“Toda la información contenida en este apartado es de carácter orientativo. Los entornos de Psious son herramientas de apoyo terapéutico que deben ser utilizadas por el profesional de la salud dentro de un proceso de evaluación e intervención diseñado según las características y necesidades del usuario.
Recuerda además que dispones de la Guía Clínica General en la que tienes más información sobre cómo adaptar las técnicas de intervención psicológica (exposición, desensibilización sistemática, reestructuración cognitiva, economía de fichas…) a los entornos de Psious.”
Objetivos de evaluación
Evaluar presencia y comorbilidad de otros trastornos emocionales, en especial agorafobia, trastorno por pánico y otras fobias.
Evaluar ansiedad asociada a componentes: asfixia y restricción (falta de control).
Definir configuraciones estimulares temidas por el paciente y en qué grado. Elaboración jerarquía de exposición.
Evaluar la presencia de pensamientos distorsionados. En el caso de la RMN, en especial aquellos asociados a asfixia, posibles daños causados por la máquina y miedo a perder el control.
Algunos instrumentos útiles para la evaluación de la Claustrofobia
Teniendo en cuenta los objetivos de evaluación pasamos a enumerar algunas herramientas que pueden serte útiles para obtener información relevante sobre las características de tu usuario. Recuerda que una buena definición de objetivos, caracterización del paciente y planificación de la intervención son importantes para la eficiencia y eficacia terapéutica, así como para la satisfacción de tu usuario. En la bibliografía encontrarás los artículos en los que revisar las características de los instrumentos propuestos a continuación:
Claustrophobia Questionnaire (CLQ) – Adaptación española
Claustrophobia Situations Questionnaire (CSQ)
Claustrophobia General Cognitions Questionnaire (CGCQ).
Autoinformes Psious para la elaboración de la jerarquía
Desarrollo de la jerarquía de exposición con entornos Psious
Una vez que tenemos la información de la evaluación podemos proceder a elaborar la jerarquía de exposición. Para ello, podemos realizar una serie de preguntas (ej. ¿Qué nivel de malestar, en una escala de 0 a 100, te genera estar en el rellano esperando un ascensor grande?, ¿Qué nivel de malestar, en una escala de 0 a 100, te generaría quedarte encerrado, por una avería, en un ascensor pequeño lleno de gente?, ¿Crees que hay algo que pueda generarte un malestar aún mayor?) dirigidas a planificar la intervención mediante la realidad virtual.
Ejemplo de jerarquía
En el apéndice encontrarás una herramienta autoinformada para obtener la jerarquía de actuación usando los entornos de Psious.
According to the American Psychiatric Association, claustrophobia is the fear of being enclosed in small spaces or the feeling of enclosure and/or the fear of not being able to flee. Symptoms are similar to those experienced in a panic Virtual Claustrophobia and virtual reality attack or similar manifestations (dizziness, falls, vomiting, cardiac discomfort, etc). As a consequence, the person tries to avoid these situations limiting their daily lives. With reference to the differential diagnosis, it is important to evaluate (Rachman, S., & Taylor, S.,1993), the fear of immobility and/or running out of breath, or in other words, the oxygen in the space where the person is located runs out (e.g an elevator).
Furthermore, cognitive behavioral therapy relies upon vast observational evidence in terms of evaluating and intervening in this type of psychopathology (Öst, L.-G., et al., 1982; McIsaac, H.K. et al., 1998; Öst, L.-G., et al., 2001 y Thorpe, S. et al. 2008). Nonetheless, ongoing fundamental research continues (Stella F.et al., 2011) seeking explanations as to what the causes of claustrophobia may be.
Virtual reality is an effective alternative tool to the traditional techniques used in the treatment of emotional disorders, including claustrophobia (Botella, C. et al. 1998; Botella, C. et al., 2000; M Krijn et al., 2004; Botella et al., 2012). Virtual reality allows standardization and control over the parameters in exposure sessions. Moreover, it is particularly useful for repeating the exposure to feared situations as many times as needed, providing flexibility and customized therapeutic procedures.
Psious’ environments facilitate the use of multiple psychological intervention techniques: exposure, cognitive reconstruction, systematic desensitization, social skills training… in order to achieve better results, use the most suitable technique that best suits the patient’s characteristics and base your intervention on those techniques with more empirical support.
Según la Asociación Americana de Psiquiatría, la claustrofobia es el miedo a encontrarse en un espacio o una situación en los que se teme estar encerrado y/o de difícil huida. Los síntomas son similares a los vividos durante un ataque de pánico o manifestaciones similares (mareos, caídas, vómito, incomodidades cardíacas, etc.). Como consecuencia, la persona trata de evitar este tipo de situaciones limitando su vida cotidiana. Para el diagnóstico diferencial es importante evaluar (Rachman, S., & Taylor, S.,1993), el miedo a la inmovilidad o/y a quedarse sin aire, es decir, que se agote el oxígeno del espacio en el que se halla la persona (un ascensor, por ejemplo).
Por otro lado, la psicoterapia cognitivo-conductual cuenta con amplia evidencia empírica en cuanto a la forma de evaluar e intervenir en este tipo de psicopatología (Öst, L.-G., et al., 1982; McIsaac, H.K. et al., 1998; Öst, L.-G., et al., 2001 y Thorpe, S. et al. 2008). Aun así, se continúa con investigación básica (Stella F. et al., 2011) para intentar explicar las causas de la claustrofobia.
La realidad virtual resulta una buena herramienta alternativa a las técnicas tradicionales usadas en el tratamiento de los trastornos emocionales, entre ellos de la claustrofobia (Botella, C. et al. 1998; Botella, C. et al., 2000; M Krijn et al., 2004; Botella et al., 2012). La realidad virtual permite la estandarización y el control sobre los parámetros de las sesiones de exposición. Así mismo, es particularmente útil para repetir la exposición a las situaciones temidas las veces que sea necesario, facilitando la personalización y flexibilización del proceso terapéutico.
Los entornos de Psious te permiten la utilización de diversas técnicas de intervención psicológica: exposición, reestructuración cognitiva, desensibilización sistemática, entrenamiento en habilidades sociales… Utiliza las que sean más adecuadas a las características de tu paciente y básate en aquellas con mayor apoyo empírico para obtener mejores resultados.
Arce, R., Velasco, J., Novo, M., & Fariña, F. (2014). Preparation and validation of a scale for the evaluation of bullying. Iberoamerican Journal of Psychology and Health, 5 (1), 71–104.
Birleson P. Hudson I, Gray-Buchanan D, Wolff S. (1987). Clinical Evaluation of a Self-Rating Scale for Depressive Disorder in Childhood (Depression Self-Rating Scale). J. Child Psychol. Psychiat 28, 43-60 https://doi.org/10.1111/j.1469-7610.1987.tb00651.x
Cerezo, F. (1997). Aggressive behavior at school age. Madrid: Pyramid.
Da Silva, JL, de Oliveira, WA, de Mello, FC, de Andrade, LS, Bazon, MR, & Iossi Silva, MA (2017). Anti-bullying interventions in schools: a systematic literature review. Ciência & Saúde Coletiva, 22 (7), 2329–2340. https://doi.org/10.1590/1413-81232017227.16242015
Del Barrio, V., Moreno-Rosset, C., López-Martínez, R., (1999). The Children’s Depression Inventory [CDI; Kovacs, 1992]. Its application in the Spanish population. Clinica y Salud 10, 393-416.
Ezpeleta, L., De La Osa, N., Domenech, JM, Navarro, JB, & Losilla, JM (1997). Test-retest reliability of the Spanish adaptation of the diagnostic interview for children and adolescents (DICA-R). Psicothema, 9 (3), 529–539.
García Pérez, EM and Magaz Lago, A. (2011 a). PEE Profile of educational styles (ed. Rev.). Bilbao: COHS Human Sciences Consultants.
García Pérez, EM and Magaz Lago, A. (2011 b). EMA Magellan Adaptation Scales (ed. Rev.). Bilbao: COHS Human Sciences Consultants.
Hollon, SD, & Kendall, PC (1980). Cognitive self-statements in depression: Development of an automatic thoughts questionnaire. Cognitive Therapy and Research, 4 (4), 383–395. https://doi.org/10.1007/BF01178214
Hirigoyen, MF (1999). Moral harassment. Barcelona: Paidós.
Irurtia Muñiz, MJ, Avilés Martínez, JM, Arias González, V., & Arias Martínez, B. (2009). The treatment of victims in the resolution of bullying cases. AMAzônica (Revista de Psicopedagogia, Psicologia Escolar E Educaçao), 2 (1), 76–99.
Kirisci, L., Clark, DB, & Moss, HB (1997). Reliability and Validity of the State-Trait Anxiety Inventory for Children in Adolescent Substance Abusers: Journal of Child & Adolescent Substance Abuse, 5 (3), 57–70.
Kovacs, M. (1992). Children’s Depression Inventory (CDI). Toronto, ON: Multi-Health Systems Inc.
Langer, LI, Aguilar-Parra, JM, Ulloa, VG, Carmona-Torres, JA, & Cangas, AJ (2016). Substance Use, Bullying, and Body Image Disturbances in Adolescents and Young Adults Under the Prism of a 3D Simulation Program: Validation of MySchool4web. Telemedicine and E-Helath, 22 (1), 18–30. https://doi.org/10.1089/tmj.2014.0213
Melero, S. (2017). Cognitive-behavioral intervention in an adolescent victim of bullying. With Children and Adolescents, 4, 149–155.
Morán Sánchez, C. (2006). Cognitive-behavioral intervention in bullying: a clinical case of bullying, 2, 51–56.
Piñuel, I and Oñate, A. (2007a). AVE, Harassment and School Violence Test. Madrid: TEA Editions.
Piñuel, I. and Oñate, A. (2007b) Bullying and School Violence in Spain: Report Cisneros X. Madrid: IIEDDI
Pynoos, RS, Frederick, C., Nader, K., Arroyo, W., Steinberg, A., Eth, S., et al. (1987). Life threat and posttraumatic stress in school-age children. Archives of General Psychiatry, 44, 1057–1063.
Quero, S., Andreu-Mateu, S., Moragrega, I., Baños, RM, Molés, M., Nebot, S., & Botella, C. (2017). A Cognitive-Behavioral Program Using Virtual Reality for the Treatment of Adaptive Disorders: A Case Series. Argentine Journal of Psychological Clinic, 26 (1), 5–18.
Reynolds, CR and Richmond, BO (2012). CMASR-2. Revised Anxiety Scale in Children Revised (2nd ed). Mexico: Modern Manual.
Seinfeld, S., Arroyo-Palacios, J., Iruretagoyena, G., Hortensius, R., Zapata, LE, Borland, D., … Sanchez-Vives, MV (2018). Offenders become the victim in virtual reality: impact of changing perspective in domestic violence. Scientific Reports, 8 (1), 1–11. https://doi.org/10.1038/s41598-018-19987-7
Serrano, A. and Iborra, I. (2005). Report Violence between classmates at school. Valencia, Spain: Reina Sofía Center for the Study of Violence. Recovered from http://www.centroreinasofia.es
Schwartz, D. (2000). Subtypes of Victims and Aggressors in Children’s Peer Groups. Journal of Abnormal Child Psychology, 28 (2), 181–192.
[ DISCLAIMER: This document has been automatically translated using Google Translate. ]
Arce, R., Velasco, J., Novo, M., & Fariña, F. (2014). Elaboración y validación de una escala para la evaluación del acoso escolar. Revista Iberoamericana de Psicología Y Salud, 5(1), 71–104.
Birleson P. Hudson I, Grey-Buchanan D, Wolff S. (1987). Clinical Evaluation of a Self-Rating Scale for Depressive Disorder in Childhood (Depression Self-Rating Scale). J. Child Psychol. Psychiat 28, 43-60 https://doi.org/10.1111/j.1469-7610.1987.tb00651.x
Cerezo, F. (1997). Conductas agresivas en la edad escolar. Madrid: Pirámide.
Da Silva, J. L., de Oliveira, W. A., de Mello, F. C., de Andrade, L. S., Bazon, M. R., & Iossi Silva, M. A. (2017). Anti-bullying interventions in schools: a systematic literature review. Ciência & Saúde Coletiva, 22(7), 2329–2340. https://doi.org/10.1590/1413-81232017227.16242015
Del Barrio, V., Moreno-Rosset, C., López-Martínez, R., (1999). El Children’s Depression Inventory [CDI; Kovacs, 1992]. Su aplicación en población española. Clínica y Salud 10, 393-416.
Ezpeleta, L., De La Osa, N., Domenech, J. M., Navarro, J. B., & Losilla, J. M. (1997). Fiabilidad test-retest de la adaptación española de la diagnostic interview for children and adolescents (DICA-R). Psicothema, 9(3), 529–539.
García Pérez, E. M. y Magaz Lago, A. (2011 a). PEE Perfil de estilos educativos (ed. rev.). Bilbao: COHS Consultores en Ciencias Humanas.
García Pérez, E. M. y Magaz Lago, A. (2011 b). EMA Escalas Magallanes de Adaptación (ed. rev.). Bilbao: COHS Consultores en Ciencias Humanas.
Hollon, S. D., & Kendall, P. C. (1980). Cognitive self-statements in depression: Development of an automatic thoughts questionnaire. Cognitive Therapy and Research, 4(4), 383–395. https://doi.org/10.1007/BF01178214
Hirigoyen, M.F. (1999). El acoso moral. Barcelona: Paidós.
Irurtia Muñiz, M. J., Avilés Martínez, J. M., Arias González, V., & Arias Martínez, B. (2009). El tratamiento de las víctimas en la resolución de los casos de Bullying. AMAzônica (Revista de Psicopedagogia, Psicologia Escolar E Educaçao), 2(1), 76–99.
Kirisci, L., Clark, D. B., & Moss, H. B. (1997). Reliability and Validity of the State-Trait Anxiety Inventory for Children in Adolescent Substance Abusers: Journal of Child & Adolescent Substance Abuse, 5(3), 57–70.
Kovacs, M. (1992). Children’s Depression Inventory (CDI). Toronto, ON: Multi-Health Systems Inc.
Langer, L. I., Aguilar-Parra, J. M., Ulloa, V. G., Carmona-Torres, J. A., & Cangas, A. J. (2016). Substance Use, Bullying, and Body Image Disturbances in Adolescents and Young Adults Under the Prism of a 3D Simulation Program: Validation of MySchool4web. Telemedicine and E-Helath, 22(1), 18–30. https://doi.org/10.1089/tmj.2014.0213
Melero, S. (2017). Intervención cognitivo-conductual en una adolescente víctima de acoso escolar. Con Niños Y Adolescentes, 4, 149–155.
Morán Sánchez, C. (2006). Intervención cognitivo-conductual en el acoso escolar: un caso clínico de bullying, 2, 51–56.
Piñuel,I y Oñate, A. (2007a). Test AVE, Acoso y Violencia Escolar. Madrid: TEA Ediciones.
Piñuel, I. y Oñate, A. (2007b) Acoso y Violencia Escolar en España: Informe Cisneros X. Madrid: IIEDDI
Pynoos, R. S.,Frederick, C., Nader, K., Arroyo, W., Steinberg, A., Eth, S., et al. (1987). Life threat and posttraumatic stress in school-age children. Archives of General Psychiatry, 44, 1057–1063.
Quero, S., Andreu-Mateu, S., Moragrega, I., Baños, R. M., Molés, M., Nebot, S., & Botella, C. (2017). Un Programa Cognitivo-Conductual Que Utiliza La Realidad Virtual Para El Tratamiento De Los Trastornos Adaptativos: Una serie de casos. Revista Argentina de Clínica Psicológica, 26(1), 5–18.
Reynolds, C.R y Richmond, B. O. (2012). CMASR-2. Escala de Ansiedad Manifiesta en Niños Revisada (2ª ed). México: Manual Moderno.
Seinfeld, S., Arroyo-Palacios, J., Iruretagoyena, G., Hortensius, R., Zapata, L. E., Borland, D., … Sanchez-Vives, M. V. (2018). Offenders become the victim in virtual reality: impact of changing perspective in domestic violence. Scientific Reports, 8(1), 1–11. https://doi.org/10.1038/s41598-018-19987-7
Serrano, A. e Iborra, I. (2005). Informe Violencia entre compañeros en la escuela. Valencia, España: Centro Reina Sofía para el Estudio de la Violencia. Recuperado de http://www.centroreinasofia.es
Schwartz, D. (2000). Subtypes of Victims and Aggressors in Children’s Peer Groups. Journal of Abnormal Child Psychology, 28(2), 181–192.
To increase the sense of immersion in Virtual Reality, you can include comments, questions or ideas in the session so the experience will seem more realistic to your patient.
Some examples could be:
“Imagine that these are your classmates with whom you are having problems” … “How does it feel to see them?” “What do you think they think of you?” “Which one do you feel most unhappy with and why?” “Which generates the most fear or anxiety?” “Which one do you trust or give you greater security?” “Do they make you nervous?” “What do they usually do when the teacher is away?”, Etc.
In turn, it is highly recommended to try to keep the patient in the same body position in which the protagonist of the scene is (in this case, sitting at the classroom desk).
Similarly, it may be useful to add any element of the scene or context where the events occur. In this case, offering the patient a pen or pencil and a notebook can help to make the immersion more effective and provide the child / adolescent with the sensations of the conflictive environment.
Siempre es interesante y positivo tratar de complementar la experiencia de Realidad Virtual con comentarios, preguntas o indicaciones para facilitar que el paciente pueda ponerse más fácilmente en situación y sienta una mayor inmersión en el entorno.
Algunos ejemplos podrían ser:
“Imagínate que estos son tus compañeros de clase con los cuales estás teniendo problemas”… “¿Qué sientes al verlos?” “¿Qué crees que piensan de ti?” “¿Con cuál te sientes más a disgusto y porque?” “¿Cuál te genera más miedo o ansiedad?” “¿En cuál confías o te da mayor seguridad?” “¿Te ponen nervioso?” “¿Qué suelen hacer cuándo no está el profesor?”, etc.
A su vez, es muy recomendable tratar de mantener al paciente en la misma posición corporal en la que se encuentra el sujeto protagonista de la escena (en este caso, sentado en el pupitre del aula).
Del mismo modo, puede ser útil añadir cualquier elemento propio de la escena o del contexto donde suceden los hechos. En este caso, ofrecer al paciente un bolígrafo o lápiz y una libreta puede ayudar a hacer más efectiva la inmersión y facilitarle al niño/adolescente las sensaciones propias del entorno conflictivo.
“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.”
It is important to note that in this section we will only show and suggest some points to guide the intervention through the virtual environment of Psious to address bullying or bullying. The treatment must be adapted to the characteristics of each patient and the healthcare professional may adapt it according to their criteria. A good first orientation can be obtained in the Action protocol in situations of bullying – UNICEF .
Steps of therapy to overcome bullying
As we have seen in the evaluation section, the treatment of cases of bullying usually takes place in 3 phases: evaluation , intervention and follow-up.
By using our environment it will be possible to bring the victim of bullying closer to a similar situation that helps us carry out the approach of the different phases of bullying treatment.
EVALUATION
In this first phase we will confront our patient with the environment in order to evaluate his behavior in relation to the problem. During the course of the scene and once its execution is finished, we will try to collect relevant information about the case, through a semi-structured interview 2. We will therefore focus on knowing the patient’s profile. It is important to collect information both from the intrapersonal part (as I am), and from the interpersonal part (as they see me and I relate to others). In this way, once the initial exploration has been carried out, we will have more information to determine a personalized action plan.
INTERVENTION
In this second phase our objective of locating the patient in the environment will be to try to execute the action plan appropriate or training in relation to the evaluation phase. Therefore, we will provide the patient with those tools that help them solve psychopathological aspects that contribute to aggravating or maintaining the problem of bullying.
The following table summarizes groups different useful aspects to work in cases of bullying and the different techniques often applied:
Training in problem solving / Training in self-instruction
Social skills / Assertiveness
Training in communication skills / debate / discussion / argumentation
Summary table: Adapted from Morán Sánchez, 2006
2 The relevant information to collect is detailed in section 2.2 .one.
FOLLOW-UP
It is important, once the intervention has been carried out, to schedule follow-up sessions after a period of time. In this way we can ensure the effectiveness of the intervention and detect possible aspects that may need to be reinforced again.
Proposal for intervention for victims of bullying
Below we show you a proposal for intervention with PSIOUS for victims and participants in situations of bullying.
The following proposal is made to evaluate coping styles in a school conflict situation.
Session 1
Inform the patient about discomfort in relation to problems at school, as well as about the emotional responses involved: anxiety, sadness, anger …
Present and justify the techniques that will be used throughout the treatment: evaluation of thoughts and strategies for dealing with situations of conflict and aggression at school, empathy
Observation and evaluation of thoughts in a neutral school situation (in the hallway of the institute and during the exam.
ITEM
ENVIRONMENT
CONFIGURATION
EVENT
Psychoeducation anxiety
What are emotions How do we feel emotions
Being alone in the hall, waiting for the teacher to arrive and start the exam
Institute, easy, just
Being with a few classmates in the hall before an exam and they seem very calm
Institute, easy, few people
Being doing an exam that is short in a classroom full of people
Anxiety before exams
Institute, easy, many people
many people Start exam
Session 2
Review achievements of the previous session and establish objectives of the session: Assessment behavior, thoughts and emotions in a situation of aggression at school.
Evaluation of thoughts and strategies for dealing with situations of conflict and aggression at school.
Identification emotional states
ITEM
ENVIRONMENT
CONFIGURATION
EVENT
Being with a few classmates in the hallway before an exam and they seem very calm
Anxiety exams
Institute, easy, many people
Being in class and being approached by a classmate alone to rebuke
Bullying
Just
Begin
Identification emotional states (up to 12 years old)
Mindfulness kids: Summer
Exercises in Summer environment, especially Energy recharge and end of summer
Begin
Control of physiological activation: Breathing exercises
Relaxation Breathing Under the sea / Prairie
At the patient’s choice, adjust the frequency of comfortable breathing for the patient
Begin
Session 3
Review achievements of the previous session and establish objectives of the session: Evaluation of behavior, thoughts and emotions in a situation of aggression at school.
Cognitive restructuring
Orientation of the focus of attention
ITEM
ENVIRONMENT
CONFIGURATION
EVENT
To be in class and to be approached by a single partner to reprimand
Bullying
Accompanied
Start
Focus Attention
Mindfulness kids: Winter
Introduction, home and lighthouse
Begin
Control of physiological activation: Breathing exercises
Relaxation Breathing Under the Sea / Meadow
At the patient’s choice, adjust the comfortable breathing rate for the patient.
Begin
Session 4
Review achievements of the previous session and establish objectives of the session: Assessment of behavior, thoughts and emotions in a school environment.
Cognitive restructuring
Social skills training
Generation of pleasant emotions
ITEM
ENVIRONMENT
CONFIGURATION
EVENT
Being with a few classmates before an exam and they seem very calm
Anxiety exams
Institute, easy, many people
start
Training in Social Skills
Audience
Few people
Start, easy questions
Generation pleasant emotions
Mindfulness kids: Autumn
Introduction, Pinwheel
start
Session 5
Review previous session achievements and set session objectives: Assessment behavior, thoughts and emotions in school environment.
Cognitive Restructuring
Social Skills Training
Nice Emotions Generation
ITEM
ENVIRONMENT
CONFIGURATION
EVENT
Being with few peers in class before an exam and they seem very calm
Anxiety exams
Institute, difícill, many people
begin
Generation pleasant emotions
Mindfulness kids: Autumn
Introduction, Pinwheel and Projection joy and end of autumn
begin
Session 6
Review achievements of the previous session and establish objectives of the session: Evaluation of behavior, thoughts and emotions in a school environment.
Cognitive Restructuring
Social Skills Training
Energy Generation = Activation
ITEM
ENVIRONMENT
CONFIGURATION
EVENT
To be in class and to be approached by a companion to be shocked
Bullying
Accompanied
Begin
Training in social skills
Audience
Many people
Start, difficult questions
Generation Activation
Mindfulness kids: summer
Introduction, magic items , recharges energy, End of summer
beginning
Session 7
Review achievements of the previous session and establishment of session objectives: Assessment of behavior, thoughts and emotions in a school environment.
Cognitive Restructuring
Activation Generation
Relaxation
ITEM
ENVIRONMENT
CONFIGURATION
EVENT
Being with a few classmates before an exam and they seem very calm
Anxiety exams
Institute, easy, many people
start
Generation Activation
Mindfulness kids: summer
Introduction, magic items, recharge energy, End of summer
start
control physiological arousal: breathing exercises
Relaxation breathing Under the sea / Meadow
a choice of the patient, adjust frequency comfortable breathing for the patient
start
Remember that you have the clinical guide to inform you of therapeutic procedures with empirical evidence and how to adapt them to the intervention with the virtual environments of Psious.
[ DISCLAIMER: This document has been automatically translated using Google Translate. ]
