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Using Virtual Reality in the Treatment of Gambling Disorder: The Development of a New Tool for Cognitive Behavior Therapy

Virtual reality (VR) can be used in the treatment of gambling disorder to provide emotionally charged contexts (e.g., induce cravings) where patients can practice cognitive behavior therapy (CBT) techniques in the safety of the therapist’s office. This raises practical questions, such as whether the...

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Autores principales: Bouchard, Stéphane, Robillard, Geneviève, Giroux, Isabelle, Jacques, Christian, Loranger, Claudie, St-Pierre, Manon, Chrétien, Maxime, Goulet, Annie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5324022/
https://www.ncbi.nlm.nih.gov/pubmed/28286486
http://dx.doi.org/10.3389/fpsyt.2017.00027
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author Bouchard, Stéphane
Robillard, Geneviève
Giroux, Isabelle
Jacques, Christian
Loranger, Claudie
St-Pierre, Manon
Chrétien, Maxime
Goulet, Annie
author_facet Bouchard, Stéphane
Robillard, Geneviève
Giroux, Isabelle
Jacques, Christian
Loranger, Claudie
St-Pierre, Manon
Chrétien, Maxime
Goulet, Annie
author_sort Bouchard, Stéphane
collection PubMed
description Virtual reality (VR) can be used in the treatment of gambling disorder to provide emotionally charged contexts (e.g., induce cravings) where patients can practice cognitive behavior therapy (CBT) techniques in the safety of the therapist’s office. This raises practical questions, such as whether the cravings are sufficient to be clinically useful but also manageable enough to remain clinically safe. Pilot data are also needed to test the development of a treatment manual and prepare large randomized control trials. This paper reports on three studies describing (a) cravings induced in VR compared to real gambling and a control game of skill with no money involved (N = 28 frequent gamblers and 36 infrequent gamblers); (b) the usefulness of a treatment protocol with only two CBT sessions using VR (N = 34 pathological gamblers); and (c) the safety of a four-session treatment program of CBT in VR (N = 25 pathological gamblers). Study 1 reveals that immersions in VR can elicit desire and a positive anticipation to gamble in frequent gamblers that are (a) significantly stronger than for infrequent gamblers and for playing a control game of skill and (b) as strong as for gambling on a real video lottery terminal. Study 2 documents the feasibility of integrating VR in CBT, its usefulness in identifying more high-risk situations and dysfunctional thoughts, how inducing cravings during relapse prevention exercises significantly relates to treatment outcome, and the safety of the procedure in terms of cybersickness. Results from Study 3 confirm that, compared to inducing urges to gamble in imagination, using VR does not lead to urges that are stronger, last longer, or feel more out of control. Outcome data and effect sizes are reported for both randomized control pilot trials conducted in inpatient settings. Suggestions for future research are provided, including on increasing the number of VR sessions in the treatment program.
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spelling pubmed-53240222017-03-10 Using Virtual Reality in the Treatment of Gambling Disorder: The Development of a New Tool for Cognitive Behavior Therapy Bouchard, Stéphane Robillard, Geneviève Giroux, Isabelle Jacques, Christian Loranger, Claudie St-Pierre, Manon Chrétien, Maxime Goulet, Annie Front Psychiatry Psychiatry Virtual reality (VR) can be used in the treatment of gambling disorder to provide emotionally charged contexts (e.g., induce cravings) where patients can practice cognitive behavior therapy (CBT) techniques in the safety of the therapist’s office. This raises practical questions, such as whether the cravings are sufficient to be clinically useful but also manageable enough to remain clinically safe. Pilot data are also needed to test the development of a treatment manual and prepare large randomized control trials. This paper reports on three studies describing (a) cravings induced in VR compared to real gambling and a control game of skill with no money involved (N = 28 frequent gamblers and 36 infrequent gamblers); (b) the usefulness of a treatment protocol with only two CBT sessions using VR (N = 34 pathological gamblers); and (c) the safety of a four-session treatment program of CBT in VR (N = 25 pathological gamblers). Study 1 reveals that immersions in VR can elicit desire and a positive anticipation to gamble in frequent gamblers that are (a) significantly stronger than for infrequent gamblers and for playing a control game of skill and (b) as strong as for gambling on a real video lottery terminal. Study 2 documents the feasibility of integrating VR in CBT, its usefulness in identifying more high-risk situations and dysfunctional thoughts, how inducing cravings during relapse prevention exercises significantly relates to treatment outcome, and the safety of the procedure in terms of cybersickness. Results from Study 3 confirm that, compared to inducing urges to gamble in imagination, using VR does not lead to urges that are stronger, last longer, or feel more out of control. Outcome data and effect sizes are reported for both randomized control pilot trials conducted in inpatient settings. Suggestions for future research are provided, including on increasing the number of VR sessions in the treatment program. Frontiers Media S.A. 2017-02-24 /pmc/articles/PMC5324022/ /pubmed/28286486 http://dx.doi.org/10.3389/fpsyt.2017.00027 Text en Copyright © 2017 Bouchard, Robillard, Giroux, Jacques, Loranger, St-Pierre, Chrétien and Goulet. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Bouchard, Stéphane
Robillard, Geneviève
Giroux, Isabelle
Jacques, Christian
Loranger, Claudie
St-Pierre, Manon
Chrétien, Maxime
Goulet, Annie
Using Virtual Reality in the Treatment of Gambling Disorder: The Development of a New Tool for Cognitive Behavior Therapy
title Using Virtual Reality in the Treatment of Gambling Disorder: The Development of a New Tool for Cognitive Behavior Therapy
title_full Using Virtual Reality in the Treatment of Gambling Disorder: The Development of a New Tool for Cognitive Behavior Therapy
title_fullStr Using Virtual Reality in the Treatment of Gambling Disorder: The Development of a New Tool for Cognitive Behavior Therapy
title_full_unstemmed Using Virtual Reality in the Treatment of Gambling Disorder: The Development of a New Tool for Cognitive Behavior Therapy
title_short Using Virtual Reality in the Treatment of Gambling Disorder: The Development of a New Tool for Cognitive Behavior Therapy
title_sort using virtual reality in the treatment of gambling disorder: the development of a new tool for cognitive behavior therapy
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5324022/
https://www.ncbi.nlm.nih.gov/pubmed/28286486
http://dx.doi.org/10.3389/fpsyt.2017.00027
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