A virtual reality (VR) platform that counselors can use to enhance treatment techniques and improve outcomes among those with alcohol use disorder - Project Summary/Abstract Alcohol use disorder (AUD) is among the top causes of disability globally. Although several treatment approaches are effective in helping those with AUD reduce their drinking, only 35-40% are asymptomatic a year after treatment, suggesting there is ample room to improve treatment efficacy. Innovation in counseling- based treatments for AUD has been slow, with treatment remaining largely unchanged since the mid-1990s. The core of many effective, counseling-based treatments for AUD, including cognitive behavior therapy and relapse prevention, is helping patients learn and use coping skills to avoid drinking when urges strike or in high-risk situations. Reviews suggest that these skills are also a core mechanism that explains why these treatments are effective. Traditionally, counselors have used verbal/written instruction, role play, and rehearsal to help patients learn these skills. Although helpful, this approach relies extensively on abstract thinking and memory and provides few opportunities to practice using these skills in situations that feel like those patients will experience in their daily lives. Virtual reality (VR) refers to computer-generated experiences that give users a convincing sense that they are physically present in a digital environment. A large body of research shows that simulation-based training involving VR improves skill learning and transfer. For this reason, VR has been used to enhance psychotherapy for a variety of mental health conditions, most notably anxiety disorders, since it can realistically immerse users in feared situations that are too difficult to recreate in vivo. Meta-analyses suggest that VR-assisted treatments for anxiety perform as well as in vivo treatments and are likely to be significantly easier to deliver. Despite the promise of VR in anxiety treatment, there have been few dedicated efforts to explore VR’s utility as a treatment tool for AUD. VR experiences that immerse users in situations and environments that are high-risk for relapse, like bars, celebrations, or general stressors, could provide more authentic context for helping AUD patients learn coping skills that elicit more genuine emotional and social responses – making coping strategies more memorable and transferable. At Real Recovery VR Inc., we have designed six environments that match common high-risk situations that patients with AUD report encountering while in recovery. In this Phase I SBIR application, we propose to complete the development of the Real Recovery VR platform and establish its technical merit with cycles of usability studies with AUD counselors and patients (Aim 1). Once the full platform is complete, we will use mixed methods (product demo, qualitative interview, follow-up survey) to evaluate its feasibility with AUD counselors and patients recruited from a partner treatment facility (Aim 2). We will then use similar methods with directors of addiction treatment facilities to evaluate its commercial potential (Aim 3). Accomplishing these aims would provide essential data needed to pursue a Phase II to evaluate the impact of the platform on AUD-related clinical outcomes and to begin exploring other potential applications of VR to addiction treatment.
