scholarly journals Bringing Virtual Reality From Clinical Trials to Clinical Practice for the Treatment of Eating Disorders: An Example Using Virtual Reality Cue Exposure Therapy

10.2196/16386 ◽  
2020 ◽  
Vol 22 (4) ◽  
pp. e16386 ◽  
Author(s):  
Theresa Brown ◽  
Emily Nauman Vogel ◽  
Sarah Adler ◽  
Cara Bohon ◽  
Kim Bullock ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Virtual Reality ◽  
Exposure Therapy ◽  
Empirical Support ◽  
Intervention Development ◽  
Drop Out ◽  
Innovative Technology ◽  
Evidence Based ◽  
Full Potential ◽  
Cue Exposure

Novel treatment options for eating disorders (EDs) are critically needed to enhance treatment outcomes and reduce the rates of treatment dropouts. On average, only 50% of individuals receiving evidence-based care remit, whereas 24% drop out before treatment completion. One particularly promising direction involves integrating virtual reality (VR) with existing evidence-based treatments (EBTs) such as cue exposure therapy (CET). Across psychiatric disorders, VR-based interventions are demonstrating at least preliminary efficacy and noninferiority to traditional treatments. Furthermore, VR technology has become increasingly portable, resulting in improved acceptance, increased access, and reductions in cost. However, more efficient research processes may be needed to uncover the potential benefits of these rapid technological advances. This viewpoint paper reviews existing empirical support for integrating VR with EBTs (with a focus on its use with EDs) and proposes key next steps to more rapidly bring this innovative technology-based intervention into real-world clinic settings, as warranted. VR-CET for EDs is used to illustrate a suggested process for developing such treatment enhancements. We recommend following a deployment-focused model of intervention development and testing to enable rapid implementation of robust, practice-ready treatments. In addition, our review highlights the need for a comprehensive clinical protocol that supports clinicians and researchers in the implementation and testing of VR-CET and identifies key missing protocol components with rationale for their inclusion. Ultimately, this work may lead to a more complete understanding of the full potential of the applications and integrations of VR into mental health care globally.

scholarly journals Translating Virtual Reality Cue Exposure Therapy for Binge Eating into a Real-World Setting: An Uncontrolled Pilot Study

2021 ◽  
Vol 10 (7) ◽  
pp. 1511
Author(s):  
Katherine Nameth ◽  
Theresa Brown ◽  
Kim Bullock ◽  
Sarah Adler ◽  
Giuseppe Riva ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Eating Disorder ◽  
Binge Eating ◽  
Real World ◽  
Exposure Therapy ◽  
Post Treatment ◽  
Cue Exposure ◽  
Treatment Gains ◽  
Intent To Treat

Binge-eating disorder (BED) and bulimia nervosa (BN) have adverse psychological and medical consequences. Innovative interventions, like the integration of virtual reality (VR) with cue-exposure therapy (VR-CET), enhance outcomes for refractory patients compared to cognitive behavior therapy (CBT). Little is known about the feasibility and acceptability of translating VR-CET into real-world settings. To investigate this question, adults previously treated for BED or BN with at least one objective or subjective binge episode/week were recruited from an outpatient university eating disorder clinic to receive up to eight weekly one-hour VR-CET sessions. Eleven of 16 (68.8%) eligible patients were enrolled; nine (82%) completed treatment; and 82% (9/11) provided follow-up data 7.1 (SD = 2.12) months post-treatment. Overall, participant and therapist acceptability of VR-CET was high. Intent-to-treat objective binge episodes (OBEs) decreased significantly from 3.3 to 0.9/week (p < 0.001). Post-treatment OBE 7-day abstinence rate for completers was 56%, with 22% abstinent for 28 days at follow-up. Among participants purging at baseline, episodes decreased from a mean of one to zero/week, with 100% abstinence maintained at follow-up. The adoption of VR-CET into real-world clinic settings appears feasible and acceptable, with a preliminary signal of effectiveness. Findings, including some loss of treatment gains during follow-up may inform future treatment development.

Why Do People Get Better With Exposure Therapy?

2019 ◽  
pp. 19-32
Author(s):  
Carolyn Black Becker ◽  
Nicholas R. Farrell ◽  
Glenn Waller
Keyword(s):  
Eating Disorders ◽  
Anxiety Disorders ◽  
Therapeutic Intervention ◽  
Exposure Therapy ◽  
Therapeutic Benefit ◽  
Evidence Based ◽  
Systematic Desensitization ◽  
Evidence Based Treatments ◽  
Inhibitory Learning

This chapter outlines a theoretically based rationale for using exposure consistently in the treatment of individuals with eating disorders. Due to the substantial overlap between eating disorders and anxiety disorders (both in symptom content and in comorbidity between the conditions), exposure therapy is a sound choice for therapeutic intervention. Indeed, the most evidence-based treatments for eating disorders contain a number of exposure-based strategies that drive much of the therapeutic benefit. The chapter discusses habituation, systematic desensitization, and inhibitory learning and differentiates exposure therapy from systematic desensitization. Using a case study to consider how exposure therapists can help patients learn to tolerate their anxiety by leaning into it rather than engaging in safety behaviors, this chapter lays the foundation for the application of exposure therapy to patients with eating disorders.

Application of Virtual Reality-Cue Exposure Therapy for Reducing Alcohol Craving

2006 ◽  
Author(s):  
Hyoseok Kwon ◽  
Sungwon Roh ◽  
Joonho Choi ◽  
Byung-Hwan Yang ◽  
Jang-Han Lee
Keyword(s):  
Virtual Reality ◽  
Exposure Therapy ◽  
Cue Exposure ◽  
Alcohol Craving

Application of Virtual Reality-Cue Exposure Therapy for Reducing Alcohol Craving

2006 ◽  
Author(s):  
H. Kwon ◽  
J. Choi ◽  
S. Roh ◽  
B-H. Yang ◽  
J-H. Lee
Keyword(s):  
Virtual Reality ◽  
Exposure Therapy ◽  
Cue Exposure ◽  
Alcohol Craving

scholarly journals Translating Virtual Reality Cue Exposure Therapy for Binge Eating into a Real-World Setting: A Pilot Study

2021 ◽  
Author(s):  
Katherine Nameth ◽  
Theresa Brown ◽  
Kim Bullock ◽  
Sarah Adler ◽  
Giuseppe Riva ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Eating Disorder ◽  
Binge Eating ◽  
Real World ◽  
Exposure Therapy ◽  
Post Treatment ◽  
Cue Exposure ◽  
Treatment Gains ◽  
Intent To Treat

Binge-eating disorder (BED) and bulimia nervosa (BN) have adverse psychological and medical consequences. Novel interventions, like the integration of virtual reality (VR) with cue-exposure therapy (VR-CET), enhance outcomes for refractory patients compared to cognitive behavior therapy (CBT). Little is known about the feasibility and acceptability of translating VR-CET into real-world settings. To investigate this question, adults previously treated for BED or BN with at least one objective or subjective binge episode/week were recruited from an outpatient University eating disorder clinic to receive up to eight weekly one-hour VR-CET sessions. Eleven of 16 (68.8%) eligible patients enrolled; nine (82%) completed treatment; 82% (9/11) provided follow-up data 7.1 (SD=2.12) months post-treatment. Overall, participant and therapist acceptability of VR-CET was high. Intent-to-treat objective binge episodes (OBEs) decreased significantly from 3.3 to 0.9/week (p &amp;lt; .001). Post-treatment OBE 7-day abstinence rate for completers was 56%, with 22% abstinent for 28 days at follow-up. Among participants purging at baseline, episodes decreased from a mean of one to zero/week, with 100% abstinence maintained at follow-up. The adoption of VR-CET into real-world clinic settings appears feasible and acceptable, with a preliminary signal of efficacy. Findings, including some loss of treatment gains during follow-up may inform future treatment development.

Testing virtual reality-based cue-exposure software: Which cue-elicited responses best discriminate between patients with eating disorders and healthy controls?

2017 ◽  
Vol 24 (4) ◽  
pp. 757-765 ◽  
Author(s):  
Joana Pla-Sanjuanelo ◽  
Marta Ferrer-García ◽  
Ferran Vilalta-Abella ◽  
Giuseppe Riva ◽  
Antonios Dakanalis ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Virtual Reality ◽  
Healthy Controls ◽  
Cue Exposure

Exposure Therapy for Eating Disorders

2019 ◽  
Author(s):  
Carolyn Black Becker ◽  
Nicholas R. Farrell ◽  
Glenn Waller
Keyword(s):  
Eating Disorders ◽  
Binge Eating ◽  
Exposure Therapy ◽  
Behavioral Therapy ◽  
Limited Attention ◽  
Evidence Based ◽  
Walk Away ◽  
Wide Range ◽  
Evidence Based Treatments ◽  
Family Based

Exposure therapy is a core component of evidence-based treatments for eating disorders (EDs), including cognitive-behavioral therapy and family-based treatment. Despite this, existing treatment guides give relatively limited attention to the clinical issues associated with good implementation of exposure. This book is designed to augment a wide variety of treatment manuals by providing ED clinicians with practical advice for maximizing the effectiveness of exposure, regardless of which evidence-based treatment they use or the profession to which they belong. Written in an easy-to-understand format, this book not only translates the most up-to-date empirical research on exposure for EDs, it also extrapolates clinical advice from the anxiety disorders literature to help busy clinicians become more effective in treating EDs. Readers will walk away with a solid foundation in the theoretical underpinnings of exposure therapy, as well as an understanding of how to utilize this information to sell the rationale for exposure to their ED patients. Clinically rich chapters, with ample case material, demonstrate how to prepare to embark on exposure therapy with a wide range of ED patients, including those with anorexia nervosa, bulimia nervosa, binge-eating disorder, and avoidant/restrictive food intake disorder. Specific types of ED exposure are covered in detail, including exposure to food and eating, cue exposure for binge eating, weighing and weight exposure, body image exposure, emotion and interpersonally focused exposure, and novel forms of exposure for EDs. Clinicians also will walk away with strategies for overcoming obstacles to implementation of exposure therapy, including institutional resistance.

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