Workshop​​ 
W07 -​​ 
Virtual Reality. Digital Tools. e-Therapies. Can Technology Help With the Delivery of Mental Health Care?​​ 

Friday, 23 October​​ 

11:15 – 12:45 (1.5 hrs)
David Gratzer*, MD, FRCPC; Raymond Lam, MD, FRCPC; Trisha Chakrabarty, MD​​ 

 

CanMEDS Roles:​​ 

  • Leader​​ 

  • Scholar

  • Collaborator

At the end of this session, participants will be able to:​​ 1) Describe the literature supporting virtual reality (VR), digital tools, and e-therapies; 2) Critically understand the benefits and challenges of trying to incorporate technology into clinical care programs; and 3) Apply these understandings to shape the future direction of mental health care in light of technological change.​​ 

Access to mental health care is problematic, and studies show uneven quality of care. Can technology help? We draw on our experiences highlighting three initiatives:​​ 

1) Virtual reality (VR) cognitive remediation in depression. VR technology is increasingly accessible, and its attributes (immersiveness, interactivity, and the ability to recreate real-world settings) make it promising for psychiatric interventions. We review pilot data for a novel VR cognitive remediation program in depression. Preliminary outcome data, including measures of enjoyment and usability, will be used to illustrate the potential benefits and barriers to using VR in clinical settings.​​ 

2) Technology-enhanced measurement-based care (MBC) for depression. MBC, the routine use of validated outcome scales to support management decisions, is a recognized evidence-based approach that improves depression outcomes, yet MBC has low uptake among psychiatrists. Instead of traditional "pen and paper" versions of scales, we describe the use of web and smartphone apps for patients to collaboratively track outcomes with their psychiatrist and how these apps are used in EMBED, a novel Chinese implementation study of MBC. We will focus on lessons for Canada.

3) Internet-assisted cognitive-behavioural therapy (iCBT). While well supported in the literature, traditional CBT is impractical for some, because of physical issues (pain) or personal obligations (occupational). A literature supports iCBT. We will review The Scarborough Hospital's experiment with iCBT, a first of its kind in a Canadian community hospital program (n = 120 with a high retention rate). We will also discuss iCBT at CAMH.

References:

  • Spek V, Cuijpers P, Nyklicek I, et al. Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: a meta-analysis. Psychol Med 2007;37:319–28.

  • Park MJ, Kim DJ, Lee U, et al. A literature overview of virtual reality (VR) in treatment of psychiatric disorders: recent advances and limitations. Front Psychiatry 2019;10:505.

 

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