COVID Feel Good—An Easy Self-Help Virtual Reality Protocol to Overcome the Psychological Burden of Coronavirus

Abstract

Background Living in the time of the COVID-19 means experiencing not only a global health emergency but also extreme psychological stress with potential emotional side effects such as sadness, grief, irritability, and mood swings. Crucially, lockdown and confinement measures isolate people who become the first and the only ones in charge of their own mental health: people are left alone facing a novel and potentially lethal situation, and, at the same time, they need to develop adaptive strategies to face it, at home. In this view, easy-to-use, inexpensive, and scientifically validated self-help solutions aiming to reduce the psychological burden of coronavirus are extremely necessary. Aims This pragmatic trial aims to provide the evidence that a weekly self-help virtual reality (VR) protocol can help overcome the psychological burden of the Coronavirus by relieving anxiety, improving well-being, and reinforcing social connectedness. The protocol will be based on the “Secret Garden” 360 VR video online ( ) which simulates a natural environment aiming to promote relaxation and self-reflection. Three hundred sixty–degree or spherical videos allow the user to control the viewing direction. In this way, the user can explore the content from any angle like a panorama and experience presence and immersion. The “Secret Garden” video is combined with daily exercises that are designed to be experienced with another person (not necessarily physically together), to facilitate a process of critical examination and eventual revision of core assumptions and beliefs related to personal identity, relationships, and goals. Methods This is a multicentric, pragmatic pilot randomized controlled trial involving individuals who experienced the COVID-19 pandemic and underwent a lockdown and quarantine procedures. The trial is approved by the Ethics Committee of the Istituto Auxologico Italiano. Each research group in all the countries joining the pragmatic trial, aims at enrolling at least 30 individuals in the experimental group experiencing the self-help protocol, and 30 in the control group, over a period of 3 months to verify the feasibility of the intervention. Conclusion The goal of this protocol is for VR to become the “surgical mask” of mental health treatment. Although surgical masks do not provide the wearer with a reliable level of protection against the coronavirus compared with FFP2 or FFP3 masks, surgical masks are very effective in protecting others from the wearer’s respiratory emissions. The goal of the VR protocol is the same: not necessarily to solve complex mental health problems but rather to improve well-being and preserve social connectedness through the beneficial social effects generated by positive emotions.

A Free Weekly Self-Administered at-Home Virtual Reality based Protocol for Overcoming the Psychological Burden of Coronavirus: A Pragmatic Waitlist-Controlled Trial Conducted During COVID-19 lockdown in Italy with 2-week follow-up

“…These advantages offered by VR has been already exploited in VR-based self-help treatments for treating phobias and anxiety disorders 85,8643 Here, we have further exploited the potentiality of VR as a "simulative instrument" to provide participants with the opportunity to be immersed in a naturalistic and safe digital place 55 , far from the stressful situations experienced in routine daily contexts, where they can learn how to relax and reflect upon their experience following a guided protocol. This effect has been enhanced by creating a bridge with the real-life context with different daily social tasks aiming at facilitating a process of critical examination and eventually revision of core assumptions and beliefs 52 .…”

“…In addition, each activity has a specific objective: All the exercises are designed to be experienced with another person (not necessarily physically together), to facilitate a process of critical examination and eventual revision of core assumptions and beliefs related to personal identity, relationships, and goals. The full description of the sessions is provided in 52 .…”

“…[43][44][45][46][47]49 A recent meta-analysis reviewed 34 studies with different type of self-guided therapeutic approaches (including cognitive-behavioral, mindfulness, and acceptance-based interventions) and globally these approaches showed small to medium effects in comparison to control groups 48 . In particular, advanced technologies, such as Virtual Reality (VR) could play a unique role in times of COVID-19 pandemic by supporting the delivery of accessible and affordable self-guided therapeutic interventions that offer multiple advantages, considering also high-treatment costs and the limited availability of health professionals 31,50,51 The present controlled trial tested the effectiveness of COVID Feel Good 52 , a novel self-help VR-based protocol aimed at helping individuals in cope with the psychological burden related to COVID-19 pandemic and restrictive social distancing measures. The protocol is currently freely available online (http://www.covidfeelgood.com) in 12 different languages -English, Spanish, French, Brazilian/Portuguese, German, Italian, Turkish Japanese, Korean, Farsi, Romanian and Catalan.…”

Telemedicine and Virtual Reality at Time of COVID-19 Pandemic: An Overview for Future Perspectives in Neurorehabilitation

“…In line with the necessary adaptation of healthcare services to the COVID-19, TR technological solutions are increasingly considered as potentially effective options for continuing the rehabilitation process at a distance (45,(67)(68)(69)(70). Currently, many efforts are now focused on the treatment of subjects recovering from COVID-19 (71-74), but it seems extremely important to implement TR protocols also in non-COVID subjects in various settings of neurological care, in order to provide a continuity of care during this pandemic contingency and possibly in the future (75)(76)(77)(78).…”

An Actual Natural Setting Improves Mood Better Than Its Virtual Counterpart: A Meta-Analysis of Experimental Data

“…Other mechanisms may be less likely to be activated in simulations, including reducing air and noise pollution (mitigation pathways) and promoting physical activity and social contacts (instoration pathways) (see Figure 1). Simulations could activate mitigation and instoration pathways if they masked noise in loud environments (e.g., hemodialysis centers; Burrows et al, 2020), accompanied vigorous walking on treadmills or cycling on stationary trainers (Howard, 2017;Birenboim et al, 2019), or supported interactions between multiple users (White et al, 2018;Riva et al, 2020). However, the vast majority of simulations today offer passive single-person experiences with only audio input, only visual input, or a combination of the two (LaValle, 2017).…”