How VR and 5G can help returning vets heal

There are approximately 20 million veterans in the United States. Over a third of them have reported at least one bout of post-traumatic stress disorder (PTSD). And this year, military suicides are up by 20%. Can virtual reality (VR) help our vets overcome the traumas of war?

While traditional in-person therapy has been largely off-limits since the start of the pandemic, new technology has stepped in to try to stem the tide. One clinical psychologist, Dr. Albert “Skip” Rizzo, is using VR to help 80% of veterans in his lab see a meaningful reduction in PTSD symptoms and live more fulfilling lives after their service.

Veterans relive their trauma safely

A clinical psychologist and Director of Medical Virtual Reality at the University of Southern California Institute for Creative Technologies, Rizzo has been developing virtual reality systems to help patients overcome a variety of clinical conditions for over 20 years.

“For children with attention deficit disorder, teenagers with autism, elderly individuals with dementia, and veterans with post-traumatic stress disorder,” Rizzo says, VR has been a very effective and safe way to help people.

He and his team started working with veterans returning from the wars in Iraq and Afghanistan in 2003. “The best evidence-based approach for treating PTSD,” he says, “is what we call trauma-focused therapy, where the patient imagines their traumatic event in a clinical session with a supportive clinician and narrates their experience.”

By repeatedly confronting and reprocessing these very difficult and emotional memories in a safe environment, the fear and anxiety associated with the memory decrease over time.

“We can build out simulations of Iraq and Afghanistan that very closely mimic the situations in which they were traumatized,” Rizzo says. For instance, if the vet was involved in a bombing on the way to a market, the clinician can re-create the experience virtually by pulling from a library of scenarios and then adjusting things like time of day, where the bomb went off, whether a plane flew overhead, whether the veteran was in a vehicle, where they sat in the vehicle, and how many people were present. This moment-by-moment customization of the experience helps each patient go back to a memory that is specific to them.

This type of therapy with VR has two purposes, Rizzo says. One, the repeated exposure to an event has been shown to reduce the “fight or flight” response, and two, feeling safe in a VR environment will allow the subjects to open up in ways that they might not have been able to before.

When tech outweighs human presence

In recent studies, researchers found that patients were more likely to disclose PTSD symptoms while speaking to a virtual human than to an in-person clinician. “When a squad returns from duty,” Rizzo says, “they have to fill out a medical checklist, and even though they are told it will be confidential, they fear it will follow them through their careers and tend to just say ‘no’ to everything.” But artificial intelligence (AI) is helping clinicians and doctors improve medical care. When a very personable AI bot asks questions that progress from “How are you doing?” to “Are you happy to see your family?” and “How are you sleeping?” veterans are much more likely to open up.

Rizzo has found significant statistical differences between veterans who underwent typical PTSD treatment and those who used VR and AI. Patients working with Rizzo saw a 50% decrease in symptoms like anxiety, depression, anger and isolation. Sixteen out of 20 users no longer meet the criteria for PTSD treatment, and most report an improved quality of life.

The implications of 5G on the future of VR care

With 5G being released in more markets and VR headsets getting lighter, faster and cheaper, Rizzo is one of many doctors who sees tremendous opportunities for this kind of treatment to grow.

“Right now, we have to use tethered headsets because the computational power needed for these scenarios is so great,” he says. “But I envision a future where a clinician can pull a stand-alone headset out of their desk drawer, give it to a client, then use their tablet to draw from a cloud library of a thousand different clinical applications and stream it straight to the patient’s headset.

“5G cloud computing promises to advance this capability by offloading much of the real-time simulation processing to remote servers.”

“Clinical VR has evolved from aspirational vision to pragmatic reality,” he says. “As the costs and complexity for developing and delivering health and wellness VR applications have gone down, the sheer capacity of the technology has concomitantly gone up.”

While working with the military has been a major focus, Rizzo and his team have used the technological advances for other projects as well, like virtual job interviews for disadvantaged youth and people who have high-functioning autism.

“If you look at the World Health Organization,” he says, “they estimate that right now on the planet, 450 million people are suffering from a mental health condition. Of that number, a full two thirds of them will never, never in their entire life see the inside of a therapy office. So there's a big driver to push care out into the environment in ways that is more accessible.”

For Rizzo, virtual reality is the solution. “It's the future. We have documented over the last 25 years with good research that VR and AR matter.”

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