How Oxford VR is transforming access to mental healthcare with virtual reality
One of the most vexing difficulties therapy is designed to help is to break destructive patterns — but many people don’t have access to therapy or other tools to achieve those goals.
Oxford VR is a mental health technology company with roots in psychology, a natural culmination of Barnaby’s previous work. Earlier in his career, he used biomechanics to help children with disabilities adapt to the world around them and interact with their surroundings in more meaningful ways. Without the ability to implement decisions — including bad choices — he observed that these children were not able to learn as effectively.
“Children have to be able to try things that may not be right, to learn how to get a better response from the world,” he said. “If you can’t move, speak, or write, you’re going to struggle to do all of those things, so there’s a huge psychological element to adaptive technology. I love seeing the transformation in people.”
Barnaby’s early work led to the development of a pioneering online delivery system for cognitive behavioral therapy. The idea was to use an immersive, computer-simulated environment in virtual reality (VR) to develop psychological interventions that produce measurable outcomes.
“We learned that variation between therapists is significant; just because someone is qualified and accredited doesn’t mean they’ll deliver good quality therapy,” Barnaby said. “People who stick to protocol get great outcomes, and people who don’t, don’t. But that’s very hard to manage with one to one, private conversations.”
A VR therapy coach
Oxford VR has developed therapeutic intervention protocols using a virtual coach. For example, a patient in the social avoidance program might find themselves interacting with people in a virtual cafe or playing a virtual game with strangers with the help of the coach.
Participants know they are just wearing a headset in a lab, so they are free to challenge the intrusive thoughts that make them feel unsafe with the coach’s guidance.
“The coach never gets bored, and she’s happy to go through the process,” Barnaby said. “She takes you through tasks, but she also explains how each step challenges intrusive thoughts. Once you challenge them, you can actually break and reverse a vicious cycle back into a more virtuous pattern of being more engaged.”
For many patients, the idea of conjuring up imaginary anxiety to beat the real kind might seem counter-intuitive — but Barnaby insists that the technique merely helps the brain see the situation from all sides.
“For somebody with a social anxiety disorder, for example, there is nothing in their anxiety that is real or protective, but these issues prevent them from going to public places, and eventually they feel and become real,” he said. “We’re simply enabling people to see it another way. It’s impossible to do that in the real world, because the very experience is too much.”
This is partly why the team chose to develop the acrophobia program first: natural human anxiety surrounding heights isn’t an unhelpful, intrusive thought. The researchers noticed that many people go on to develop more serious acrophobia upon having children, and this led them to observe the gradual process of releasing fear.
“If you’re standing on the edge of a cliff, you should be feeling danger,” adds Barnaby. “Those of us who have children learn to let them go closer to the edge, safely. In this program, you’re doing the same thing yourself, giving yourself more freedom to take risks, but none that are really dangerous.”
Mental health treatment for all
Long before Barnaby began using VR to treat mental health, he was delivering mental health treatment using technology as a mediator to provide consistency.
“Measuring mental health outcomes is really important,” he said. “It sounds obvious because we do it in physical health, but for years mental health was pretty much unmeasured.”
Barnaby points to an NHS program, Improving Access to Psychological Therapies, which allows patients to self-refer for assessment and treatment. The program, while considered successful, reaches only about 15 percent of those with target mental health conditions, but now has a goal 25 percent.
“Imagine if 75 percent of people went untreated in physical health,” said Barnaby. “Technology is key to expanding that up to 70, 80, or 90 percent.”
Oxford VR is not in the business of putting therapists out of work. In fact, it envisions a world where everyone accesses mental health treatment. “We’re big fans of therapists, there’s just a shortage of people that we can train to do the work, and a shortage of financial resources,” Barnaby said. “Face-to-face therapy is a fundamentally important tool in our armory, particularly for some people with certain conditions.”
However, the team sees a realistic need for some people to use a blended mix of self-help tools — including VR and face-to-face therapy. “We can’t double the number of therapists easily,” said Barnaby. “I’d much rather get the same therapist to be able to treat 10 or 20 times as many patients.”
Seeing the future
The vision for Oxford VR includes expanding the company’s reach. “Our goal for Oxford VR is not to do a quick exit,” Barnaby said. “I don’t know what the technology will be in 10 years, but I know we’ll be using it, and not to sell one point solutions as panaceas.
“You need a whole armory of tools to be able to do this effectively. That’s where Oxford VR going to be, and I think we will transform mental health care.”
Barnaby also hopes to see more companies tackling tough healthcare challenges despite regulatory hurdles—because that’s the space where mental health lives.
“One of the things about health that always bothers me is many tech startups from a non-clinical background choose to focus on wellness rather than health because it’s less regulated,” he said. “Don’t get me wrong, it’s a good thing to do, but how many companies actually really tackle the really difficult regulated markets which are treating really serious conditions? I’d love to see much more emphasis on that in both mental and physical health.”
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