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TECHNOLOGY IN PSYCHOLOGICAL TREATMENT

Friend or Foe?

By Anna Samuel


Credits: Illustration by Gracia Lam


The world of psychological treatments is undergoing a revolution, driven by the widespread emergence of digital technology. I will be discussing some of the most ground-breaking, innovative, and exciting new technologies which could become a major part of psychological treatment in the years to come. These technologies create several possibilities and pose many challenges, leading us to question: is technology a friend or foe to the world of psychological therapy?


Virtual reality (VR) enables immersion into a computer-generated environment, creating a sense of reality using headsets and motion trackers. VR provides an exciting opportunity in clinical settings as it merges the tightly controlled conditions of the laboratory with the ecological validity of an everyday environment. Evidence supports the effective use of VR in treating a range of psychological disorders such as phobias (Anderson et al., 2013), PTSD (Rothbaum et al., 2014) and autism (De Luca and Leonardi et al., 2019). Schizophrenia is typically treated with anti-psychotic drugs which ease positive symptoms of delusions and hallucinations. However, patients with schizophrenia may lack social and cognitive abilities, leading to poor relationships, inability to work and issues with independence. The use of VR in training cognitive and social skills has shown promising results for enhancing vocational outcomes in people with schizophrenia (Tsang and Man, 2013). VR-based rehabilitation allows the training of skills and exposure to challenges within a safe environment that can be customised to each user’s need. A limitation of using VR is the high cost of the technology. However, through advances in the technology market, costs are expected to decrease, enabling greater access to these promising interventions. It must be highlighted that VR is a complementary tool which can be integrated alongside other established therapies and anti-psychotics, but would likely be inappropriate and distressing for people with hallucinations and delusions. These positive symptoms should be treated with anti-psychotics beforehand and, only then should VR be incorporated.


Robotics technologies also possess infinite possibilities in psychological interventions. Robots have incredible physical capabilities, including running, climbing, grabbing, and even making facial expressions. It has been suggested that robotics could be incorporated into therapy for Autism Spectrum Disorder by social engagements between the child and robot, thus facilitating human relationships. Longitudinal research (Robins et al., 2004) involving the exposure of children with autism to a humanoid robot led to imitations of movement and helped mediate the involvement of the experimenter in these interactions by the children.


Furthermore, robot use in dementia care has huge potential. Healthcare systems are under tremendous strain from the rapidly growing demand associated with an ageing population. With over 850,000 people living with dementia in the UK, there is a pressing need for research that will enhance dementia care. Social robots can provide companionship and social interaction, improving quality of life for elderly people. Eventually, the development of more complex, intelligent robots could also act as carers, enabling people to live in the comfort of their homes safely, instead of being moved into a care home.


PARO is a robotic seal and is commonly used in care homes as a substitute for animal therapy, as robotic pets are more predictable and require less care. PARO is equipped with sensors which respond to touch and speech enabling physical and verbal interaction. Research has shown that these therapeutic robotic seals reduce stress and agitation, as well as promoting social interaction, improving mood and speech fluency (Shibata and Coughlin, 2014). These findings are promising for the much-needed provision of social and emotional support for elderly people. With no cure for dementia currently, it is essential to develop these innovative solutions to care for the vulnerable population.


However, there have been some infection concerns associated with PARO being used in clinical settings as it can be difficult to clean. The cost is also an issue as the robot costs a substantial $6000. There are serious ethical issues with introducing robotics into psychological therapy and care. There is a risk of infantilizing care as robots such as PARO are criticized for being ‘toylike’ and ‘childish’, thus elderly people may find them humiliating and disrespectful. Furthermore, individuals who dislike animals may find it distressing. The use of robotics in care may result in limited human interaction which is a critical component of quality care. The dehumanization of care will result in these vulnerable people feeling ostracized from society. It is impossible for robots to provide the complex emotional support that this population depends upon. Whilst social assistive robots provide a useful addition to healthcare and seem to have positive effects on wellbeing, it is essential that this is utilised alongside, rather than as a replacement of human contact and compassionate care. Guidelines for appropriate and ethical use of robots should be developed to ensure that the dignity of these people is maintained.


In conclusion, psychological therapies will likely benefit from integrating these exciting technological innovations. Both virtual reality and robotics have shown positive effects in clinical settings but before we see the widespread use of these therapies, a larger body of research and a more affordable solution is required. We must ensure that as the use of technological interventions increase, there is not a reduction of face-to-face treatments. This compassionate human interaction is essential for emotional support. It is vital that these technologies are used alongside human contact and must never replace it. So…friend or foe? I believe that technology has the potential to be a great ‘friend’ if used appropriately.


Paro, a robotic seal, could help reduce loneliness in healthcare settings.


Credit: National Institute of Advanced Industrial Science and Technology, Japan.


Anna Samuel is in her 2nd year of studying Experimental Psychology at Corpus Christi College.



References


Anderson, P. L., Price, M., Edwards, S. M., Obasaju, M. A., Schmertz, S. K., Zimand, E., & Calamaras, M. R. (2013). Virtual reality exposure therapy for social anxiety disorder: A randomized controlled trial. Journal of consulting and clinical psychology, 81(5), 751.


De Luca, R., Leonardi, S., Portaro, S., Le Cause, M., De Domenico, C., Colucci, P. V., ... & Calabrò, R. S. (2019). Innovative use of virtual reality in autism spectrum disorder: A case-study. Applied Neuropsychology: Child, 1-11.


Robins, B., Dickerson, P., Stribling, P., & Dautenhahn, K. (2004). Robot-mediated joint attention in children with autism: A case study in robot-human interaction. Interaction studies, 5(2), 161-198.


Rothbaum, B. O., Price, M., Jovanovic, T., Norrholm, S. D., Gerardi, M., Dunlop, B., ... & Ressler, K. J. (2014). A randomized, double-blind evaluation of D-cycloserine or alprazolam combined with virtual reality exposure therapy for posttraumatic stress disorder in Iraq and Afghanistan War veterans. American Journal of Psychiatry, 171(6), 640-648.


Shibata, T., & Coughlin, J. F. (2014). Trends of robot therapy with neurological therapeutic seal robot, PARO. Journal of Robotics and Mechatronics, 26(4), 418-425.


Tsang, M. M., & Man, D. W. (2013). A virtual reality-based vocational training system (VRVTS) for people with schizophrenia in vocational rehabilitation. Schizophrenia research, 144(1-3), 51-62.

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