Virtual reality. The idea of entering an alternative universe or an immersive environment was merely a notion for science-fiction not so long ago. However, advancements in digital technology and production have made virtual reality (VR) not just an actual reality but accessible to the general public. Today an interested party can buy a portable headset for under $400, less than a new series Xbox. In fact, the VR market is expected to reach $22.9 billion by the end of 2020, with 37 million headsets expected to be in use worldwide (Milijic, 2019). With the popularity and availability of VR technology growing at exponential rates, we need to explore areas outside of gaming where this technology can support and advance current practices. What possibilities does VR offer social work?
Researchers have begun to examine just how VR technology can improve our current evidence-based practices. Lindsey Getz discusses some of the ways virtual reality has been researched, as well as possibilities and future advances, in her 2018 Social Work Today article. She describes early research on VR in treating addictions where clients can practice coping skills in a realistic setting without the risks of a real-world situation, as well as the development of an exposure therapy application to treat PTSD. Ms. Getz suggests VR can be an additional tool for therapists to deliver already established evidence-based practices but cautions it is not a replacement for the expertise of a clinician.
In his October 2020 podcast, Tom Oates interviews two research assistant professors from the University of Utah’s School of Social Work about the development and use of virtual reality to train students and staff in child welfare agencies. The researchers noted, unlike many other professional roles, social work strongly relies on learning on the job to training. Military, pilots, and even Wall Street traders utilize simulation training in conjunction with real-life practice to improve their skills. They emphasize the need to rely on collaboration networks to access resources such as funding. From there development must be based on theory to enhance effectiveness. Tools for implementation included coaching, operationalizing, adapting for best contextual fit, availability, trialability, and post-training support.
Bell et al (2020) recognized the capabilities of VR could be beneficial for both assessment and treatment of mental health issues and conducted a literature review regarding the benefits, applications, and challenges to integrating VR into mental health services. VR has been seen as beneficial since it allows users to control and manipulate the environment and can be individualized to client needs and abilities.
Persky and Lewis (2019) reviewed the use of VR in behavioral medicine, its impact on patient care, challenges to translating research to practice, and the role of implementation science in facilitating VR use. Given preliminary research in immersive technology for treating some behavioral medicine concerns, the authors wanted to better disseminate information regarding how these technologies could improve client outcomes and ways to introduce VR into clinical settings.
What’s stopping virtual reality becoming a social work reality?
Keller et al (2017) used social listening to better understand public opinion related to virtual reality in healthcare. The authors recognize the multiple successful uses of VR to treat both medical and physical concerns. They point out that the acceptability of the platform is an important characteristic to consider for successful implementation. Through analyses of unsolicited feedback on Facebook about a news video regarding the use of VR at Cedars-Siani Hospital, it was found that there was generally positive regard for the clinical application of VR by the general public.
So why VR has not yet changed our lives even though it is being used in many areas of research and training? Nicole Garrison (n.d.) identifies five barriers to the more general use of VR. These include the cost of tools to use and develop the technology, the need for more consumer-friendly transportable design, and lack of consumer awareness about the advances VR could make in multiple person-centered industries. Traditionally people were more often exposed to new technology in the workplace. Now things such as AR and VR are more common in our personal lives and will likely be introduced more readily to the workplace by younger technology-infused generations.
Laurell, Sandstrom, Bethold, & Larsson (2019) sought to identify barriers to the uptake of VR particularly related to the technology itself along with cost and trialability. The authors were unable to identify previous attempts at determining why VR had been better diffused or ways to address these barriers. They analyzed social media data related to Oculus and HTC headsets specifically to identify ways users interacted with and discussed the platforms. The functionality of the technology (how fun it was, how easy to use), and the availability of applications (apps) were the primary concerns of users. Cost and trialability were less often mentioned by users, however, they did contribute to the decision to buy. Although technological advances have made VR easier to set up and use there is still an issue with cost. Even more challenging is the lack of evidence and consistent research to support the use of VR in treatment. Additional barriers include lack of inner setting structure to support VR use, lack of training and evidence-based applications, time and resources to support the learning curve, and the fear of technology replacing mental health professional roles (Bell, 2020) as well as the functionality of the technology, ease of use, and the need for more realistic VR scenarios (Keller et al, 2017).
So what will help social work embrace this new tool?
There have been no clear recommendations for overcoming barriers for VR use in treatment. In 2018 Gleg and Levac examined the barriers and facilitators to the use of virtual reality in clinical practice. They wanted to assess what was preventing clinical staff from using VR given the evidence it was a useful tool. They also sought to identify interventions that promoted the adoption of VR by addressing these barriers and make recommendations for future development. A scoping review of journal articles regarding the uses of VR in clinical settings over the past 13 years was completed. To overcome these challenges the following recommendations were made base on principles of implementation science:
- Making context-specific assessments in places where VR is being considered as an intervention
- Training staff in the technology
- Including clinicians and game developers in the planning and designing of clinical VR applications
- Involving stakeholders as early as the development stage
- Selection, training, and systems intervention drivers play a part in VR adoption according to the article.
- Clarifying and developing appropriate research methods to meet standards of evidence-based
- Expanding on theories of behavioral change
- Improved understanding of organizational readiness in adopting VR
(Perskey and Lewis, 2019; Gleg and Levac, 2018).
So what’s next? Does virtual reality have a place in the assessment and treatment of those we serve? Can it be a tool that enhances evidence-based practices? Can social work as a profession embrace change and technology? Only time will tell.
References
Bell, I., Nicholas, J., Alvarez-Jimenez, M., Thompson, A., & Valmaggia, L. (2020). Virtual reality as a clinical tool in mental health research and practice. Dialogues in Clinical Neuroscience, 22(2), 169–177.
Garrison, N. (n.d.). Why haven’t AR And VR changed our lives yet? 5 barriers to adoption. ARPost. Retrieved October 12, 2020, from https://arpost.co/2019/11/27/ar-and-vr-changed-our-lives-5-barriers-adoption/
Getz, L. (n.d.). A Whole New World—Virtual Reality in Social Work—Social Work Today Magazine. March/April 2018, 18(2), 6.
Glegg, S. M. N., & Levac, D. E. (2018). Barriers, facilitators and interventions to support virtual reality implementation in rehabilitation: A scoping review. PM & R : The Journal of Injury, Function, and Rehabilitation, 10(11), 1237-1251.
Keller, M. S., Park, H. J., Cunningham, M. E., Fouladian, J. E., Chen, M., & Spiegel, B. M. R. (2017). Public perceptions regarding use of virtual reality in health care: A social media content analysis using facebook. Journal of Medical Internet Research, 19(12).
Laurell, C., Sandström, C., Berthold, A., & Larsson, D. (2019). Exploring barriers to adoption of virtual reality through social media analytics and machine learning – An assessment of technology, network, price and trialability. Journal of Business Research, 100, 469–474.
Milijic, M. (2019, October 15). 29 Virtual Reality Statistics to Know in 2020. Leftronic.
Oates, T. (n.d.). Transcript_cwig_virtual_reality_next_step_caseworker_training.pdf (No. 43). Retrieved October 13, 2020, from https://www.childwelfare.gov/pubPDFs/cwig_podcasts/transcript_cwig_virtual_reality_next_step_caseworker_training.pdf
Persky, S., & Lewis, M. A. (2019). Advancing science and practice using immersive virtual reality: What behavioral medicine has to offer. Translational Behavioral Medicine, 9(6), 1040–1046.
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