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ABC’s look at treating PTSD with virtual reality: Classic example of anecdote over evidence

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Treating PTSD With Virtual Reality Therapy: A Way to Heal Trauma

Our Review Summary

Boy looks fascinated into Virtual Reality HeadsetThis story from ABC News looks at the use of virtual reality (VR) technologies to help treat patients suffering from post-traumatic stress disorder (PTSD).

Unfortunately the information is relayed in a cursory and anecdotal way: The story includes the viewpoint of only one patient and the patient’s psychologist. The story doesn’t place the work in a broader context. For example, readers could easily assume that PTSD treatment with VR is a new phenomenon, when it has been the subject of research for almost 20 years.

Also lacking: The context of other established, effective therapies; a discussion of the availability of VR treatment options for PTSD patients; what such treatments may cost; or whether there are any potential risks associated with such treatment.

 

Why This Matters

PTSD is, unfortunately, far from rare. According to the U.S. Department of Veterans Affairs’  National Center for PTSD, 10 percent of U.S. women and 4 percent of U.S. men will experience PTSD during their lifetime, and those percentages are higher for veterans. The center estimates that 8 million U.S. adults experience the condition each year. PTSD can have significant adverse effects on a patient’s relationships and overall quality of life. There is some evidence that it can also increase the likelihood that an individual will try to commit suicide.

In short, PTSD is a serious condition that affects a great many people. It is important to discuss this condition openly and honestly, both to destigmatize PTSD and to raise awareness of treatment options. But it is important to answer fundamental questions that people may have about those treatment options. Are they available? Are they affordable? How well do they work? What are their limitations? This story addresses none of those baseline questions.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The story does not address cost. This is particularly problematic, given that cost is a particularly timely issue for the field of virtual reality treatment of PTSD. A Tech Insider story published earlier this year paid particular attention to the recent rise of virtual reality (VR) technology, and the corresponding decrease in the cost of that technology. That story quoted the same researcher who is quoted in this ABC News story. In the Tech Insider piece, the researcher says: “It has not been the theory or research that has held back clinical VR, rather the availability, adoption and costs that have limited its widespread use.” We wish this story had addressed the issue.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

Benefits are not quantified. In fact, with the exception of one patient’s experience, benefits aren’t discussed. And for that one patient, the benefits are discussed in only vague terms.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

Potential harms aren’t discussed. Even if there are few or no risks, that needs to be addressed. And there is the potential that VR therapy could lead to profound psychological distress for some patients. A chapter in the 2009 book Post-Traumatic Stress Disorder highlights the issue, saying that researchers have reported that at least one patient has discontinued treatment “due to experiencing a distressing flashback.” The chapter authors note that “While this is rarely reported in the exposure literature, this report highlights the need for well-trained clinicians with expertise in the delivery of exposure therapy at a rate that the patient can effectively handle and process and in the sensitive monitoring of patient status.” In other words, this is an issue worth mentioning.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

The quality of evidence isn’t discussed. This story makes it sound as if the research on VR treatment for PTSD is being done only in one place by one group of researchers. But there are papers on VR treatment for PTSD dating back to the late 1990s (like this one), and the work has been done with patients who experienced trauma in a variety of contexts outside of the battlefield. The story doesn’t mention any of the studies done in this field.

Does the story commit disease-mongering?

Satisfactory

No disease mongering here.

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

The story cites one patient and one researcher who has worked with the patient. There is no third-party input and no expert evaluation on the state of the field as a whole.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The story does discuss exposure therapy, but only in the context of explaining one researcher’s approach to using VR to treat PTSD. There is no attempt to compare the effectiveness of VR treatment to any other form of treatment — including exposure therapy. It’s worth noting that a review article of the existing literature, published in 2012, found little difference between VR therapy and exposure therapy, but reported that it may be useful for patients who are resistant to traditional exposure therapy. There is no discussion in the story of pharmaceutical treatment options, or of effective psychotherapy methods, such as cognitive-behavioral therapy and others.

Also, a note on this statement: “Virtual reality offers a unique opportunity for clinicians and clients alike: to be immersed in the environment that evokes the original trauma, rather than relying on the patient’s imagination.” This could be interpreted to mean that patients “relying on [their] imagination” are not experiencing relevant stimuli–when in fact patient memories can be vivid, painful and very salient.

Does the story establish the availability of the treatment/test/product/procedure?

Not Satisfactory

There is no discussion of the availability of VR treatment options for PTSD. Readers could easily assume that it is currently available only at the research center discussed in the story. According to that research center’s own website, it provides treatment at more than 60 sites — and that doesn’t even account for the availability of VR treatment from other providers. For readers who may be interested in learning more about VR treatment opportunities (much less taking advantage of them), this complete lack of information about availability must be frustrating.

Does the story establish the true novelty of the approach?

Not Satisfactory

As noted above, researchers have been evaluating the use of VR treatment to address PTSD since the late 1990s. It’s not clear what is novel about the approach being described in this particular story, nor why the story is being told now. As noted above, an overview of some of the previous work is available in an (open access) review article that was published in 2012.

Does the story appear to rely solely or largely on a news release?

Satisfactory

The story does not appear to be based on a news release.

Total Score: 2 of 10 Satisfactory

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