Intervention proposal
“All the information contained in this section is for guidance only. Psious environments are therapy supporting tools that must be used by the healthcare professional within an evaluation and intervention process designed according to the characteristics and needs of the user.
Also remember that you have the General Clinical Guide in which you have more information on how to adapt psychological intervention techniques (exposure, systematic desensitization, cognitive restructuring, chip economy…) to Psious environments.”
Example of intervention in Social Anxiety
The general work dynamics for VR sessions in social anxiety and Social Skills problems (HHSS) are presented below:
- The healthcare professional presents the situation / environment to the patient: “You are in a bar with some friends speaking of various topics, you can intervene at certain times by giving your opinion… ”It is positive to carry out a simulation in consultation, where the healthcare professional encourages the patient to talk about a specific topic (better if it is one of the topics that will be discussed in the environment) and where the healthcare professional offers an assertive model of behavior (give an opinion, make a request, etc.)
- The exposure begins and in this way the patient can reproduce what he has observed in the model.
- After the exposure, the healthcare professional gives feedback to the patient about his execution: positive reinforcement of behaviors and proposals for improvement with forms of alternative models that the patient can rehearse in the consultation, repeating the event of VR and at home.
- The exposure and the work dynamics of the modeling are repeated.
SESSION 1
Psychoeducation: Inform the patient about social anxiety (Causes, symptoms, prevalence …)
- Present and justify the techniques that will be used throughout the treatment: exposure with virtual reality and live exposure …
- Elaboration of the exposure hierarchy and exposure to items of the hierarchy of 20-30 USA’s (example)
- Start the exposure hierarchy with an item close to 30 USA’s.
| ITEM | SUD’s | ENVIRONMENT | CONFIGURATION | EVENT |
|---|---|---|---|---|
| Being in a bar with some lifelong friends and listening to how they talk | 20 | Bar in a group | Friendly | No Events |
| Have the waitress bring the bill and thank you kindly | 25 | Bar in a group | Friendly | Ask for a bill |
| Say goodbye to two friends who They leave the bar | 30 | group bar | Friendly | Farewell |
| Thank a colleague who pays the bill | 40 | group bar | Friendly | Request account |
SESSION 2
- Review of achievements in the previous session and goal setting for the current session: Call the waitress to order the drink.
- Exposure begins with gradual and systematic response prevention with virtual reality. Cognitive restructuring, if applicable.
- The reports are shown to the patient to see the clinical progress.
TASKS FOR HOME
Live exhibition meeting a couple of friends and listening to them talk.
| ITEM | SUD’s | ENVIRONMENT | CONFIGURATION | EVENT |
|---|---|---|---|---|
| A friend makes a positive comment about what I just said | 45 Group | Bar | Friendly | No Events |
| Have your friends ask you to give your opinion on what they are talking about | 50 Group | Bar | Friendly | No Events |
| Tell the waitress what Do you want to drink | 55 Group | Bar | Friendly | Order a drink |
| Call the waitress to order a drink | 60 Group | Bar | Friendly | Order a drink |
SESSION 3
- Review the achievements of the previous session and goal setting for the current session: having to call the waitress to change the drinks he had already brought.
- Exposure begins with gradual and systematic response prevention with virtual reality. Cognitive restructuring, if applicable.
- The reports are shown to the patient to see the clinical progress.
TASKS FOR HOME
Live exhibition in a place known to the patient, talking and listening to a couple of friends; if you feel comfortable, order the drink.
| ITEM | SUD’s | ENVIRONMENT | CONFIGURATION | EVENT |
|---|---|---|---|---|
| Ask the waitress where the bathroom is and to answer you very cordiallyAsk | 60 Group | Bar | Friendly | Bathroom |
| you to call the waitress to ask for the bill | 65 Group | Bar | Friendly | Ask for account |
| They ask you to call the waitress to change the drink | 70 Group | bar | Kind | Drink change |
SESSION 4
- Review of the achievements of the previous session and goal setting of the current session: Call the waitress and be unkind.
- Exposure begins with gradual and systematic response prevention with virtual reality. Cognitive restructuring, if applicable
- Reports are shown to the patient to view clinical progress.
TASKS FOR HOME
Live exhibition calling a waitress to ask where the bathroom is, the bill, etc. + covert exposure at home repeating the process worked in consultation through imagination.
| ITEM | SUD’s | ENVIRONMENT | CONFIGURATION | EVENT |
|---|---|---|---|---|
| Being in a bar with friends who are angry and distant | 70 | Bar in a group | Unfriendly | Bathroom |
| Hearing that a friend only makes negative comments about what others say | 75 | Bar in a group | Unfriendly | Ask for an account |
| Call the waitress to order the drink and be unkind | 80 Group | bar | Unfriendly | Drink change |
SESSION 5
- Review of the achievements of the previous session and goal setting of the current session: They ask you for your opinion on a topic that you do not master.
- Exposure begins with gradual and systematic response prevention with virtual reality. Cognitive restructuring, if applicable.
- Repeat 2 times each of the exercises.
- Reports are shown to the patient to view clinical progress.
TASKS FOR HOME
Covert exhibition reviewing the process followed in the session.
| ITEM | SUD’s | ENVIRONMENT | CONFIGURATION | EVENT |
|---|---|---|---|---|
| Having to call the waitress because they have asked you unkindly to lower the air conditioning | 80 | Bar in a group | Unfriendly | Temperature |
| That after asking the waitress where the bathroom is, he answers you in a bad way | 85 | Bar in a group | Unkind | Bathroom |
| Being asked for your opinion on a topic that you do not dominate in a brusque and unkind way | 90 Group | bar | Unfriendly | No event |
SESSION 6
- Review of achievements in the previous session and goal setting for the current session: Hear negative comments from a friend after asking the waitress where the bathroom is.
- Exposure begins with gradual and systematic response prevention with virtual reality. Cognitive restructuring, if applicable.
- Repeat 2 times each of the exercises
- Reports are shown to the patient to see the clinical progress.
TASKS FOR HOME
Imaginal exhibition reviewing the process followed in consultation.
| ITEM | SUD’s | ENVIRONMENT | CONFIGURATION | EVENT |
|---|---|---|---|---|
| Call the waitress to change your drink and make it seem like she responds angrily | 90 Group | bar | Not friendly | Drink change |
| Have a friend give you a critical comment after you comment on the topic of conversation | 95 Group | bar | Unfriendly | No event |
| After asking the waitress where the bathroom is, hearing a friend comment that why don’t I go and see where it is instead of bothering the waitress | 100 Group | bar | Unfriendly | Bathroom |