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Virtual Reality Therapy in France: A Therapeutic Innovation Between Technology and Care

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Abstract

The latest form of cognitive behavioral therapy, virtual reality therapy has been developing in France since 2012, in both university hospitals and private practices. Patients receiving this therapy are immersed in a digitally created environment, using a virtual reality headset, in order to be exposed to their phobias. How does the introduction of technical objects such as the virtual reality headset affect and transform the care relationship between the patient and the therapist? Based on an ethnographic study conducted between 2012 and 2018 in the psychiatric unit of a French university hospital, this article outlines the emergence of virtual reality therapy, describes how it operates, and analyzes how it shapes the patient-therapist relationship. I argue that this device—namely virtual reality therapy—promotes a new therapeutic style in psychiatry, whose format and therapeutic indications align with the requirements of evidence-based medicine.

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Notes

  1. Behavioral therapy (BT) was popularized by Burrhus Skinner in the US in the 1950’s, then has been enriched with cognitive therapy in the 1970 by Aaron Beck—considered as a “second wave” where it also got its actual acronym, cognitive and behavioural therapy (CBT). In the early 1990, other inspirations such as mindfulness, meditation-oriented therapy, and rational-emotive therapy has brought CBT to the actual “third wave”.

  2. All names and places collected on the field have been anonymized.

  3. A research area developed in the United States, Canada, and Australia in the 2000s, cyberpsychology focuses on the relationship between individuals and machines. It examines how technology affects individuals and how the introduction of virtual elements, such as VRT or online psychotherapy, transforms clinical practice.

  4. At the crossroads of technology and care, a new market for the creation of virtual environments has been emerging in France for 5 years. Several start-ups specialize in designing these “movies” and rent them out on a monthly subscription basis to practitioners seeking to develop VRT.

  5. The gradual exposure technique involves putting a patient in contact with anxiety-inducing stimuli until a reduction in the reaction to the phobia is achieved.

  6. The author’s name varies—it could be Marcel Proust or Frank Herbert.

  7. Amaxophobia is the fear of driving.

  8. The “AWARE model for coping with anxiety” is an anxiety-management model, derived from the theory of Aaron Beck, one of the founding fathers of cognitive therapy: Acknowledge anxiety (do not try to fight it), Watch anxiety (and rate its intensity from 0 to 10), Act through (slow down but keep doing what are doing), Repeat process (repeat the first three steps), Expect the best (reach your destination, rewarding yourself for the exposure to anxiety).

    https://specialtybehavioralhealth.com/wp-content/uploads/AWARE_Model.pdf.

  9. Sociological research funded by the Ministry of Health's Directory of Research, Study, Evaluation and Statistics on virtual reality for patients with addictions is currently underway. The survey is coordinated by Céline Borelle and Author ("Décrocher en ligne" / "Get off drugs online" 2022-2024) in three French university hospitals.

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Funding

This study was funded by the CEMS (EHESS) n°DAPI.

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  1. École des Hautes Études en Sciences Sociales, Centre d’Étude des Mouvements Sociaux, 54, boulevard Raspail, Paris 6e, France

    Elsa Forner-Ordioni

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  1. Elsa Forner-Ordioni
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Correspondence to Elsa Forner-Ordioni.

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I, Elsa Forner-Ordioni, author of the present paper, declare that I have no conflict of interest.

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Forner-Ordioni, E. Virtual Reality Therapy in France: A Therapeutic Innovation Between Technology and Care. Cult Med Psychiatry 47, 722–742 (2023). https://doi.org/10.1007/s11013-022-09801-5

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