May 19, 2023
Healing with a headset: Virtual Reality shows promise in treating substance use disorders
VCU psychologist will present clinical trial findings to Congress on June 7.
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For the past two years, some military veterans who have struggled with substance use disorders regularly visited an island campground as part of their therapy. They meditated, enjoyed hot-air balloon rides, took cross-country road trips and even played fetch with a wolf.
All within a virtual-reality headset.
Developed by a Virginia Commonwealth University psychologist and a prominent Richmond-based visual effects artist, The TST Retreat is an immersive, interactive VR environment created to help individuals with addictions and mental health conditions and guide them toward recovery.
“One of our patients told us that if it wasn’t for this VR program, he would have left treatment,” said Jarrod Reisweber, Psy.D., the clinical brainpower behind The TST Retreat and co-founder of a mental health and substance use disorder treatment program called Transcending Self Therapy. He is an affiliate assistant professor in the Department of Psychology at the VCU College of Humanities and Sciences and clinical psychologist at the Central Virginia VA Health Care System.
The roots and meaning of TST
Over the past decade, Reisweber developed the Transcending Self Therapy program along with other VCU and VA-affiliated clinicians and researchers. The TST Retreat is grounded in concepts of cognitive behavioral therapy, which promotes treatment through behavioral change to recover from addiction, depression and other mental health conditions.
Reisweber’s program adds a layer to CBT by advocating not only for behavioral change but for connecting with others and pursuing passions aligned to a person’s moral compass or spiritual beliefs.
“With TST, instead of chasing the trappings of this world, you look inside yourself for what is good and right, and chase that,” Reisweber said. “Once you learn TST and implement it in your life, your potential and quality of life can go way up.”
And that’s the goal of The TST Retreat: to use virtual reality to practice concepts learned during in-person therapy, improve understanding of TST concepts, increase treatment satisfaction — and recover.
Bringing TST to life in VR
Mark Lambert is a Richmond-based visual effects and VR developer whose film work includes “Harry Potter and the Sorcerer’s Stone” and “The Polar Express.” In 2015, he began creating in VR, working with companies around the world before starting a firm, Lighthouse XR, with his wife.
They had an idea for a VR platform that would help those with addictions or mental health conditions “find their way to recovery,” he said. But he needed someone with clinical expertise.
Lambert was introduced to Reisweber through Brent Fagg, senior licensing manager at VCU TechTransfer and Ventures. Lambert serves on the office’s advisory board.
“I looked into what TST was all about,” Lambert said. “And I realized Jarrod and the TST program were exactly what we had been looking for.”
Lambert and Reisweber began building The TST Retreat in early 2020; its intellectual property is protected by VCU and the Department of Veterans Affairs. After extensive user interviews and initial concept development, the team developed a version with four TST sessions, which has since grown to 10 half-hour lessons. The TST Retreat began clinical trials in December 2021 with veterans at the Central Virginia VA, and it has expanded to VA sites in Minneapolis, eastern Massachusetts and Raleigh, N.C.
Early results, Reisweber says, are promising. Working with VCU and VA neuroscientist Jim Bjork, Ph.D., to manage data, researchers surveyed 81 patients who overwhelmingly found the platform to be helpful, useful and easy to use. Reisweber will present his initial findings to Congress on June 7.
The two are adamant that The TST Retreat is a complement to, not a replacement for, traditional therapy.
“It extends the therapeutic reach of the clinician,” Reisweber said. It is meant as homework —practice — for patients, on top of weekly, hourlong, in-person therapy sessions.
Playing ‘The Retreat’
Wearing a VR headset, patients explore an open-world VR environment situated around a waterfront cabin. The TST Retreat offers lessons and hours of quizzes, mini-games and meditations. Reisweber himself is featured in The TST Retreat and teaches the TST lessons.
Anyone who regularly plays video games will find The TST Retreat’s mechanics user-friendly, with sharp and smooth gameplay comparable to mainstream gaming systems. (Those familiar with the iconic 1993 game “Myst” will surely find similarities.)
To be sure, not everything in The TST Retreat is meant to teach. Some mini-games and experiences serve as diversions, such as the cross-country road trip or playing fetch with a wolf. “If you have moments where you need to just chill out for a bit, it’s something you can do that is positive at 2 a.m.,” Lambert said.
The TST Retreat incorporates some of Lambert’s other work through his company, VArtisans. Patients can unlock the ability to ride in a convertible across the U.S. while enjoying 360-degree views within the headset – all of it filmed by Lambert’s team for a separate project. Users can soar in a hot-air balloon over the Alps or a reserve in Kenya, and they can take double-decker bus tours of cities like Paris or Rome. The programs are being used for senior citizen mental health applications for older adults but have similar applications for those in recovery to get out and explore the world for a few minutes.
The platform is funded in part by grants from VCU, the Veterans Health Administration Innovation Ecosystem and the Virginia Innovation Partnership Corporation. Lambert and his wife, both of whom have family members who faced substance use disorders, also have invested money to bring it to life.
“This is something we truly believe in, and we have put a lot of our own savings into creating The TST Retreat,” Lambert said. “We did it because we think it will truly make a difference and help those in recovery.”
Reisweber said he has given his full trust to Lambert and his team to collaborate and continuously improve The TST Retreat, with the goal of making it a key component of treatment.
“We fully believe that if you lean into this TST process, you will make your recovery a priority. Our hope is that with a combination of in-person therapy and VR treatment, people can go on to recovery and move on without us in the future. We want them to become their own therapist, to be less dependent on us as treatment providers, and live a happy life,” Reisweber said.
“This is treatment to achieve recovery. It’s a philosophical shift that allows people to enjoy and tolerate life without using drugs.”
More information on TST can be found at transcendingselftherapy.com
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