batgirl
28-11-2007, 05:14 AM
The use of video games to treat anxiety has been approved in Great Britain, but experts here warn that while they may help certain specific phobias or mild depression, a video game is no substitute for a therapist. In Great Britain, the game "FearFighter" was given the seal of approval to treat panic attacks, mild depression and phobias by a group of mental-health professionals. The game had proved effective in small-scale studies, and it was endorsed partly because about 90 percent of people with mild depression never see a therapist, and patients routinely wait six months or more for mental-health services in Britain's National Health Service.
"It could be helpful for people who have agoraphobia or social phobia who wouldn't otherwise be able to get out of the house to get treatment," said Dr. Karen Steinberg, a clinical psychologist and assistant professor of psychiatry at the University of Connecticut.
Research shows that the therapeutic alliance, the relationship between the doctor and patient, is an active ingredient in therapy, often adding to the effectiveness of the treatment.
"By using a game instead of a therapist, you're saying the relationship doesn't matter," Steinberg said. "A computer could ask these same questions, such as when does the person have symptoms of anxiety and how long it's been going on, but the therapist's expressions of warmth and positive regard, those are things that are hard for a computer to do."
"FearFighter" is based on some of the principles in cognitive behavior therapy, Steinberg said. Patients are asked by the computer program to identify the situations that set off their panic attacks, for example, and then given instructions on how to cope with their fears. A person can learn to do these things without a therapist, Steinberg said. After the patient answers questions rating the severity of their fears and how well they adjust to their situation at work and in social settings, the computer presents scenarios so that patients can face their fears long enough to get used to them. This is known as exposure therapy. But what about missing more serious mental illness or even suicide? Only a live human can assess those risks, Steinberg said.
Although he has not seen "FearFighter" specifically, Dr. David Tolin, an anxiety expert at Hartford's Institute for Living, sees promise in using computer games to treat phobias. Say, for example, the patient is afraid of flying on an airplane. "Flying on a real airplane can get awfully expensive, and you can't get off the plane if you become anxious in the middle of the flight, but we can use virtual reality technology to facilitate exposure to flying on an airplane, seeing the sights and hearing sounds in a much more feasible manner," Tolin said. "The patient faces their fears in a controlled manner, when those fears are not easy to face in real life."
In Tolin's office, some patients are treated with virtual reality games in which they are seated in a chair and given goggles to wear. Within the goggles are small screens with images that re-create various frightening scenarios, including airplane travel.
Chicago psychiatrist Dr. Alexander Obolosky said that in places like Britain a computer program might make sense for mild depression or specific anxieties. "But if you have a person with a more serious anxiety disorder, using a game will waste precious time in doing things that are not helpful," said Obolosky, who is also an assistant professor of psychiatry at Northwestern University medical school. "If patients are not evaluated appropriately they can even commit suicide. It can compound the problem."
Obolosky would like to see video games prescribed after an evaluation by a psychiatrist to rule out more serious issues such as bipolar disorder. He further points out that using a video game instead of interpersonal therapy could be enabling patients to avoid their problems altogether. "People who are suffering from mental illness are very embarrassed. It is a stigma," Obolosky said. "We are only playing into it because they don't want to see a real person and establish a real relationship. We're telling them, 'It's not that bad, go play on the computer.'"
Although video games may play a continuing role in mental health treatment, more study is needed, experts say. For a lot of patients with no health insurance or who live in a remote location, it may be useful to consider an alternative. Any therapy may be better than no therapy.
"Computer-assisted therapy can help many people with anxiety-related disorders, but that's not to say it's as good as you can get with a therapist," said Tolin. "Ultimately, we are going to need research on how receiving treatment from a computer compares to receiving treatment from a therapist."
Source: Alix Boyle, The Hartford Courant
"It could be helpful for people who have agoraphobia or social phobia who wouldn't otherwise be able to get out of the house to get treatment," said Dr. Karen Steinberg, a clinical psychologist and assistant professor of psychiatry at the University of Connecticut.
Research shows that the therapeutic alliance, the relationship between the doctor and patient, is an active ingredient in therapy, often adding to the effectiveness of the treatment.
"By using a game instead of a therapist, you're saying the relationship doesn't matter," Steinberg said. "A computer could ask these same questions, such as when does the person have symptoms of anxiety and how long it's been going on, but the therapist's expressions of warmth and positive regard, those are things that are hard for a computer to do."
"FearFighter" is based on some of the principles in cognitive behavior therapy, Steinberg said. Patients are asked by the computer program to identify the situations that set off their panic attacks, for example, and then given instructions on how to cope with their fears. A person can learn to do these things without a therapist, Steinberg said. After the patient answers questions rating the severity of their fears and how well they adjust to their situation at work and in social settings, the computer presents scenarios so that patients can face their fears long enough to get used to them. This is known as exposure therapy. But what about missing more serious mental illness or even suicide? Only a live human can assess those risks, Steinberg said.
Although he has not seen "FearFighter" specifically, Dr. David Tolin, an anxiety expert at Hartford's Institute for Living, sees promise in using computer games to treat phobias. Say, for example, the patient is afraid of flying on an airplane. "Flying on a real airplane can get awfully expensive, and you can't get off the plane if you become anxious in the middle of the flight, but we can use virtual reality technology to facilitate exposure to flying on an airplane, seeing the sights and hearing sounds in a much more feasible manner," Tolin said. "The patient faces their fears in a controlled manner, when those fears are not easy to face in real life."
In Tolin's office, some patients are treated with virtual reality games in which they are seated in a chair and given goggles to wear. Within the goggles are small screens with images that re-create various frightening scenarios, including airplane travel.
Chicago psychiatrist Dr. Alexander Obolosky said that in places like Britain a computer program might make sense for mild depression or specific anxieties. "But if you have a person with a more serious anxiety disorder, using a game will waste precious time in doing things that are not helpful," said Obolosky, who is also an assistant professor of psychiatry at Northwestern University medical school. "If patients are not evaluated appropriately they can even commit suicide. It can compound the problem."
Obolosky would like to see video games prescribed after an evaluation by a psychiatrist to rule out more serious issues such as bipolar disorder. He further points out that using a video game instead of interpersonal therapy could be enabling patients to avoid their problems altogether. "People who are suffering from mental illness are very embarrassed. It is a stigma," Obolosky said. "We are only playing into it because they don't want to see a real person and establish a real relationship. We're telling them, 'It's not that bad, go play on the computer.'"
Although video games may play a continuing role in mental health treatment, more study is needed, experts say. For a lot of patients with no health insurance or who live in a remote location, it may be useful to consider an alternative. Any therapy may be better than no therapy.
"Computer-assisted therapy can help many people with anxiety-related disorders, but that's not to say it's as good as you can get with a therapist," said Tolin. "Ultimately, we are going to need research on how receiving treatment from a computer compares to receiving treatment from a therapist."
Source: Alix Boyle, The Hartford Courant