INTERREALITY IN THE MANAGEMENT AND TREATMENT OF STRESSRELATED DISORDERS
B. K. Wiederhold, A. Gaggioli, G. Riva
Virtual Reality Medical Institute, Brussels, Belgium
Interstress is a new e-health project developing an ICT-based solution for the assessment and
treatment of psychological stress. The project has its roots in the well-validated Cognitive
Behavioral Therapy (CBT) approach. CBT intervention focuses on the enhancement of
coping strategies to deal with daily stressors and traumatic events, on the optimization of use
of personal and social resources, as well as on relaxation exercises and monitoring of stress
responses. Interstress uses these approaches in a new paradigm for e-health called Interreality.
Interreality integrates the assessment and treatment within a hybrid virtual environment, in
which the behavior in the physical world influences the experience in the virtual world. The
bridging of virtual worlds with reality should overpass the limitations of traditional CBT by
creating a top-down model of change (from cognitions to emotions), customizing the protocol
based on patient characteristics and giving more relevance to the protocol then to the
therapist. The use of PDA, mobiles phone and unobtrusive biosensors will allow constant
monitoring throughout the virtual and real experience. The system will be able to identify any
critical stressors and to assess what the user has learned. Physiological measures will
continuously track body motion, heart rate variability, skin conductance, peripheral skin
temperature as well as EEG.
The biosensors will provide feedback to the system and influence the virtual experience, in a
full-time closed-loop. A Personal Biomonitoring System (PBS) is used to track the emotional
and health status of the user and to influence his/her experience in the virtual world: these
data will be integrated and analyzed by a Decision Support System (DSS). The virtual world
will adapt to the real world experience, for example by addressing specific issues in case of
poor emotional regulation during the day. On the other hand the DSS will influence behavior,
for example by increasing possible warnings and providing additional homework in case of
poor coping skills in the virtual world. Interaction through avatars will allow role-playing
situations with other users.
Moreover in the clinical setting the therapist will be able to control virtual experiences in a
full-immersion mode in order to improve coping skills and emotional regulation and to link
them to real experience.
Particular attention will be paid to the scientific validation of the efficacy of Interreality tools
in a healthcare context through controlled clinical trials.