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Virtual Vietnam PTSD Exposure Therapy Prototype

This video shows our prototype Virtual Vietnam system that will be made freely available to clinicians for the treatment of Posttraumatic Stress (PTS) in Vietnam-era Veterans. The use of Virtual Reality to deliver the evidence-based approach of Prolonged Exposure therapy has been shown to be successful in a number of studies where PTS symptoms were significantly reduced in Service Members and Veterans from the Iraq and Afghanistan conflicts (Gerardi et al, 2008; Reger et al., 2008, 2011; Rizzo et al., 2010; McLay et al., 2011; Rothbaum et al., 2014) and survivors of the terrorist attack on the World Trade Center (Difede et al., 2002, 2007, 2014). This approach is believed to provide a low-threat context where the patient can begin to confront and therapeutically process the emotions that are relevant to a traumatic event. Virtual Reality Exposure therapy may also offer an appealing treatment option that is perceived with less stigma by Veterans who may be more reluctant to seek out what they perceive as traditional talk therapies. The MedVR Lab at the ICT has over 10 years of experience in the design, development and implementation of a Virtual Iraq and Virtual Afghanistan PTS treatment system (called BRAVEMIND) and we have recently completed new components of this system that address the specific needs of Combat Medics and Corpsmen and for those whose PTS is the result of military sexual trauma. We had started on a prototype of the system (see images below), but lack of expected funding has halted the project. Why are we doing this now? In a recent follow-up with surviving Vietnam-era Veterans who had participated in the National Vietnam Veterans Readjustment Study, 11% were still found to suffer from post-traumatic stress disorder. Moreover, Vietnam-era Veterans, as they are aging and retiring from the workforce, are now finding that the emotions from unresolved trauma experiences that they have kept contained and lived with over most of their adult lives, are now becoming more difficult to manage. This may be due to the increased emotional vulnerability that can sometimes accompany the aging process or simply from the fact that once one retires, they may have more time on their hands to dwell on unresolved emotional issues from the past. Regardless of the cause, the VA system is seeing a resurgence of Vietnam-era Veterans coming into VA centers for PTS treatment. Recent articles in the Wall Street Journal (Ansberry, 2014) and Los Angeles Times (Zarembo, 2014) have drawn attention to this challenge as well as findings reported in the recent Institute of Medicine (IOM, 2014) analysis on the DoD and VA efforts to address PTS. The IOM report stated that in 2013 approximately 69,000 new PTS cases from the Iraq/Afghanistan conflicts were seen at the VA. During the same period approximately 62,000 new PTSD cases were seen from previous wars, primarily from the Vietnam era. The fact that 60,000 new Vietnam-era Veterans are now coming forward to seek help, on top of all of those who have struggled with similar PTS symptoms over the last half century DEMANDS our attention and REQUIRES a response! Vietnam-era veterans deserve our best efforts to provide state of the art care now that is on par with the options that are available to the current cohort of Service Members and Veterans. Let’s face it, Veterans from the Vietnam era, through no fault of their own, did not receive the same level of care and respect upon the return home. It was a turbulent political period in the USA and it was also a time where PTS didn’t even exist as a formal diagnosis with specified symptoms and recommended evidence-based care. It is now past the time to recognize and respect the sacrifice of those who served during the Vietnam era and make available this form of exposure therapy to help address this significant health condition. This is especially important in light of the fact that trauma focused exposure therapy approaches have shown success in treating PTS many years after the trauma has occurred. We owe these Veterans the opportunity to access this treatment in the hope that it may help them to reclaim the years they have left to live in the peace they deserve.