Researchers Look to Virtual World Technology to Enhance Psychological Health Care

WASHINGTON, DC—Civilian and military experts gathered to discuss the use of virtual world technology to address psychological health for servicemembers, veterans, and their families at a conference held by the National Center for Telehealth & Technology (T2) in August.

A virtual world is a three-dimensional computer-based simulation environment that users can inhabit and interact via avatars. Currently, stigma and access issues sometimes prevent servicemembers and veterans from receiving mental health help.

Virtual worlds may offer another avenue to engage young people when it comes to psychological health care, according to Kevin M Holloway, PhD, a clinical psychologist with DoD’s T2. “We want to learn to leverage technology to address some of the challenges of receiving mental health care [and] education services for outreach.”

A virtual world has the benefit of allowing users some anonymity since they are interacting with their environment via an avatar. In addition, environments that are difficult or impossible to replicate in real life can be created in a virtual world, Holloway said.

Holloway acknowledged that virtual world technology may not be the right solution for every scenario, but by exploring its use researchers will have a better idea of when it could be suitable to use. “If we continue to learn more about virtual worlds and the possibilities that are there, and we are trying out different functions, we will have a better sense for what are they well suited for and what are they not well suited for.”

Virtual Island in Second Life

As a way to reduce the stigma in receiving mental health care, T2 researchers are currently developing a “virtual island” in Second Life ( that aims to give servicemembers a virtual learning experience about PTSD. Second Life is a free 3D virtual world where any user can connect online.

Users of the virtual island will be able to participate and interact in a scenario via an avatar that simulates a combat situation at various intensities of their choosing. The tool is designed to offer education on PTSD and how to get help for it through a participatory experience. “The reason we are doing this is to really illustrate how PTSD may be acquired,” according to Holloway.

The simulated combat scenario is designed to set up the message that PTSD is a normal human response to a traumatic event and that what is abnormal is the traumatic event. The virtual experience will also address how avoidance after the event of trauma can actually help to prolong PTSD symptoms. Another segment of the experience will take the user in a shopping mall where the user learns what it is like to have PTSD symptoms and how they might manifest.

Users will also be educated about available treatments and how to get help. Holloway said that the virtual island is an education tool that researchers hope will help servicemembers to seek care if they need it.

Researchers, he said, wanted to design a tool that could be easily accessed by servicemembers. Users will be able to access this virtual experience online 24-hours a day, seven days a week on a personal computer for free.

Virtual World Technology for Training and Resilience

Randy Hinrichs, managing partner of 2b3d, a company that builds virtual world strategies and solutions, said research shows that young people in the US will have spent about 10,000 hours gaming by the time he or she is age 21. This compares to the 10,080 hours young people spend in school between the 5th grade and 12th grade, if they have not missed a single day.

If virtual world technology is harnessed for educational means it could be transformative, he said. “What if we start to engage in virtual worlds that are meaningful, where we can use virtual worlds to do simulations of nursing events and you can bring entire classrooms into the environment and put them together,” he said at the conference.

CDC Behavioral Scientist Richard W Klomp, who runs CDC’s Workforce and Responder Resiliency Program in the Office of Health and Safety, said that CDC is using virtual reality technology as part of resiliency training for deploying staff.

Klomp said that as CDC staff have deployed to an increased number of disasters and events around the world in recent years there has been concern about their resiliency. “About 10 or 12 years ago CDC was sending very few people out in response to very limited emergency situations. We would send maybe a dozen. When Hurricane Katrina hit we sent over 1,000 people to participate in that,” said Klomp.

Staff, he said, is often exposed to dead bodies and human suffering in its response efforts around the world, such as the tsunami in 2004 and Hurricane Katrina in 2005. Staff members that participate in the resiliency training are able to immerse in a virtual reality environment to prepare for some of the stressful scenarios they might encounter.

Klomp said that smells are included in the experience with scents that are contained in little jars—such as body odor, garbage, or urine—that can be released while the user participates in the virtual experience. “We want to prepare these individuals for the kinds of sights, sounds, and smells that they will likely encounter when they are out in the field.”

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