ABSTRACT
Some of the problems faced by Cybertherapy along the last two decades are far from being restricted to technical issues. They entail new challenges of medical education, mainly related with the adequate insertion of new technologies in therapeutic processes without distorting the relation between medical professionals and clients. We contend that the acknowledgment of the effects of the systemic effects of therapeutic applications of virtual reality is not fully predictable and can only be achieved attending to the way the patient enacts certain tasks oriented by goals. Enaction means the patient is placed at the centre of the treatment processes, not only as an informed agent, but also as the agent of change through practice. Focusing on the requirements of Cybertherapy applied to Post-Traumatic Stress Disorder, we propose a theoretic reflection on the conditions of training and treatment in virtual settings. We underline the decisive role of Health Care professionals in applying and improving the potentialities of biometric sensors, graphic and aural engines in virtual (and hybrid) settings. This role can only be adequately understood within a framework of different levels of recursion of the therapeutic system. Two main levels are referred, the first encompassing the patients adaptation and learning to "move within" the interfaces, the second requiring a reflection on the architecture and design of the physical setting and the computerized rendering of sensory data. Further levels concern the larger framework of therapy, relating to its allocation of resources and the social ends that therapeutic technologies, particularly those concerning mental health, must accomplish.
- Alsina-Jurnet, I. and Gutiérrez-Maldonado, J. 2010. Influence of personality and individual abilities on the sense of presence experienced in anxiety triggering virtual environments. Int. J. Human-Computer Studies (2010), 68, 788--801. Google Scholar
- Beer, S. 1986. Recursions of Power. In Power, autonomy, utopia. New directions toward complex systems. R. Trappl, Ed., Plenum Press, New York, 3--17.Google Scholar
- Bouchard, S., Guitard, T., Bernier et al. 2011. F. Virtua l Reality and the Training of Military Personnel to Cope with Acute Stressors. In Adv. Comput. Intell. Paradigms in Healthcare 6. Virtual Reality in Psychotherapy, Rehabilitation, and Assessment. S. Brahnam and L. C. Jain, Eds., Springer, Berlin, 109--28.Google Scholar
- Bouchard, S., Wiederhold, B. K. and Bossé, J., Arachnophobia and Fear of Other Insects: Efficacy and Lessons Learned from Treatment Process. In Advances in Virtual Reality and Anxiety Disorders, B. K. Wiederhold, S. Bouchard, Eds., Springer, New York, 91--117. DOI=10.1007/978-1-4899-8023-6_5Google Scholar
- Costa, M. R., Kim, S. Y., and Biocca, F. 2013. Embodiment and Embodied Cognition. In Virtual, Augmented and Mixed Reality. Designing and Developing Augmented and Virtual Environments. R. Shumaker, Ed. Springer, Heidelberg, 333--42.Google Scholar
- Fromme, J., Biermann, R. and Unger, A. 2010. «Serious Games» oder «taking games seriously»?, In Digitale Lernwelten. Konzepte, Beispiele und Perspektiven. K.-U. Hugger and M. Walber, Eds., VS Verlag, Wiesbaden, 39--58.Google Scholar
- Gamito, P., Oliveira, J., Morais, et al. 2007. War PTSD: A VR Pre-Trial Case Study. In Annual review of cybertherapy and telemedicine. B. K. Wiederhold, G. Riva, and S. Bouchard, Eds., 5, Interactive Media Institute, San Diego, 191--198Google Scholar
- Gamito, P., Oliveira J., Morais D. et al., 2008. Virtua l reality therapy controlled study for war veterans with PTSD. Preliminary Results. Studies in Health Technology & Informatics, 144 (2008), 269--72.Google Scholar
- Gamito, P., Oliveira, J., Rosa, P., et al. 2010. PTSD Elderly War Veterans: A Clinical Controlled Pilot Study. Cyberpsychology, Behavior, and Social Networking, 13, 1 (2010), 43--8.Google Scholar
- Gamito, P., Oliveira, J., Morais et. al., D. 2010. Serious Games for Serious Problems: from Ludicus to Therapeuticus. In Virtual Reality, J.-J. Kim, Ed., InTech, Online: http://www.intechopen.com/books/virtual-reality/serious-games-for-seriousproblems-from-ludicus-to-therapeuticusGoogle Scholar
- Gamito, P., Pacheco, J., Ribeiro, C., Pablo, C. and Saraiva T. 2005. Virtual War PTSD -- a Methodological Thread. Annual Review of Cyber Therapy and Telemedicine 3 (2005), 173--178.Google Scholar
- Gamito, P., Saraiva, T., Oliveira, J. et al. 2008. Physiological assessment during VR PTSD treatment of a motorvehicle accident patient. Journal of CyberTherapy and Rehabilitation 1, 3 (2008), 258--66.Google Scholar
- Lawson, B. D. 2015. Motion Sickness Symptomatology and Origins. In Handbook of Virtual Environments. Design, Implementation, and Applications. K. S. Hale and K. M. Stanney, Eds., 2nd ed., Taylor & Francis, New York, 531--600.Google Scholar
- Maturana, H. 2002. Autopoiesis, structural coupling and cognition: A history of these and other notions in the biology of cognition. Cybernetics & Human Knowing, 9, 3--4 (2002), 5--34.Google Scholar
- McMahan, R. P., Bowman, D. A., Zielinski, D. J., and Brady, R. B., Evaluating Display Fidelity and Interaction Fidelity in a Virtual Reality Game. IEEE Transactions on Visualization and Computer Graphics 18 (2012), 626--633. Google Scholar
- Meehan, M., Insko, B., Whitton, M. et al. 2002. Physiological measures of presence in stressful virtual environments. ACM Transactions on Graphics, 21, 3 (2002), 645--652. Google Scholar
- Meskó, B. 2014. The Guide to the Future of Medicine: Technology AND the Human Touch. ElektroPress, Budapest.Google Scholar
- Meyerbröker, K. and Emmelkamp, P. M. Virtual Reality Exposure Therapy for Anxiety Disorders: The State of the Art. In Adv. Comput. Intell. Paradigms in Healthcare 6. Virtual Reality in Psychotherapy, Rehabilitation, and Assessment. S. Brahnam and L. C. Jain, Eds., Springer, Berlin, 47--62.Google Scholar
- Powers, M. B., Emmelkamp, P. M. 2008. Virtual reality exposure therapy for anxiety disorders: A meta-analysis. Journal of Anxiety Disorders 22 (2008), 561--569. DOI=10.1016/j.janxdis.2007.04.006Google Scholar
- Riva, G. 2003. La réalité virtuelle en psychiatrie. Journal de Thérapie Comportamentale et Cognitive, 13, 2 (2003), 101--5.Google Scholar
- Riva, G. 2005. Virtual reality in psychotherapy: review. Cyberpsychology & behavior 8, 3 (2005), 220--230.Google Scholar
- Riva, G. 2008. Enacting interactivity: the role of presence. In Enacting intersubjectivity: a cognitive and social perspective on the study of interactions. F. Morganti, A. Carassa and G. Riva, Eds., IOS Press, Amsterdam, 97--114. Online: http://www.emergingcommunication.com/volume10.html.Google Scholar
- Riva, G. 2009. Is presence a technology issue? Some insights from cognitive sciences. Virtual Reality 13, 3 (May. 2009), 59--69. Google Scholar
- Riva, G., Mantovani, F., Gaggioli, A. (2004). Presence and rehabilitation: toward second-generation virtual reality applications in neuropsychology. Journal of NeuroEngineering and Rehabilitation 1, 9 (2004) 1--11. DOI:10.1186/1743-0003-1-9Google Scholar
- Rothbaum, B. 2005. Commentary on Riva, G. Cyberpsychology & behavior 8, 3 (2005), 239--40.Google Scholar
- Rothbaum, B., Rizzo, A. and Difede, J. 2010. Virtua l reality exposure therapy for combat-related posttraumatic stress disorder. Annals of the New York Academy of Sciences, 1208 (2010), 126--32. DOI: 10.1111/j.1749-6632.2010.05691.xGoogle Scholar
- Rus-Calafell, M., Guttiérrez-Maldonado, J. and Ribas-Sabaté, J. 2013. Neurocognition, Presence and Acceptance Of a VR Programme For Psychotic Patients: A Correlational Study. In Annual Review of Cybertherapy and Telemedicine 2013. Positive Technology and Health Engagement for Healthy Living and Active Ageing, B. K. Wiederhold and G. Riva (Eds.). IOS Press, Amsterdam, 141--145. doi:10.3233/978-1-61499-282-0-141Google Scholar
- Saraiva, T., Gamito, P., Oliveira, J. et al. 2007. The use of VR exposure in the treatment of motor vehicle PTSD: A case report. In Annual review of cybertherapy and telemedicine. B. K. Wiederhold, G. Riva, and S. Bouchard, Eds., 5, Interactive Media Institute, San Diego, 199--205.Google Scholar
- Shapiro, L. 2014. When Is Cognition Embodied? In Current Controversies in Philosophy of Mind. U. Kriegel, Ed. Routledge, New York, 73--90.Google Scholar
- Spagnolli, A., Bracken, C. B. and Orso, V. 2014. The role played by the concept of presence in validating the efficacy of a cybertherapy treatment: a literature review. Virtual Reality 18 (Jan. 2014) 13--36.Google Scholar
- Tichon, J. and Banks, J. 2006. Virtual reality exposure therapy: 150-degree screen to desktop PC. Cyber Psychol Behav 9, 4 (2006) 480--9.Google Scholar
- Varela, F. 2003. On the Conceptual Skeleton of Current Cognitive Science. In Beobachter. Konvergenz der Erkenntnistheorien? N. Luhmann, H. Maturana, M. Namiki, V. Redder and F. Varela, Eds., 3rd ed., Wilhelm Fink Verlag, München, 13--23.Google Scholar
- Vincelli F., Riva G. 2000. Virtual reality as a new imaginative tool in psychotherapy. Studies in Health Technology & Informatics, 70 (2000) 356--8.Google Scholar
- Wallach, H., Safir, M., Samana, R. et al. 2011. How Can Presence in Psychotherapy Employing VR Be Increased? In Adv. Comput. Intell. Paradigms in Healthcare 6. Virtual Reality in Psychotherapy, Rehabilitation, and Assessment. S. Brahnam and L. C. Jain, Eds., Springer, Berlin, 129--47.Google Scholar
- Wiederhold, B. and Rizzo, A. 2005. Virtual Reality and Applied Psychophysiology. Applied Psychophysiology and Biofeedback 30, 3, (Sep. 2005), 183--5.Google Scholar
- Wiederhold, B. K. and Wiederhold, M. D. 2014. Virtua l Reality for Posttraumatic Stress Disorder. In Advances in Virtual Reality and Anxiety Disorders, B. K. Wiederhold, S. Bouchard, Eds., Springer, New York, 211--33. DOI: 10.1007/978-1-4899-8023-6_10Google Scholar
Index Terms
- A theoretical inquiry into the role of enaction in cybertherapy
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