VR Therapy Technology Overview
This tutorial explains the software, hardware, and Internet/Wi-Fi resources used to support VR therapy. Therapists reading this should keep in mind what resources they may need in order to use VR in their practice.
Technology resources explained below include:
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Software, also known as VR therapy products, content, or apps.
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Hardware for use by the client and therapist.
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Internet access via Wi-Fi, which is required for using certain products.
VR therapy requires a combination of software (or apps) and hardware that are compatible with each other, the conditions to be treated, and the type of therapy practice (in-office or teletherapy). Internet access via Wi-Fi may also be required.
A therapist should look for software or VR therapy products first, based on the needs of their practice. The next step is looking for hardware compatible with the selected therapy product. Some VR therapy products are bundled as packages that include both software and some or all of the necessary hardware.
This page provides an overview of VR therapy technology to help therapists determine what will be needed to use VR in their practice. SVRT also provides a series of buyer's guides for each item and template for cost analysis.
The process of using VR during therapy is described in VR Psychotherapy Overview and the process of selecting content for use as part of a client's treatment plan is discussed in Selecting VR Therapy Content.
Many therapists will only need one VR therapy product and a compatible VR headset. Their existing office computer may be usable as the therapist workstation for controlling and monitoring the client's virtual environment. Internet/Wi-Fi will be required but this is available in many offices.
Other therapists may have different requirements. For example, a tethered VR headset that requires a special computer, or a VR therapy product that does not require Internet/Wi-Fi.
Software
The primary software used as part of VR therapy are VR therapy products because these products provide a combination of content crafted for use in therapy and therapist workstation controls. These controls allow a therapist to select, control, and monitor their client's virtual reality experiences, and modify certain aspects of virtual environments, via the therapist workstation.
Augmented reality (AR) software options are currently limited to an app for tablets or smartphones that provides superimposed spiders and similar creatures for exposure therapy. This app should be controlled by the therapist and only suitable for use in-office (not teletherapy).
Other software programs and sources of 'supporting content' may also be used, either during a session or for client homework. These include consumer VR apps, non-VR consumer apps, and online content sources.
In the past, VR therapy products only supported exposure therapy. Today, most vendors offer VR products with content for all three major therapeutic usages: instruction, exposure therapy, and reward/relaxation (see the VR Psychotherapy Overview). However, vendors may package content in different ways. For example, some vendors offer content for exposure therapy separately from content for instruction and reward/relaxation. Other vendors offer products intended for treating one or more psychological diagnosis or condition that includes content for all three therapeutic usages.
Therapists who are getting started with VR may want to start by identifying one or two VR therapy products that meet their clinical needs, in terms of the psychological conditions they treat most often and other requirements. See the VR Therapy Product Buyer's Guide. Then look at what hardware is included with the selected VR therapy product(s)—if any—and what additional hardware may be required for using these product(s).
If you have access to a VR headset that can be reused, this may eliminate the need to purchase a VR headset for therapy. In this case, start by looking for therapy software products that are compatible with this VR headset, see the VR Therapy Product Buyer's Guide.
For help locating and evaluating supporting content, including selected VR and non-VR consumer apps, see the VR Therapy Supporting Content Buyer's Guide.
When evaluating multiple VR therapy product options, the VR Therapy Cost Analysis Guide provides templates can be used to estimate and compare the costs associated with each option including software, hardware, and Internet/Wi-Fi (if required).
Hardware
Most therapeutic uses of VR involve a client wearing a VR headset and experiencing a virtual environment that can be selected, controlled, and monitored by the therapist using a therapist workstation. While the client is in VR, the therapist can monitor what the client is seeing on their therapist workstation, provide instruction, and solicit feedback.
Variations on this scenario, each with different hardware requirements, include:
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In-office treatment: where therapist and client are in the same room.
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Teletherapy: where therapist and client are in different physical locations and interact via a video link.
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VR Homework: where the client makes use of VR between sessions, as instructed by the therapist. Clients can use consumer VR apps or VR content from other sources for homework; VR therapy products may not support client usage without therapist involvement.
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Augmented Reality (AR) where the client views an actual scene through a device that adds superimposed creatures or other images. For example, looking at a table through a smartphone camera/display combination and seeing CGI spiders walking on the tabletop.
The ability to use a VR therapy product for teletherapy depends on how the VR headset communicates with the VR therapist workstation. Teletherapy compatible products use the Internet/Wi-Fi for this communication. Products that are limited to in-office situations use short range communications or physical cables.
In-Office
In-office treatment is where the therapist and client are in the same location. During VR, the client wears a VR headset, and the therapist can control and monitor the client's virtual environment using VR therapy software and the display on the therapist workstation.
Typical equipment includes:
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VR headset (or head-mounted display) of any of the types described in the VR Headsets Buyer's Guide.
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VR Therapist workstation of any of the types described in the VR Therapist Workstation Buyer's Guide.
Optional equipment may include:
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VR Peripheral devices such as handheld controllers, special purpose controllers, vibrating platforms, etc. See the VR Peripheral Devices Buyer's Guide.
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Biofeedback devices for monitoring the client's biological responses, see the VR Therapy Biofeedback Devices Buyer's Guide.
Teletherapy
For teletherapy, the therapist and client are in different locations and communicate via video link or telephone. Video is strongly preferred over telephone for VR teletherapy so the therapist can observe what the client is doing.
VR peripheral devices are optional for teletherapy and typically would only include simple devices such as handheld controllers provided with a VR headset. Specialized peripherals are typically only used in-office.
Biofeedback devices are typically not practical for teletherapy unless the client also uses biofeedback for homework. Consider this on a case-by-case basis depending on the biofeedback device and the client's ability to utilize it.
Current smartphone-based augmented reality therapy products are only suitable for in-office use. The therapist cannot monitor or control the client's experience remotely, as needed for teletherapy.
For teletherapy, the therapist will typically need:
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Teletherapy video conferencing capability on their workstation or using a separate device.
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VR Therapist workstation for monitoring and controlling the client's virtual environment.
Note that a computer-based therapist workstation may be able to provide both functions simultaneously, as well as access to an electronic health record for charting. Tablet-based therapist workstations are more limited and may only support one function at a time.
Therapists who are doing teletherapy should also have access to a VR headset similar to the client's headset for troubleshooting and testing. These headsets typically require Internet/Wi-Fi.
For teletherapy, each client will need:
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Video conferencing device such as a smartphone, tablet, or computer.
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VR headset that can be any of the types described in VR Headsets Buyer's Guide but is likely to be one of the simpler/less expensive types. Note that clients will need two devices and cannot use a single smartphone for video conferencing and a smartphone-based headset simultaneously.
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Optionally, peripheral equipment such as handheld controllers. Certain VR headsets come with associated handheld controllers.
Clients may obtain VR equipment in various ways:
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Some clients (or their children) may have suitable VR headsets for other uses.
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Clients may be willing to purchase VR equipment specifically for therapy and homework.
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Therapists or clinics can arrange for VR headset rental or loans.
If clients are obtaining their own equipment, you should provide:
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Detailed specifications for suitable VR equipment including compatible brands, models, etc.
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Instructions for setting up their equipment for use with your VR therapy products including setting up network access, installing any apps/software, etc.
When considering teletherapy with a client:
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Ask yourself: Is this person a suitable client to treat when you are not physically near them to monitor and comfort them as needed? Are they prone to strong emotional distress or likely to react negatively to VR?
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Do you know the physical location of your client, what crisis resources are available at the client's location, and how to contact these resources if needed?
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Are you and your client comfortable with the technology? Do you have a plan if there is a technical glitch? What will you each do if there is a poor connection, the VR stops, etc.?
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Document that the client has given informed consent for teletherapy.
VR Homework
Homework can be part of in-office therapy or teletherapy. In-office clients will need a VR headset if their homework includes VR. Teletherapy clients will already have a VR headset.
Hardware required for VR homework includes a VR headset compatible with the homework software. This can be any of the types described in VR Headsets Buyer's Guide, especially a smartphone-based headset or other less expensive options.
Peripheral equipment is optional for VR homework unless the devices come with the headset. For example, certain headsets are sold with handheld controllers and software designed for these headsets typically requires using these controllers.
Augmented Reality
Currently there is only one augmented reality (AR) therapy product in the VR Therapy Product Buyer's Guide. This is an app for a smartphone or tablet computers designed for use as part of exposure for specific phobias of spiders, animals, etc. The user can view a scene using the device camera and sees CGI images of the phobic creature superimposed onto the scene, similar to Pokémon Go. This app more suitable for in-office use where the therapist can control the app settings than for teletherapy or homework.
Other AR hardware devices are becoming available including combined VR/AR headsets and AR glasses. Currently these devices are not supported by VR therapy products.
Internet/Wi-Fi
Most, but not all, VR therapy products require Internet access via Wi-Fi at the therapist's location, including all products that support teletherapy. Situations where Internet/Wi-Fi access is not provided may require adding this service to support VR therapy or only considering VR therapy products that do not require Internet/Wi-Fi.
Check with the vendor for each VR therapy product under consideration and ask if Internet/Wi-Fi access is required for the therapist workstation and/or VR headset.
Most VR therapy products use the Internet to coordinate the display and controls on the therapist's workstation with the virtual environment displayed in the VR headset, and for other functions. Computer-based therapist workstations can connect to the Internet using either Wi-Fi or a cable (Ethernet). Most tablet-based therapist workstations and VR headsets (but not all) connect to the Internet via Wi-Fi.
Internet access via Wi-Fi is available at many therapist work locations. However, there are exceptions which may require workarounds (as explained below). Exceptions include work locations without any Internet access, locations that have wired Internet access but not Wi-Fi, and locations where VR therapy equipment is not allowed to access the existing Internet/Wi-Fi service.
Workaround options for the lack of Internet/Wi-Fi access include:
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Installing Internet access/Wi-Fi specifically for VR therapy use. See the VR Therapy Internet/Wi-Fi Buyers Guide for more information.
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Considering only VR therapy products that do not require Internet/Wi-Fi access, as explained below.
There are alternatives for locations where Internet/Wi-Fi cannot be used. For example, BehaVR offers a product (originally from Limbix VR) that includes a standalone VR headset paired with a dedicated tablet computer as the VR therapist workstation. These devices communicate with each other using short-range wireless networking so that Internet/Wi-Fi access is not required. This product is not cannot be used for teletherapy.
Next Steps
If you need to do a cost analysis to compare the costs of multiple options or to cost justify the investment required for VR therapy, see the VR Therapy Cost Analysis Guide.
For help choosing between available options see the SVRT Buyers Guides:
