Simulated Exposure Trainer (SET-VR): Implementing Targeted Experiential Training with a Virtual Patient

项目摘要/摘要 尽管存在许多针对精神障碍的循证实践(EBP)，但它 很难在社区环境中传播这些做法。焦虑症的暴露疗法 是这种研究与实践差距的最明显的例子之一。就像病人担心的那样 面对恐惧，治疗师通常不愿使用暴露疗法，因为他们自己有焦虑的信念。 这对患者来说可能是危险和/或无法忍受的，即使在接受了专门的暴露训练之后也是如此。 新兴的培训研究建议纳入有针对性的行为策略(即角色扮演、自我暴露) 在标准的说教培训课程之外，可以减少焦虑的信念。通过利用相同的 减少患者焦虑(即暴露)的行为改变原则，行为策略可以量身定做 目标治疗师对治疗的焦虑信念(即，将培训作为“暴露”进行)。 不幸的是，目前的体验式培训任务未能紧密复制人们通常担心的临床情况 背景，结果是缺乏必要的能力来潜在地克服治疗师水平的接受障碍 和培训后提供高质量的治疗。虚拟现实(VR)已显示出强大的实用性和成本- 提供曝光的有效方法。我们计划调查VR作为一种量身定制的培训工具的应用 (即，对治疗师来说，虚拟的“暴露”)能够提高体验的数量和质量 学习目前的暴露培训计划所缺乏的知识。拟议的为期20个月的第I阶段沙田试验研究将会 测试在两个平台上提供的虚拟现实培训计划的实施情况(即虚拟现实耳机和基于网络的平台) 评估哪种平台提供沉浸感、可用性、目标参与度和可扩展性的理想平衡。 研究分三个阶段进行：1)初步开发，2)迭代评估和开发以进行优化 可用性，3)临床培训试验以建立目标敬业度。可用性和目标接洽信息 从这项试点试验中，将支持STTR第二阶段项目，旨在扩大和广泛传播VR- 强化培训方法。

PROJECT SUMMARY/ABSTRACT Despite the existence of numerous, well-established evidence-based practices (EBPs) for mental disorders, it has been difficult to disseminate these practices in community settings. Exposure therapy for anxiety disorders represents one of the most glaring examples of this research-to-practice gap. Just as patients are anxious about approaching their fears, therapists are often reluctant to use exposure therapy due to their own anxious beliefs that it may be dangerous and/or intolerable for patients, even after receiving specialized exposure training. Emerging training research suggests the inclusion of targeted behavioral strategies (i.e., role play, self-exposure) can reduce anxious beliefs above and beyond standard didactic training sessions. By leveraging the same behavior change principles that reduce patient anxiety (i.e., exposure), behavioral strategies can be tailored to target therapists’ anxious beliefs about the treatment (i.e., conduct training as “exposure to exposure”). Unfortunately, current experiential training tasks have failed to closely replicate commonly feared clinical contexts, and as a result lack the necessary potency to potentially overcome therapist-level barriers for uptake and quality treatment delivery following training. Virtual reality (VR) has demonstrated utility as a potent and cost- effective approach for delivering exposure. We plan to investigate the application of VR as a tailored training tool (i.e., virtual “exposure to exposure” for therapists) capable of enhancing the quantity and quality of experiential learning that is lacking in current exposure training initiatives. The proposed 20-month Phase I STTR study will test the implementation of a VR training program delivered on two platforms (i.e., VR headset and web-based) to assess which platform provides the ideal balance of immersion, usability, target engagement, and scalability. The study takes place in three stages: 1) initial development, 2) iterative evaluation and development to optimize usability, 3) clinical training trial to establish target engagement. Usability and target engagement information from this pilot trial will support a Phase II STTR project aimed at building out and broadly disseminating the VR- enhanced training approach.