Therapeutic recreation specialists should give special attention to VR applications in health care settings and proactively examine their possible use in a therapeutic recreation intervention program.
Brandon balances precariously on a four-inch rock ledge, twenty feet above his belayer, wondering how he ever let his friends talk him into rock climbing. He is frozen in place, gripped by his fear of heights, afraid to move up or down. Frustrated, overcome with fear, and not sure what to do next, Brandon reaches out and turns the virtual reality simulator off telling the recreation therapist, "I'll try again next time."
Virtual Reality is the 3-dimensional (3-D) virtual world created with computer graphics, body-tracking devices, and head-mounted displays. Although Virtual Reality (VR) technology is relatively new, it has had considerable impact in industry and education (Grealy, Johnson, & Rushton, 1999). Currently, the virtual environments are moving out of computer science labs and into health care settings. Although VR applications in health care settings are limited, special attention should be paid to the potential that VR therapy holds as a therapeutic recreation treatment modality. This article has four primary purposes: (1) providing a basic introduction to VR, (2) sharing examples of VR therapy programs in the areas of mental health and physical medicine/rehabilitation, (3) examining the advantages of VR therapy, and (4) discussing the possible applications of VR to therapeutic recreation.
VR is a new human-computer interaction in which users are no longer simply external observers of images on a computer screen, but are active participants within a computer-generated 3-D virtual world. Rothbaum and Hodges (1999) point out that VR environments differ from traditional displays in that computer graphics and various display and input technologies are integrated to give the user a sense of presence, or immersion, in the virtual environment. The most common approach to the creation of a virtual environment is to fit the user with a head-mounted display. The sensory aspects of the virtual environment (auditory, visual, and tactile) are delivered to the individual through the head-mounted display. The sensory experiences depend upon the individual's movements within the environment, which are relayed back to the computer from the helmet sensor and other control devices (e.g., joy stick, the data gloves, or body suit). In short, VR integrates real-time computer graphics, body-tracking devices, visual displays, and other sensory input devices to immerse a participant in a computer-generated virtual environment (Rothbaum & Hodges, 1999). However, VR also comes in a `non-immersive' form in which sensory aspects of the virtual environment are presented on a conventional computer monitor and the individual controls his or her movement by means of a joy-stick or other control devices (Rose, Attree, & Johnson, 1996).
Development of VR systems that allow patients to move and grasp virtual objects could rapidly change the nature of rehabilitation programs (Grealy, et al., 1999). Within health care settings, medical applications for VR include surgical simulators, telepresence surgery, and rehabilitation. Mental health has had an increasing level of acceptance and implementation of VR as a viable treatment option among psychologists, clinicians, and therapists (Mahoney, 1997).
Virtual Reality has been identified as an effective modality for the treatment of many mental disorders. In 1995, Hodges and Rothbaum conducted the first controlled study of VR therapy in the treatment of acrophobia (fear of height). In their study, Hodges and Rothbaum developed height-related virtual environments (e.g., a bridge and a glass elevator). The virtual environment was proven an effective means of reducing subjects' acrophobia. Since that time, similar results have been reported in the treatment of other types of phobias, such as the fear of flying and the fear of spiders (Carlin, Hoffman, & Weghorst, 1996). …