An adaptation algorithm for personalised virtual reality exposure therapy.

BACKGROUND: Anxiety disorders are highly prevalent in mental health problems. The lives of people suffering from an anxiety disorder can be severely impaired. Virtual Reality Exposure Therapy (VRET) is an effective treatment, which immerses patients in a controlled Virtual Environment (VE). This creates the opportunity to confront feared stimuli and learn how to deal with them, which may result in the reduction of anxiety. The configuration of these VEs requires extensive effort to maximise the potential of Virtual Reality (VR) and the effectiveness of the therapy. Manual configuration becomes infeasible when the number of possible virtual stimuli combinations is infinite. Due to the growing complexity, acquiring the skills to truly master a VR system is difficult and it increases the threshold for psychotherapists to use such useful systems. We therefore developed a prototype of a supportive algorithm to facilitate the use of VRET in a clinical setting. This automatised system assists psychotherapists to use the wide range of functionalities without burdening them with technical challenges. Thus, psychotherapists can focus their attention on the patient. METHODS: In this paper both the prototype of the algorithm and a first proof of concept are described. The algorithm suggests environment configurations for VRET, tailored to the individual therapeutic needs of each patient. The system aims to maximise learning during exposure therapy for different combinations of stimuli by using the Rescorla-Wagner model as a predictor for learning. In a first proof of concept, the VE configurations suggested by the algorithm for three anonymised clinical vignettes were compared with prior manual configurations by two psychotherapists. RESULTS: The prototype of the algorithm and a first proof of concept are described. The first proof of concept demonstrated the relevance and potential of the proposed system, as it managed to propose similar configurations for the clinical vignettes compared to those made by therapists. Nonetheless, because of the exploratory nature of the study, no claims can yet be made about its efficacy. CONCLUSIONS: With the increasing ubiquity of immersive technologies, this technology for assisted configuration of VEs could make VRET a valuable tool for psychotherapists.

Operationalization of One Health Burnout Prevention and Recovery: Participatory Action Research-Design of Nature-Based Health Promotion Interventions for Employees.

Burnout is, besides a global, complex phenomenon, a public health issue with negative consequences on personal, organizational, social, and economic levels. This paper outlines the co-design of a novel Nature-based Burnout Coaching intervention, called NABUCO. Due to the complexity of burnout, we propose a One Health approach in healthcare, educational and governmental pilot organizations, to deliver guidelines and protocols for prevention and recovery of burnout. We advocate the inclusion of the salutogenic and mutual healing capacity of nature connectedness, facilitating a positive impact on mental and environmental health. A transdisciplinary Participative Action Research-design resulted in an iterative adaptive cycle of co-design, implementation, and evaluation of NABUCO.