Imagine you’re on a plane when the sky gets dark, the weather gets more and more turbulent, the plane starts shaking and your seat rattles violently.
While this would be uncomfortable for anyone, it might be too much of a challenge for someone with a fear of flying.
However, putting them in such a situation under the supervision of an expert can help them overcome their phobias.
Tanjina Ashraf Khan, CEO and founder of MentCouch, a psychology center in Kuala Lumpur, calls it exposure therapy and recommends it to those who want to overcome their extreme sense of fear of an object or situation.
He says that as they work with a therapist to learn how to deal with their anxiety, they will gradually be exposed to their phobias.
“What we want to see in a session is a person who has less anxiety about their fears. We start on a scale of one to 10.
“Initially, they may rate their anxiety level as a nine. When it gets to six, that’s progress,” he says.
However, he says exposure therapy is difficult to do physically. For example, if the client is afraid of snakes or cockroaches, it is not realistic to bring these elements into the room.
Enacting certain scenarios, such as boarding a plane, could also be costly.
“It could also be dangerous for the client to suffer severe panic attacks on the plane. We may have to request an emergency landing,” adds MentCouch CEO Justin Kung.
This was the impetus for the use of virtual reality – by simply putting on a VR headset, a person can be safely “transported” to another place or situation.
“The most important thing is that we can reassure them that they are in control,” says Tanjina.
He explains that clients typically spend up to 30 minutes in VR while a trained therapist monitors them on a computer.
Kung says, “We can communicate with them using visual commands. In this way, they can remain immersed in the environment without too much external interference.
“MentCouch advisor Syahirah Husna says: “We usually take a 10-minute break and assess their anxiety level and talk about relaxation techniques such as deep breathing.
“When they’re ready to move on, they can practice the techniques they’ve learned in their chosen environment.”
In addition to overcoming phobias, MentCouch uses VR as part of its stress-relief therapy, where an individual would be guided through techniques such as muscle relaxation in a soothing virtual environment such as a beach or forest.
“Some people have trouble concentrating during therapy because they’ll be stressed thinking about work or what the traffic will be like when it’s time to go home,” she says, adding that such sessions help them be more mindful and calm.
Kung agrees, saying, “They feel that with VR, it takes less effort to help them relax.”
Raises the bar
At Taman Desa in KL, licensed physiotherapist Lian Yun-Perng uses VR as part of physiotherapy procedures and describes the virtual world as “a form of distraction from pain”.
“We recommend it especially for people recovering from a stroke or those who may be living with chronic pain.
“It can be difficult to lift an object because of their condition, so we help them achieve upper extremity movement through exercises using VR,” says Lian, who owns and operates Ace Physiotherapy.
Lian begins the session by fitting the patient with a headset and adjusting the focus so that he can see clearly. Patients do not need to walk and will mostly sit.
“I will walk them through the process because I will see what they see on my smartphone.
“Sensors will track their hands and be able to perform movements such as picking up an object such as a rock or throwing a ball in a virtual environment,” he says.
They can also be tasked with completing a block puzzle. It starts with three blocks, with the number of blocks and complexity increasing as the patient progresses.
Each VR session typically lasts about 10 to 15 minutes, and after three months of training, Lian will measure patients’ progress by checking their muscle strength.
“We hope to see improvements in severely debilitated patients, including the ability to perform movements such as making a fist, moving the fingers or lifting the wrist,” he says.
Lian first integrated VR as part of his physiotherapy services in 2019 – while researching ways to improve his services, he came across a crowdfunding campaign for a VR headset.
“The product was designed for gaming, but I was inspired by the possibilities and started looking at how I could use VR for rehabilitation,” he says.
He ultimately decided to go with Oculus after testing several products and finding apps that he felt would be a good fit for his physical therapy plan.
“The headset is light and portable. I don’t need cables (uses a rechargeable battery) or carry extra equipment like monitors.
“I can prepare it in 10 minutes over the phone and not waste the patient’s time,” he says.
Lian is careful not to introduce VR to patients without first assessing their suitability.
“They must not have conditions such as epilepsy or severe balance problems. If they get dizzy while using VR, then the treatment ends,” he says.
Feedback for incorporating VR as part of physical therapy treatment has been encouraging, Lian says, adding that most patients have been receptive.
“They get to try something new and there’s a fun element to it,” he says.
Fun is the last thing on the minds of workers at the Genting Tunnel East Coast Rail Link (ECRL) construction site in Bentong, Pahang, as they have to be alert to stay safe and minimize risks.
“Safety is a priority for everyone. It is mandatory to undergo safety training due to exposure to different types of hazards,” says Datuk Osman Haron, Director of Health, Safety and Environment at China Communications Construction ECRL, the main contractor of the ECRL project, which owns Malaysia Rail Link (MRL). ).
To improve and raise the level of safety awareness on site, the company said it has set up a VR Safety Experience Hall to allow its employees to learn about safety in a more immersive environment.
It has two VR safety experiences, the first is a VR module that simulates the experience of a fast moving vehicle.
In the demo, the module simulated a bumpy cart ride with sharp turns and steep slopes in a snowy mountain, made more realistic by its ability to blast air and physically move in multiple directions.
“There are trainings to simulate car accidents and falls from great heights. These experiences are meant to remind workers to always carry out safety checks on site and equip themselves with the required equipment,” adds Osman.
The second VR service gives the worker freedom of movement in a designated space and allows him to pick up tools and operate them in the virtual world.
Depending on the scenario chosen – it claims to offer up to 100 options, including one inspired by real-life construction tragedies in China – the dangers faced will vary.
Workers may find themselves operating a crane only to have the host cable break and injure others, or drilling a tunnel while standing on an unstable platform that would break.
After each experience, a popup will show the actions that led to the accident.
For example, in the first scenario, the rope could have broken because no prior check was made to ensure that all equipment was in order, and in the second, it could have been because the workers did not have safety harnesses and the scaffolding was not built to a safety standard.
“Employees would typically have to go through hour-long security briefings and because of a static setup, they don’t need to retain all the information.
“By experiencing what could happen if they weren’t aware of the precautions with VR, it makes for more beneficial learning,” says Osman.
However, Osman admits that VR cannot replace all aspects of safety training, as hands-on experience is still an important aspect.
For example, workers must learn how to operate machines in real life, to feel “weight” and how objects move under certain weather conditions.
“For some aspects of safety training, we’re trying to find ways to combine it with VR because it has the advantage of helping workers fully visualize situations,” he says.
He adds that VR also helps remove limitations such as the need to be in different locations and devices for training.
“We had problems where training could not be carried out because there was no trainer.
“But with VR, there is no such problem. We can also upgrade the software with a new experience so that our workers are informed of new safety instructions when they move to a new workplace,” he says.
Meanwhile, Tanjina says she is “moving fast” with VR, seeing the potential of using it for online sessions where both therapist and patient appear as 3D avatars.
What’s key now, he says, is creating greater awareness of the benefits of VR and other forms of technology in mental health treatment.
“People weren’t open to technology being used as part of mental health treatment until the pandemic opened up the opportunity for people to try online therapy.
“The biggest hurdle is helping more people realize the benefits of technology in certain aspects,” he says.
Lian agrees and says people need to be more open to trying new forms of technology for physical therapy treatment.
He claims that robotics such as an exoskeleton can be incorporated into rehabilitation therapies and that an artificial intelligence-powered device is being developed to help stroke patients perform movements.
“I encourage people to think outside the box and not limit themselves to what they learned at university.
“Attend exhibitions and conferences to learn about technological advances in health. I would also advise them to look at the science and research behind it,” he says.
Osman adds that in addition to VR, the company relies on technologies such as drones to monitor remote areas that are difficult for humans to reach.
“We are closely following the development of technologies in various areas to see how they can be implemented.
“Technology is a very important aspect of what we do,” he says.