Picture this: As you float peacefully in a crystal blue sea, dolphins swim gently around you. 

One performs a slow barrel roll, while another nudges its pod mate to play. 

They’re so close you could touch them.

While it may feel like you’re in the Caribbean somewhere, you’re actually more than a thousand miles away—in Princeton, N.J. 

This is virtual reality (VR), and while it is often used throughout the country as part of exposure therapy to treat patients with phobias, therapists at Penn Medicine Princeton House Behavioral Health Inpatient Service are among the first in the region to use it to help patients cope with general anxiety. 

“Virtual reality can help patients set aside outside distractions and focus on relaxation techniques that can be useful in reducing anxiety,” said Yuko Martin, MA, director of Allied Clinical Therapies at Princeton House Inpatient Service. “Most patients have reported a reduction in their anxiety after using VR.” 

An Effective Approach  

Anxiety disorders are among the most common mental health conditions in the United States, affecting nearly 30 percent of adults at some point in their lives, according to the American Psychiatric Association.

Traditional treatment for anxiety typically involves psychotherapy (talk therapy), medications or a combination of the two. 

Now virtual reality is also being used, and according to multiple research studies, is proving to be effective. 

By pairing VR technology with traditional therapies, a person with anxiety can be safely immersed in a therapeutic environment and develop valuable techniques, such as mindfulness, paced breathing or calming distraction to cope with heightened stress. 

“Using these techniques increases awareness of your physical and emotional reactions to stress as well as your surroundings,” Martin said. “By gaining this awareness you can change your perspective and responses to the stressor, even when you may not be able to change the situation.” 

VR in Action

Yuko Martin holding a virtual reality headset
Yuko Martin, MA, director of Allied Clinical Therapies at Princeton House Inpatient Service

Princeton House first began using virtual reality in June 2022 with patients experiencing co-occurring mental health and substance use disorders, including those receiving medical detoxification. Since then, the program called Coping with Anxiety Through Virtual Reality has been expanded to include patients with anxiety disorders without substance disorder. 

In the group sessions, patients are provided with VR headsets—which were purchased through a Princeton Health Innovations Grant from Princeton Medical Center Foundation—and asked to select two short programs to experience.

For the first part of the session, participants can choose from a number of breathing exercises, mindfulness exercises, and guided relaxation programs. 

Their second selection focuses on guided imagery and calming distraction, such as a visit to a tropical beach, a stroll through the romantic streets of Paris, or a swim with dolphins. 

After the programs are completed, the group discusses how they were impacted by what they experienced and how to apply what they practiced in the virtual world into their real-life situations.

While most patients can benefit from virtual reality therapy, they must meet certain safety criteria. For instance, patients with auditory or visual hallucinations, migraines, a history of seizures, or fall precautions would not be candidates. 

Positive Results  

“Virtual reality integrates with other therapies very well,” said Jennifer Sever, MA, senior allied clinical therapist at Princeton House. “Sometimes therapy can bring up distressing thoughts and feelings, and VR is another tool therapists can use to help patients regulate those feelings in the moment.” 

A board-certified registered art therapist, Sever also noted that she often invites patients to use art to capture something about their experience in the virtual world. 

“Not always in therapy do patients have something tangible they can take with them,” Sever said. “The created art becomes something that reminds them of the tools they learned through VR and helps them feel soothed.” 

Since the start of the program at Princeton House, more than 100 patients have participated in the virtual reality group. To evaluate the program, participants complete a survey before and after the sessions. 

On average, participants report a 35 percent reduction in anxiety after the sessions and give the program a 4.75 out of 5 rating for its helpfulness. 

“Nothing else can bring me to a calm, soothing place,” one participant wrote on the survey, noting they have an active mind, making it difficult to relax. “VR helps this active mind.” 

Another participant wrote that virtual reality “relaxed me and took the negativity away.” 

“Since adding VR to our therapeutic programming for those with anxiety, the results have been very positive.” Martin said. “Most of the participants find the VR programs help them relax easily and effectively. Now, they can use the new skills they’ve learned when they face difficult situations in real life.” 

To learn more about VR and other services offered at Penn Medicine Princeton House Behavioral Health, visit Princeton House Behavioral Health (princetonhcs.org)

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