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IMMERSIVE VIRTUAL ENVIRONMENTS AND HEALTHCARE
Psychotherapeutic interventions are typically a real-time engagement between two visible agents, with the intended target to achieve the facilitation of behaviour change in one party. Theories underpinning the application of psychology in psychotherapy seldom probe the metaphysical issue of the ambiguous relationship between the mind and the body. This paper investigates a pilot trial approach with individuals presenting signs of struggle in cognitive health, with a gap existing to investigate a whole body shift towards merging cognitive therapy with immersive interactive technology in virtual reality. The study finds that cognitive interventions, as psychological treatments, could be enhanced via the implementation of valid standing options capable of complementing more widespread clinically seated practice. The study introduces a unique process of intervention with ability to plug in to technology as a contemporary, holistic approach, demonstrating how this might lead to a complimentary advancement in talking therapies, to enhance subject-environment connectivity and weigh the approach against a non-technological alternative. In layman’s terms, the intention is to encourage patients seeking forms of cognitive intervention to stand on their feet; whilst suggesting to therapists who facilitate approaches that this shift could be essential to allow for a whole-body investment where experiential elements of see, touch, feel are the agents of change, which can lead to subject reasoning and autonomy. The approach shows early prototype potential to lead to the design of a cost-effective user-led model involving reduced therapist involvement, less than 240 minutes or no therapist at all, building toward the designing of systems (non tech or tech-based) for embodied interaction. The pilot trial, as a version resembling an on-going study, offers an assessment of the primary outcome and assists with on-going design as it builds toward a user-led clinical trial. Keywords: Immersive 1; Technology 2; Cognition 3; Behaviour 4; Embodied 5; Sequential 6; Interactive 7; Empowerment 8; Human Flourishing 9;
An analysis of Foucault as a human being seeking to characterise different ways contemporary society expresses power to objectivise subjects: Extradition, Expulsion, Incarceration, Condemnation, Medication, Meditation, Immersion
A single page of observation notes from a presentation: Ezio considers society has entered "a new wave of innovation", spawning a culture "in-between top-down and bottom-up" where a more "neo-liberal model" leads to "different trajectories of normalization".
As the participant enters the space they are asked to complete an initial assessment tool containing a single question: Where Are You At? This was first piloted in September 2017 as the researcher had engaged in several hundred hours of 1-1’s through Third Sector work with young people, then within schools (secondary and SEND), colleges and training organisations representing further young people and individuals who were unemployed and seeking to become re-engaged. Further people of varied age groups were signposted to the researcher, presenting: Anxiety, Depression, Suicide Ideation, Anorexia, Anger, Loneliness, Trauma, Abuse, Nihilism, Withdrawal, Alcohol or Drug Dependency and other personal challenges. The researcher wanted to design and develop a tool encouraging the participant in a 1-1 intervention to express specifically the reason they were attending, without introducing or pre-suggesting any terminology used throughout the profession of cognitive healthcare. The resulting assessment tool is presented here, together with a total of ten responses. This is now used as an initial assessment tool, alongside an I180-25, which is being developed in practice from 2019. Each of the ten responses were originally hand-written. They are presented here as typed.
The feasibility trial taking place in a rectangular, white-walled room, resulted in a series of semi-structured interviews with participants (n=12). From this, five respondents provided response to an online feedback form, providing some valuable response in terms of future design and considerations to the study. Participants were asked to complete a 14-day follow up feedback form, as emailed, asking: Any relevant thoughts since participation in the trial: Has the trial assisted in any way? Has the trial played any detrimental role in your personal development? Would you choose to re-visit the intervention? If yes, how many visits? Building on this type of data since the 2017 feasibility trial has led to considerable development and an improved methodology in the on-going study and an assembled ‘participatory advisory group’ who now inform the study’s design at different stages.
During planning and enhancing stages of developing the immersive process/product as a med-tech tool in healthcare, the researcher considered applying and adapting Verplank’s Spiral to the journey of innovation. This allowed the researcher to consider the stages of the innovation as a reflection of the process journeyed through between 2017-19. It also highlighted a requirement for the researcher to continue to develop the innovation ‘with’ the participants, not for them.
In line with the researcher’s engagement in practice with people presenting a range of ‘discomforts’ this table shows potentially influential factors which could be regarded as biological, social, emotional, environmental and other reasons.
This paper is now further advanced from 2019 and the research has continued. It was compiled to document early feasibility trial findings between 2017-18 with 12 participants. The data analysis involved IPA. This draft paper investigates a pilot trial approach with individuals presenting signs of struggle in cognitive health, where a gap exists to explore the impact of immersive interactive technology (an immersive room, or space) in digital healthcare. The research finds that cognitive interventions, as psychological treatments, could be enhanced via the implementation of valid standing options capable of complementing more widespread clinically seated practice. The research introduces a unique process of intervention with ability to plug in to technology as a contemporary, holistic approach, demonstrating how this might lead to a digital advancement in talking therapies, to enhance subject-environment connectivity and weigh the approach against a non-technological alternative. In layman’s terms, the intention is to encourage patients seeking forms of cognitive intervention to stand on their feet, whilst suggesting to therapists who facilitate approaches that this shift could be essential to allow for a whole-body investment where experiential elements of see, touch, feel are the agents of change which can lead to subject reasoning and autonomy. A further two years of work have developed since the initial feasibility trial and the study is now on-going as a PhD.
Innovation in the healthcare system; a chapter from a more broad study examining the distribution of power in UK cognitive healthcare. Keywords: Innovation 1; Social application 2; Systems 3; Concepts 4; Language 5; Healthcare 6; Cognitive 7; Boundary-shift 8; Transdisciplinarity