A Second Life for E-Health: Prospects for the Use of Virtual On-Line Worlds in Clinical Psychology - PowerPoint PPT Presentation

About This Presentation
Title:

A Second Life for E-Health: Prospects for the Use of Virtual On-Line Worlds in Clinical Psychology

Description:

A Second Life for E-Health: Prospects for the Use of Virtual On-Line Worlds in Clinical Psychology Alessandra Gorini Andrea Gaggioli, Giuseppe Riva – PowerPoint PPT presentation

Number of Views:179
Avg rating:3.0/5.0
Slides: 31
Provided by: ALE14
Category:

less

Transcript and Presenter's Notes

Title: A Second Life for E-Health: Prospects for the Use of Virtual On-Line Worlds in Clinical Psychology


1
A Second Life for E-Health Prospects for the Use
of Virtual On-Line Worlds in Clinical Psychology
  • Alessandra Gorini
  • Andrea Gaggioli, Giuseppe Riva
  • Applied Technology for Neuro-Psychology Lab
  • Istituto Auxologico Italiano, Milan, Italy

2
OUTLINE
  • Origins, definition and limitations of e-health
  • Introduction to the WEB 2.0 and the on line
    virtual worlds
  • Is it possible to use the on line virtual worlds
    for therapeutical purposes?
  • Presentation of a case study
  • Conclusions

3
At the beginning was e-health
4
WHAT IS E-HEALTH?
  • the use of technology (mobile phone, email,
    chat) to provide access to medical assessment,
    diagnosis, intervention, and information across
    distance
  • key advantages (Glueckauf et al. 2003)
  • deliver health information and services across
    geographical distance for underserved population
  • enhance the quality of health information and
    services in particular areas or for specific
    populations
  • ensure continuous medical and psychological
    service

5
MAIN LIMITATIONS
  • It does not take advantages of all the
    possibility offered by Internet being limited to
    e-mail, chat, and videoconferences
  • The sense of presence is limited
  • Conventional e-therapy tools (i.e. email)
    typically do not support multiple users

6
WEB 2.0 AND 3-D VIRTUAL WORLDS A NEW FRONTIERS
FOR E-HEALTH?
7
WEB 2.0
  • Web 2.0 is a read-write web
  • It allows users to rate, comment, annotate, edit,
    create, mix and share content from different
    locations
  • It is a people-centric social Web, that
    facilitates social networking and active
    collaboration between users

8
WEB 2.0, VR AND E-HEALTH
  • The combination of WEB 2.0 and Virtual Reality
    (VR) allows the creation of distributed on line
    VEs that enhance the communication between
    therapists and patients, increasing the sense of
    PRESENCE during the virtual interaction

9
3-D VIRTUAL WORLDS FOR E-HEALTH
  • Hp Virtual worlds may convey higher feelings of
    presence and social presence than conventional
    e-therapy tools do
  • facilitating the clinical communication process
  • creating higher levels of interpersonal trust
    between therapist and patient

10
ON LINE VIRTUAL WORLDS OFFER THEIR USERS THE
POSSIBILITY TO
  • Share common VE being in different physical
    places
  • Have digital characters representing themselves
  • Communicate in real-time using chat or voice in
    public or private way
  • Experience a great sense of presence

11
ON LINE VIRTUAL WORLDS FOR PSYCHOLOGICAL
INTERVENTIONS AN EXPLORATIVE PROTOCOL
  • Single case study
  • AIM evaluate the potential of the virtual
    support sessions when, for contingent causes,
    patient and therapist can have only one
    face-to-face encounter per month.

12
WHATS NEW?
  • The use of on line virtual worlds (SECOND LIFE)
    for psychological support/therapy
  • The use of VR environments for a
    psychoanalitic-oriented approach

13
THE PATIENT C.B.
  • Sex female
  • Age 47
  • Education academic degree in engineering
  • Status married (since 1995)
  • Son 1 (8 year old)
  • Diagnosis (2002) dependent personality disorder
    (DSM-IV) also characterized by obsessive-compulsiv
    e traits and severe physical somatizations that
    needed a pharmacological treatment.
  • Treatment from 2002 to 2006 psychoanalytic
    treatment based on two sessions per week that
    produced a significant symptomatic remission and
    an increasing in self and work efficiency.
  • From 2006 to now sporadic consultation sessions,
    with a recent request to start a second phase of
    analytic-oriented treatment, apparently
    uncompatible with her work engagement which often
    demanded her to travel in italy and abroad.
  • Technological abilities basic knowledge of the
    main Windows applications no familiarity with
    videogames and VR systems.

14
THE THERAPIST
  • Sex male
  • Age 51
  • Education MD, both psychiatrist and
    psychoanalist, with a personal interest in
    studying the relationship between human mind-body
    and technological devices of prosthesis.
  • He has recently changed his homeplace and
    life-style, living for half a week in Milan, and
    the rest of the time in another Italian city,
    located about 300 Km far from Milan.
  • Technological abilities basic knowledge of the
    main Windows applications no familiarity with
    videogames and VR systems.

15
  • The difficulty in combining their working
    commitments and the physical distance have been
    some of the reasons pushing C.B. and her
    therapist to try this innovative approach.
  • Privacy issues all the chat transcriptions were
    countersigned by both the therapist and the
    patient.

16
ASSESSMENT
Betts questionnaire Imaginative abilities Before the beginning of the treatment
Computer knowledge and experience questionnaire Computer abilities Before the beginning of the treatment
Barfield Presence questionnaire Level of Presence Every 2 weeks from the beginning of the treatment
17
THE SL VIRTUAL OFFICE
  • Eureka (152,184,44)

18
TREATMENT SCHEDULES
  • 2 virtual sessions per week (45 min each)
  • 1 face to face session per month
  • The patient and the therapist agree on date and
    time of the virtual appointments with the same
    modalities they use for real ones.

19
TECHNICAL REQUIREMENTS
  • 2 laptops and an ADSL internet connection.
  • Way of interaction text-based chat

20
PRELIMINARY DATA FROM 8 VIRTUAL SESSIONS 2 FACE
TO FACE ENCOUNTERS
21
QUANTITATIVE DATA (1)
CB The therapist
Betts questionnaire 39/70 43/70
Computer knowledge and experience questionnaire 2/5 3/5
Barfield Presence questionnaire
1) If your level in the real world is 100, and your level of presence is 1 if you have no presence, rate your level of presence in this virtual world 50 60
2) How strong was you sense of presence, being there, in the virtual environment (1-5 scale) 3 3
22
QUANTITATIVE DATA (2)
  • CB interrupted the spasmolytic therapy and
    restarted her regular job activity AS EXPECTED
    FROM A TRADITIONAL THERAPY

23
QUALITATIVE OBSERVATIONS
  • First virtual appointment slowness
  • Analysis of text chats formal aspects and
    relation style were comparable to those observed
    during the face-to-face sessions (CB refers her
    emotional contents and reactions, makes free
    associations, reports dreams waiting for
    therapists interpretation.
  • No sign of inhibition

24
THE 3 FOUNDAMENTAL RULES OF PSYCHOANALYSIS
  • The fundamental rule it urges that patients say
    whatever comes into their heads, even if they
    think it unimportant or irrelevant or
    nonsensensicalor embarrassing or distressing
  • The rule of abstinence it designates a number of
    technical recommendations that Freud stated
    regarding the general framework of the
    psychoanalytic treatment, including, for example,
    the prescription to have no physical or gaze
    contacts with the patient
  • The constancy of setting virtual reality offers
    the therapist the possibility to create a
    therapeutic environment more stable than any
    other real physical setting, other than to
    maintain the avatars aspect unchanged over time

25
THE PRIVACY PROBLEM
  • The only critical point emerged regards the
    privacy of the virtual setting.
  • The virtual office is complitely safe and only
    invited and authorizad people can have access.

26
CONCLUSION
  • The presence of a medium between the patient and
    the therapist does not interfere with the
    therapeutical relationship
  • SL is intuitive the scarce ability in the use of
    computer and technological devices does not
    significantly limit the virtual interaction
    between the patient and the therapist

27
BUT MOST IMPORTANT
  • The possibility to share a common on-line virtual
    space, gives the patient and the therapist the
    opportunity to meet each others twice a week
    even if they are physically distant.

28
NEXT STEPS
  • Collect more data
  • Make a controlled study (virtual world vs simple
    chat)
  • Test the virtual setting in different situations
    (patients with severe physical disabilities,
    underserved population, prisoners, etc)

29
CRITICAL REMARKS
  • The proposal sounds very innovative, but we would
    like to underline that in our view virtual
    therapy can be effective only if used as an
    adjunct to traditional therapy, or as part of an
    aftercare plan.
  • We advise against any kind of therapy being
    practiced exclusively on the web because of its
    supportive rather than exhaustive nature. This
    point must be made clear to online therapy
    providers and the general public.

30
  • THANK YOU FOR YOUR ATTENTION!
  • a.gorini_at_auxologico.it
Write a Comment
User Comments (0)
About PowerShow.com