Post-Traumatic Stress Disorder (PTSD) can be seen as the result of dysfunctional beliefs that associate stimuli with a danger or a threat leading to anxious reactions. Exposure therapy is so far considered to be the most effective treatment, and research suggests that it is mainly based on a habituation process. Based on learning theories, it appears that a passive systemic exposure to traumatic stimuli should not be the best option for the treatment of PTSD. We hypothesis that an active learning of safer and healthier coping strategies combined with systematic exposure should be more effective in reducing the psychological distress associated with PTSD. In this paper, we describe the theoretical foundations of this approach that focuses on the action and activity of the patient in his or her exposure environment. In this approach, we take advantage of Virtual Reality technologies and learning mechanics of serious games to allow the patient to learn new safe associations while promoting the empowerment. We named this action-centered exposure therapy (ACET). This approach exploits behaviorism, cognitivism, and constructivism learning theories. With the different benefits of virtual reality technologies, this approach would easily integrate with in-virtuo exposure therapy and would allow us to exploit as much as possible the enormous potential of these technologies. As a first step toward validation, we present a case study that supports the ACET approach.
Integration of haptics in Serious Games (SGs) remains limited compared to vision and audio. Many works seem to limit haptic interactions to the mimicking of real life feelings. Here, we address this by investigating the use of haptics to promote learning outcomes in serious games. By analyzing how we learn, we proposed a model that identifies three learning outcomes: (1) engage the user with the content of the game, (2) develop technical skills, and (3) develop cognitive skills. For each learning skill, we show how haptic interactions may be exploited. We also show that the proposed model may be used to describe and to evaluate existing methods. It may also help in the designing of new methods that take advantage of haptics to promote learning outcomes.
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