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Anxiety

Cognitive-Behavioral Therapy

Selective Mutism Virtual Reality

Selective Mutism in the Virtual Reality Exposure Therapy

Virtual Reality Exposure Therapy

Article #1: Can VR effectively treat PTSD and anxiety disorders patients?

Virtual Reality (VR) is considered a vast Landscape of anything to be invented upon the virtual reality to stimulate, engage, and entertain the user. There are limiting factors that are brought to the designer's imagination. The study is found to be still researched but one particular research on the case of Selective Mutism in the VR is exhibiting the extension of the virtual reality world that may not be considered as PTSD and Anxiety Disorders. 

Is there an Effective Treatment that the VR treats Selective Mutism?

Researchers and Clinicians over 2 decades have been using the virtual world for exposure therapy to aid the patients to recover. Exposure therapy was best applied/exposed to patients about phobias, fears, and stressors before their symptoms were decreased. Exposure therapy is accomplished outstanding, despite the represented simulation with the performers rehearsing the specific situations that the patient could or could not have gone through successfully. According to Virtual Reality Exposure Therapy (VRET), the parents and their child participants have shown that it is approved and that it is an effective treatment. The importance of this was finding the post-treatment and the follow-up measures, but no significant changes in the parent-ratio speech frequency and the anxiety measures have been found. According to the research article they mention that "Both PTSD and Anxiety Disorders have been treated/cured from within the virtual reality with the same and slightly better results. Another objective to be attained with the technology is it being used in the health care system to be applied for SM. According to the article, "The result was that virtual reality was just as efficient as non-VR exposure therapy. On top of that, the results showed “significant reductions in PTSD” as well as decreased “anxiety severity” and improved emotional Stroop test. Access to Virtual Reality will mean that there will be greater chances for the situation to remain the same due to being free from human error. Virtual reality will allow the simulation (the action of pretending) to be modified in the real world by the access through computer and headset connected to or even by using a tablet that is connected to the headset. According to the article, "This allows for stronger sensory stimuli to be administered on the fly without waiting times or having to prepare actors. 

Why I chose this article: ​

I chose this article of interest to readers (classmates), about how a VR can effectively treat PTSD and anxiety disorder patients by using it cautiously. The proper use of Virtual Reality allows for stronger sensory stimuli to be administered on the fly without waiting times or having to prepare actors. For example, "Anxiety disorders come in various shapes and forms, but they all present with debilitating anxiety, making certain everyday situations intolerable. Some of the disorders include Agoraphobia, anxiety secondary to a medical condition, panic disorder, selective mutism, separation anxiety disorder, and more." (Arik Yates, June 2021) Most of the various treatments assigned by the Virtual Reality that can treat patients with PTSD and anxiety disorders are of reaching out to, "specialized therapists, speech therapy (selective mutism), or medication, however, VR is also being used to assist in alleviating anxiety." (Arik Yates, June 2021)

Cited Source: 

Yates, A. (June 2021) Can VR effectively treat patients with PTSD and anxiety disorders? Retrieved from https://www.neurorehabvr.com/blog/vr-treats-disorders

Article #2: A Prototype for the Treatment of Children with Selective Mutism using Interactive 360° VR

A child with "selective mutism" consistently is unable to speak in situations where they should be able to (such as at school) but they can speak in other situations (such as at home). Selective mutism children often communicate non-verbally by nodding or shaking their heads. Interestingly, selective mutism affects nearly twice as many girls as boys (Carbone et al., 2010). Selective mutism is rarely recognized, so it can often go unnoticed or be detected too late. In some cases, selective mutism can result in a child leaving school early, limited prospects, and chronic anxiety and mood problems, if left untreated. But treatment is possible. Psychiatrists from the Academic Center for Child & Adolescent Psychiatry ("Levvel") and Amsterdam University Medical Center (AUMC) specialize in treating and conducting research on selective mutism in the Netherlands. Behavioral treatment protocols were developed for selective mutism in children (Güldner, et al., 2010).

Why I chose this article:

Cited Source: 

Aust, M., Otto, M., Helin, K. (2020). improve User Interfaces: Multi-User-XR for construction (Poster). In: Helin, K., de Antonio, A., Reyes-Lecuona, A. (Editors): EuroVR 2020 Application, Exhibition & Demo Track: Proceedings of the Virtual EuroVR Conference, ISBN 978-951-38- 8741-4, 71-75.

Article #3: A feasibility trial of virtual reality exposure therapy for selective mutism.

The following article discusses how Virtual Reality Exposure Therapy (VRET) has been a common practice to augment cognitive-behavioral therapy (CBT). However, most studies examined VRET's effectiveness in adults, and no study studied how it might be tailored for children with selective mutism. Children with SM aged 6-12 were recruited to complete six therapist-guided VRET sessions. Twenty participants completed six VRET sessions. Pre-and post-VRET measurements were completed by parents and clinicians. The acceptability questionnaire was performed by parents and children at post-VRET. Results indicated that the treatment was effective and acceptable for SM in all participants, as they all completed the program. Participating parents and children also reported that VRET was effective and acceptable. Compared with pre-treatment, post-treatment, and follow-up measures, there was a significant improvement in overall functioning, but there was no change in parent-rated speech frequency and anxiety. Future studies with more robust experimental designs and larger sample sizes can confirm its effectiveness. The findings suggest VRET can be used as a complement (not a replacement) of CBT in SM treatment. Technologies such as virtual environments can be explored as technology becomes more sophisticated so that evidence-based care is enhanced for children and their families.

Cited Source: 

Tan, Y. R., Ooi, Y. P., Ang, R. P., Goh, D. H., Kwan, C., Fung, D. S., & Sung, S. C. (2021). Feasibility trial of virtual reality exposure therapy for selective mutism. Clinical Child Psychology and Psychiatry. https://doi.org/10.1177/13591045211056920

Article #4: Selective Mutism: A Three-Tiered Approach to Prevention and Intervention.​

​Cited Source:

Busse, R.T., Downey, J. Selective Mutism: A Three-Tiered Approach to Prevention and Intervention. Contemp School Psychol 15, 53–63 (2011). https://doi.org/10.1007/BF03340963

Article #5: 'This is creating more loneliness': The metaverse could be a serious problem for mental health kids.

Cited Source:

Huddleston, T. (January 2022). ‘This is creating more loneliness’: The metaverse could be a serious problem for kids mental health'. Retrieved from https://www.cnbc.com/2022/01/31/psychologists-metaverse-could-be-a-problem-for-kids-mental-health.html

Article #6: Using technology for communication with selective mutism.

Cited Source:

Skacel, K. (2014, August 18). Using technology for communication with selective mutism. Retrieved March 3, 2022, from https://rdw.rowan.edu/cgi/viewcontent.cgi?article=1268&context=etd

Article #7: SMart Advice About Selective Mutism: Same Concepts in a New Virtual World.

Cited Source:

Talarico, A. (2020, May 22). YouTube. Retrieved March 3, 2022, from https://www.youtube.com/?app=desktop

Article #8: Potential for school familiarisation using Virtual Environments. 

Cited Source:

Foreman, N. (2010, January 10). (PDF) potential for school familiarisation using virtual. DOI: https://www.researchgate.net/publication/228813895_Potential_for_school_familiarisation_using_Virtual_Environments

Article #9: Definitions, importance, and application of selective mutism question in the primary care setting.

The following article has importance in order to define the disorder selective mutism and the importance that it has and how these cognitive behaviors can be treated or reduced. With selective mutism, children are at greater risk of subjective suffering and developing other associated morbidities, as well as less frequent participation in school activities and reduced social and cognitive abilities. There is no significant evidence regarding the modalities that should be used in evaluating selective mutism. According to the recent data presented in the selective mutism questionnaire (SMQ), it has been approved by various investigations with well-established psychometric properties. As a result of another reading done by the researcher, the definition of selective mutism and the applications and significance of the selective mutism questionnaire are both found to provide valuable assistance in primary care settings. Using a Selective Mutism treatment tool is an effective means for determining whether these children have behavioral speaking problems. Additionally, evidence has shown that the tool can be used to determine whether treatment has had any effect on behavior among these children. As a result of these studies, treatment of selective mutism was found to significantly enhance the scores and behavioral patterns of speaking. Although these scores were relatively low, they were still higher than those estimated for typically developing children. It has been suggested that more intensive treatment methodologies can yield better results, but these studies were not sufficiently validated, so more studies are needed for proper interpretation and validation of the current results.

Cited Source:

Esmail, M. E., Alharbi, M. B., Alayed, I. S., Alqahtani, M. S., Aldeeb, H. F., Alanazi, Y. H., … Doshi, T. A. (2021). Definitions, importance, and application of selective mutism questionnaire in the primary care setting. International Journal Of Community Medicine And Public Health, 8(12), 6076. doi:10.18203/2394-6040.ijcmph20214451

Article #10:

Cited Source: