virtual reality therapy virtual reality therapy virtual reality therapy (vrt), also known as virtual reality immersion therapy (vrit), simulation for therapy (sft), virtual reality exposure therapy (vret), and computerized cbt (ccbt), is the use of virtual reality technology for psychological or occupational therapy and in affecting virtual rehabilitation. patients receiving virtual reality therapy navigate through digitally created environments and complete specially designed tasks often tailored to treat a specific ailment; and is designed to isolate the user from their surrounding sensory inputs and give the illusion of immersion inside a computer-generated, interactive virtual environment. this technology has a demonstrated clinical benefit as an adjunctive analgesic during burn wound dressing and other painful medical procedures. technology can range from a simple pc and keyboard setup, to a modern virtual reality headset. it is widely used as an alternative form of exposure therapy, in which patients interact with harmless virtual representations of traumatic stimuli in order to reduce fear responses. it has proven to be especially effective at treating ptsd, and shows considerable promise in treating a variety of neurological and physical conditions. virtual reality therapy has also been used to help stroke patients regain muscle control, to treat other disorders such as body dysmorphia, and to improve social skills in those diagnosed with autism. virtual reality therapyother namescomputerized cbt description virtual reality therapy (vrt) uses specially programmed computers, visual immersion devices and artificially created environments to give the patient a simulated experience that can be used to diagnose and treat psychological conditions that cause difficulties for patients. in many environmental phobias, reaction to the perceived hazards, such as heights, speaking in public, flying, close spaces, are usually triggered by visual and auditory stimuli. in vr-based therapies, the virtual world is a means of providing artificial, controlled stimuli in the context of treatment, and with a therapist able to monitor the patient's reaction. unlike traditional cognitive behavioral therapy, vr-based treatment may involve adjusting the virtual environment, such as for example adding controlled intensity smells or adding and adjusting vibrations, and allow the clinician to determine the triggers and triggering levels for each patient's reaction. vr-based therapy systems may allow replaying virtual scenes, with or without adjustment, to habituate the patient to such environments. therapists who apply virtual reality exposure therapy, just as those who apply in-vivo exposure therapy, can take one of two approaches concerning the intensity of exposure. the first approach is called flooding, which refers to the most intense approach where stimuli that produce the most anxiety are presented first. for soldiers who have developed ptsd from combat, this could mean first exposing them to a virtual reality scene of their fellow troops being shot or injured followed by less stressful stimuli such as only the sounds of war. on the other hand, what is referred to as graded-exposure takes a more relaxed approach in which the least distressing stimuli are introduced first. vr-exposure, as compared to in-vivo exposure has the advantage of providing the patient a vivid experience, without the associated risks or costs. vrt has great promise since it historically produces a "cure" about 90% of the time at about half the cost of traditional cognitive behavior therapy authority, and is especially promising as a treatment for ptsd where there are simply not enough psychologists and psychiatrists to treat all the veterans with anxiety disorders diagnosed as related to their military service. vrt is also a promising adjunctive therapy for the treatment of other clinical populations, such as individuals with psychosis. a recent systematic review of psychosocial interventions using virtual reality shows these interventions are safe and well accepted in this population. the studies identified in the review show that psychosocial vrt can improve cognitive, social, and vocational skills as well as symptoms of auditory verbal hallucinations and paranoia in individuals with psychosis. recently there have been some advances in the field of virtual reality medicine. virtual reality is a complete immersion of the patient into a virtual world by putting on a headset with an led screen in the lenses of the headset. this is different from the recent advancements in augmented reality. augmented reality is different in the sense that it enhances the non-synthetic environment by introducing synthetic elements to the user's perception of the world. this in turn "augments" the current reality and uses virtual elements to build upon the existing environment. augmented reality poses additional benefits and has proven itself to be a medium through which individuals with a specific phobia can be exposed "safely" to the object(s) of their fear, without the costs associated with programming complete virtual environments. thus, augmented reality can offer an efficacious alternative to some less advantageous exposure-based therapies. history virtual reality therapy (vrt) was pioneered and originally termed by max north documented by the first known publication (virtual environment and psychological disorders, max m. north, and sarah m. north, electronic journal of virtual culture, 2,4, july 1994), his doctoral vrt dissertation completion in 1995 (began in 1992), and followed with the first known published vrt book in 1996 (virtual reality therapy, an innovative paradigm, max m. north, sarah m. north, and joseph r. coble, 1996. ipi press. isbn 1-880930-08-0). his pioneered virtual reality technology work began as early as 1992 as a research faculty at clark atlanta university and supported by funding from u.s. army research laboratory. an early exploration in 1993–1994 of vrt was done by ralph lamson a usc graduate then at kaiser permanente psychiatry group. lamson began publishing his work in 1993. as a psychologist, he was most concerned with the medical and therapeutic aspects, that is, how to treat people using the technology, rather than the apparatus, which was obtained from division, inc. psychology today reported in 1994 that these 1993–1994 treatments were successful in about 90% of lamson's virtual psychotherapy patients. lamson wrote in 1993 a book entitled virtual therapy which was published in 1997 directed primarily to the detailed explanation of the anatomical, medical and therapeutic basis for the success of vrt. in 1994–1995, he had solved his own acrophobia in a test use of a third party vr simulation and then set up a 40 patient test funded by kaiser permanente. shortly thereafter, in 1994–1995, larry hodges, then a computer scientist at georgia tech active in vr, began studying vrt in cooperation with max north who had reported anomalous behavior in flying carpet simulation vr studies and attributed such to phobic response of unknown nature. hodges tried to hire lamson without success in 1994 and instead began working with barbara rothbaum, a psychologist at emory university to test vrt in controlled group tests, experiencing about 70% success among 50% of subjects completing the testing program. a screen capture of virtual iraq in 2005, skip rizzo of usc's institute for creative technologies, with research funding from the office of naval research (onr), started validating a tool he created using assets from the game full spectrum warrior for the treatment of posttraumatic stress disorder. virtual iraq was subsequently evaluated and improved under onr funding and is supported by virtually better, inc. they also support applications of vr-based therapy for aerophobia, acrophobia, glossophobia, and substance abuse. virtual iraq proved successful in normalization of over 70% of people with ptsd, and that has now become a standard accepted treatment by the anxiety and depression association of america. however, the va has continued to emphasize traditional prolonged exposure therapy as the treatment of choice, and vr-based therapies have gained only limited adoption, despite active promotion by dod, and despite vrt having much lower cost and apparently higher success rates. a $12-million onr funded study is currently underway to definitively compare the efficacy of the two methods, pet and vrt. military labs have subsequently set up dozens of vrt labs and treatment centers for treating both ptsd and a variety of other medical conditions. the use of vrt has thus become a mainstream psychiatric treatment for anxiety disorders and is finding increasing use in the treatment of other cognitive disorders associated with various medical conditions such as addiction, ptsd and schizophrenia. applications exposure therapy virtual reality technology is especially useful for exposure therapy – a treatment method in which patients are introduced and then slowly exposed to a traumatic stimulus. inside virtual environments, patients can safely interact with a representation of their phobia, and researchers don't need to have access to a real version of the phobia itself. one of the primary challenges to the efficacy of exposure therapy is recreating the level of trauma existing in real environments inside a virtual environment. virtual reality aids in overcoming this by engaging with different sensory stimuli of the patient while heightening the realism and maintaining the safety of the environment. virtual reality being used in exposure therapy for treating ptsd in documentary crew at joint base lewis-mcchord in washington, united states. one very successful example of virtual reality therapy exposure therapy is the ptsd treatment system, virtual iraq. using a head mounted display and a game pad, patients navigate a humvee around virtual recreations of iraq, afghanistan, and the united states. by being safely exposed to the traumatic environments, patients learned to reduce their anxiety. according to a review of the history of virtual iraq, one study found that it reduced ptsd symptoms by an average of fifty percent, and disqualified over seventy-five percent of participants for ptsd after treatment. virtual reality exposure therapy (vret) is also commonly used for treating specific phobias, especially small animal phobia. commonly feared animals such as spiders can be easily produced in a virtual environment, instead of finding the real animal. vret has also been used experimentally to treat other fears such as public speaking and claustrophobia. another successful study attempted treating 10 individuals who experienced trauma as a result of events during 9/11. through repeated exposure to increasingly traumatic sequences of world trade center events, immediate positive results were self reported by test subjects. in a 6-month follow-up, 9 of the test subjects available for follow up maintained their results from exposure. virtual reality exposure therapy (vret) offers a wide range of advantages compared to traditional exposure therapy techniques. recent years have suggested an increase in familiarly and trust in virtual reality technology as an acceptable mirror of reality. a higher trust in the technology could lead to more effective treatment results as more phobics seek out help. another consideration for vret is the cost effectiveness. while the actual cost of vret may vary based on the hardware and software implementation, it is supposedly more effective than the traditional in vivo treatment used for exposure therapy while maintaining a positive return on investment. future research might pave an alternative to extensive automated lab or hospital environments. for instance, in 2011, researchers at york university proposed an affordable virtual reality exposure therapy (vret) system for the treatment of phobias that could be set up at home. such developments in vret may pave a new way of customised treatment that also tackles the stigma attached to clinical treatment. while there is still a lot unknown about the long-term effectiveness of the relatively new vret, the future seems promising with growing studies reflecting the benefits of vret to combat phobias. virtual rehabilitation the term virtual rehabilitation was coined in 2002 by professor daniel thalmann of epfl (switzerland) and professor grigore burdea of rutgers university (usa). in their view the term applies to both physical therapy and cognitive interventions (such as for patients with post traumatic stress disorder, phobias, anxieties, attention deficits or amnesia). since 2008, the virtual rehabilitation "community" has been supported by the international society on virtual rehabilitation. virtual rehabilitation is a concept in psychology in which a therapeutic patient's training is based entirely on, or is augmented by, virtual reality simulation exercises. if there is no conventional therapy provided, the rehabilitation is said to be "virtual reality-based". otherwise, if virtual rehabilitation is in addition to conventional therapy, the intervention is "virtual reality-augmented." today, a majority of the population uses the virtual environment to navigate their daily lives and almost one fourth of the world population uses the internet. as a result, virtual rehabilitation and gaming rehabilitation, or rehabilitation through gaming consoles, have become quite common. in fact, virtual therapy has been used over regular therapeutic methods in order to treat