An interesting article published by the Official Home Page of the US Army came to light recently highlighting the use of virtual worlds as a part of studies into providing better healthcare and support to US soldiers and veterans.

For the last three years, Colonel Valerie Rice, Director of the US Army Research Laboratory’s Human Research and Engineering Directorate located at Fort Sam Houston, in San Antonio, Texas, has been spearheading a team studying the use of Mindfulness-based Stress Reduction (MBSR) as way of teaching army personnel and veterans how to manage PTSD and similar disorders which have resulted from their military service. The work is part of a broader series of research activities funded by the US Army aimed at providing suitable care and support for those afflicted by PTSD.

Mindfulness – “being in the moment” – is a means of stress and anxiety relief using age-old techniques such as meditation and yoga to help focus and clear the mind. It has become a popular means of therapy and support in many areas of life.

The studies being undertaken by Dr. Rice and her colleagues have a twofold purpose. Firstly, to determine the effectiveness of MBSR techniques in helping US Army personnel and veterans deal with PTSD and related issues. Secondly, to identify whether a programme using these methods could be reasonably and effectively adopted by the Army for widespread use.

In this latter regard, MBSR is seen as a particularly worthwhile means of assisting service personnel and veterans because not only is it a proven means of treatment in civilian life, but also because instructors do not need to be qualified healthcare professionals; they only need to have successfully completed a comprehensive training and certification programme. This significantly eases the challenges involved in leveraging it for more widespread deployment and use.

MBSR is also something ideally suited to leveraging the use of virtual worlds, notably Second Life and All These Worlds LLC, which bring with them unique opportunities and benefits which are not necessarily achieved with courses and therapy conducted in the physical world.

The Mindfulness studies take place as 2-hour weekly sessions over a period of eight weeks apiece, and involve some 66 participants at a time, 36% of whom were soldiers on active duty, and the remaining 64% veterans. Half of each batch of participants meet face-to-face in real life, the other half in a virtual world environment.

In both the physical and the virtual environments, sessions are experiential in nature; participants in the study meet, go through various exercises designed to focus the mind, ease tension, and reduce stress. Classes as cumulative, each building on and reinforcing the last, providing techniques participants can carry with them into their daily lives. There are also opportunities for discussion and feedback on individual’s experiences with the techniques, and so on.

Those participating in the virtual classes are encouraged to physically perform the exercises rather than just perform them with their avatar. There is a high degree of interaction between session leaders and participants, and courses include homework sessions – exercises participants are asked to carry out when away from the sessions.

Virtual world environments are seen as a particularly beneficial for conducting sessions due to the level of anonymity they offer. There is still something of a stigma attached to seeking help for disorders such as PTSD which can make individuals shy away from any involvement in actual behavioural health classes due to misplaced feelings of embarrassment, inadequacy or shame. The use of what is essentially an anonymous avatar in a virtual environment helps eliminate these feelings, and any associated stress or anxiety which might otherwise be experienced.

The multiple ways in which participants can provide feedback through a virtual world is also seen as beneficial. Giving voice to the feelings, responses and emotions one is experiencing when in a public forum is not always easy. But in a virtual environment, a participant can, for example, opt to give their thoughts and feedback via IM to the session leader, who can in turn relay the salient points to the class in a way that also doesn’t cause the individual any additional stress or embarrassment. Even the use of voice morphing is seen as advantageous, as it again offers participants relief from any fear that their voice might otherwise be recognised.

Additional benefits in using virtual worlds are those of accessibility and the ability to establish social networks among peers. Writing in Advanced Computational Intelligence Paradigms in Healthcare 6, Jacquelyn Ford Morie, the founder of All These Worlds, and who also one of Dr. Rice’s collaborators in the study, notes:

Today’s returning soldiers are most likely geographically dispersed, which may make it difficult to get to centres where medical help is typically aggregated. In addition, a social support structure may be lacking, leaving veterans unable to socialise with comrades in person on a regular basis … Online shared virtual worlds, however, are easily accessed from any personal computer, and can support the formation of social networks, facilitate access to care, and provide social activities between soldiers where geography is no barrier.

She goes on to note that most service personal today are comfortable with using technology and in playing computer games, so accessing virtual worlds should not present them with significant barriers to entry or from engaging with online communities.

Dr. Rice and her team report that taken as a whole, the MBSR courses have seen positive results across both actual and virtual sessions, with participants registering lower blood pressure, reduced anger and increased calmness in their lives, as well as exhibiting increased energy levels and faster reactions. Her team also note that anecdotal evidence suggests that those who have participated in courses are still practicing techniques six months later.

However, the team also acknowledge that further research into the overall effectiveness of MBSR with military personnel is required before any definitive findings on its overall applicability to widespread use within the US Army can be determined.

Even so, despite the fact that such formal determination has yet to be reached, the work carried out to date is encouraging, and stands as another fascinating example of how virtual worlds can be used for the betterment of our health and welfare.

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With thanks to Ziki Questi for the initial pointer to the US Army article on this research.