still improving the relaxation module.

Originally, Tomáš Švec, who is a doctoral student at FIT BUT, was supposed to work on something entirely different. "Associate Professor Smrž came up with an information technology topic that needed further clarification. Initially, he intended for the topic to focus on cybersecurity and detection of unusual human behaviour, for example in internet banking. But I wanted to work on diagnosing and treating mental diseases and I am very grateful that Associate Professor Smrž allowed me to do so," said Švec.

The Ekhi project, named after the Basque goddess of the Sun, is supposed to symbolise hope for the patients. Tomáš Švec hopes that someday, virtual reality will become so common in the offices of Czech therapists that they will be able to also use it for mental disease prevention. But so far, it is only tested by healthy volunteers. "Situations should also provoke a stress response in the volunteers. But in patients, the reaction is much stronger," explained Švec.

This way, they obtained a lot of valuable data for example during the Night of Scientists, when interested people could give the system a try. They are currently also welcoming volunteers. "If somebody would like to help us, we would be glad. The only limiting factor is the need for the tests to be performed in Brno. But if the place is not an issue, those interested can contact us for example via the Project Ekhi Facebook profile," concluded Tomáš Švec.