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The San
Diego Union-Tribune on February 25, 2001, reports on the use of virtual
reality to treat phobias. Modern personal computers are powerful enough to
present realistic sights and sounds of phobic situations like rides on
open elevators or on airplanes. The "classical" ways to treat
phobias got people used to the phobic objects through some type of gradual
exposure. One way to accomplish this is to have patients imagine more and
more threatening situations in a non-threatening environment. This is
usually followed by gradual exposure to the real situation while the
therapist provides support and reassurance. Traditional methods might also
include exposure to slides or videotapes of the feared object or
situation. Modern computers running virtual reality software present more
vivid and realistic versions of phobic objects and allow the patient
partial control over the situation, for example by using a real steering
wheel to "drive" the virtual reality automobile. That ability is
especially valuable when exposure to the real situation is expensive and
potentially too fear provoking, as in the case of fear of flying. In
addition, the computer can be used to monitor indications of fear, blood
pressure, heart rate, and sweating, so that the therapist can control the
presentation and prevent potentially damaging panic reactions. Six centers
throughout the United States now offer this type of therapy for phobias,
with reported success rates of about 90%. The lower cost of virtual
reality therapy may encourage some of the 85% of phobics who never get
treatment to seek help rather than continuing to lead constricted lives
because of their fears. Research is under way to evaluate the use of
virtual reality to treat other mental health problems, for example the
aftermath of rape, or post-traumatic stress disorder.
Cognitive therapy reduces relapses in
major depression. A study by Dr. Robin Jarrett and her colleagues, published in the April, 2001, Archives of General Psychiatry shows that continuing cognitive therapy for 8 months reduced relapses from 31% to 10%. For younger patients, the results over 24 months were even more dramatic; relapse was reduced from 67% in control patients to 16% in the group that received the continuation therapy. Previous research had shown that relapse can be as high as 80% in patients who stop taking medication when their depression goes into remission. These findings, together with the results of previous studies showing that cognitive therapy is as effective as medication in treating patients who are in the acute phase of depression, make long-term cognitive therapy look like a good choice. Behavior Therapy for Insomnia An article in the Journal of the American Medical Association indicates that behavior therapy alone can be effective in treating many cases of insomnia. Dr. Jack Edinger, the lead author, says that cognitive behavioral therapy could be effective within 6 weeks, and the effects were still present at a 6-month follow-up. Participants in the cognitive behavioral group in their study reduced their wake time by 54 percent on average, while patients in a relaxation group reduced their wake time by only 16 percent, and those given a placebo sleeping pill reduced their wake time by only 12 percent. A great advantage of the cognitive behavior approach is that there are no side effects or danger of addiction.
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