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Barcelona rooftop

Barcelona rooftop

In this scenario we can see the city of Barcelona from the highest point of a building. Moreover, the healthcare professional can control exposure to anxiogenic interoceptive sensations.

  • Heart Volume
  • Heart Rate
  • Breath Volume
  • Breath Rate

On the other hand, thereʼs the possibility of practicing a relaxation exercise in order to reduce the patientʼs anxiety and to teach him how to use these techniques and how to apply them in real life.

HOW TO APPLY COGNITIVE BEHAVIORAL TECHNIQUES WITH AMELIA VIRTUAL CARE?

The virtual reality environments and especially the last two can be used for verbal and behavioral questioning of the negative thoughts of the patient.

The fact of being in the situation will facilitate the evocation of recurrent thoughts that it produces. Thus, the healthcare professional will be able to question them and the patient will internalize the procedure, which he will be able to apply more easily when in his real life he finds himself facing the feared situation.

In the same way, the patient will be able to test the most feared consequences of the situation, previously discussed with the healthcare professional, and verify that they are not being complied with.

For example, the healthcare professional has an acrophobic patient who believes that if his or her eyesight is clouded, he or she will probably faint, fall and eventually die. In this case, patient and healthcare professional can prove repeatedly in the virtual environment (New York or Barcelona) that in spite of experiencing these sensations, they are controllable, and their predictions are erroneous and are not fulfilled.

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Metro en hora punta

Metro en hora punta

Al inicio del entorno el paciente se encuentra dentro de la estación de metro y se dirige hacia el andén. Cuando llega el tren se sube en un vagón que va bastante lleno. 

Permanecerá en él unos minutos hasta bajar en otra estación, donde empezará a andar para salir finalmente a la calle.

Duración: 5’18’’
Dificultad: media

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Subway at rush hour

Subway at rush hour

At the beginning of the environment, the patients find themselves inside a subway station and head towards the platform. When the train arrives, they board a fairly crowded subway car.

They will ride for a few minutes until they get off at another station, where they will then walk until they reach the exit to the street.

Length: 5’18’’ 
Difficulty: medium

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Walk through a wharf

Walk through a wharf

The patient will take a walk along a very touristic port, where there are some other people.

Length: 3’12’’ 
Difficulty: medium

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Paseo por el puerto

Paseo por el puerto

El paciente se encontrará dando un paseo por el puerto, una zona muy turística en la que hay bastante gente.

Duración: 3’12’’
Dificultad: media

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Very crowded boulevard

Very crowded boulevard

This environment puts the patient in a situation where they have to walk through a busy street. There are quite a few people around them walking in both directions (which can unleash feelings of distress , flushing, etc).

Length: 4’ 42’’
Difficulty: high

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Rambla con mucha gente

Rambla con mucha gente

Este entorno permite exponer al paciente a un paseo por una calle muy concurrida, en la que verá en todo momento bastante cantidad de gente a su alrededor andando en los dos sentidos, lo que le puede desencadenar una sensación de agobio, sofoco, etc.

Duración: 4’43’’ 
Dificultad: alta

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Walk through the public square

Walk through the public square

In this environment, we are in an open square.

SETTINGS VARIABLES
  • Crowdedness
    Empty / Few people / Half full / Mass amount of people
  • Gender
    Choose between a male or female body. A neutral body is selected by default.
  • Skin tone
    Choose the skin tone that best represents your patient to enhance the feeling of immersion.
  • Sanitary mask
    You can choose whether or not the people around you will have a mask.

This virtual environment has been designed to work on the cognitive part of agoraphobia. It is important to get the patient involved in the situation. In order to get the patient involved involved in the situation, here are some examples of indications or questions you can use for this purpose:

  • You are alone/accompanied by/waiting for somebody in a square.
  • You are in a square located at 1/10/45 minutes away from your homes
  • You are in this square and you hear two people saying that in 10 minutes there’ s going to be a demonstration two streets away from the square.
  • Do you think the people around you have noticed that you’ re nervous?

In this environment, you can also practice panic attack management by adding interoceptive effects and practicing relaxation or thought stopping techniques.

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Environment

Paseo por la plaza

Paseo por la plaza

Nos encontramos en medio de una plaza muy amplia.

VARIABLES DE CONFIGURACIÓN
  • Cantidad de gente
    Nadie / Poca / Media / Mucha
  • Género
    Elige entre un cuerpo de hombre o de mujer. Por defecto será un cuerpo neutro.
  • Tono de piel
    Elige el tono de piel que mejor representa a tu paciente para mejorar la sensación de inmersión.
  • Mascarilla sanitaria
    Se podrá elegir si las personas del entorno tendrán o no mascarilla.

Este entorno virtual se ha diseñado para trabajar sobre la parte cognitiva. Primero hay que poner la persona en situación a través de indicaciones como:

  •  Estás en una plaza que se encuentra a 1/10/45 minuto(s) de tu casa.
  • Estás solo/acompañado esperando a alguien en una plaza.
  • Estás en esta plaza y escuchas que unos señores comentan que hay una manifestación muy cerca.
  • ¿Crees que la gente que tienes cerca se ha percatado de que estás nervioso?

En este entorno también se puede practicar el manejo de los ataques de pánico añadiendo efectos interoceptivos y practicando técnicas de relajación o parada del pensamiento.

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Street

Street

The avatar is located in the middle of a pedestrian walkway next to a series of bar terraces.

VARIABLES SETTINGS
  • Amount people present
    None / Few / Maximum
  • Sanitary mask
    You can choose whether or not the people around you will have a mask.

To immerse the patient in the situation, similar indications (as mentioned in Square Environment description) can be used.

After immersing the patient in the situation, the healthcare professional should ask them to elaborate on their thoughts. Again, we can find more suggestions in section 6 of this manual. 

In addition, you can practice handling attacks of panic by adding interoceptive effects and practicing relaxation or thought-stopping techniques.