Virtual reality job interview training for veterans with posttraumatic stress disorder

Abstract

BACKGROUND Veterans with posttraumatic stress disorder (PTSD) have low employment rates and the job interview presents a critical barrier for them to obtain competitive employment. OBJECTIVE To evaluate the acceptability and efficacy of virtual reality job interview training (VR-JIT) among veterans with PTSD via a small randomized controlled trial (n=23 VR-JIT trainees, n=10 waitlist treatment-as-usual (TAU) controls). METHODS VR-JIT trainees completed up to 10 hours of simulated job interviews and reviewed information and tips about job interviewing, while wait-list TAU controls received services as usual. Primary outcome measures included two pre-test and two post-test video-recorded role-play interviews scored by blinded human resource experts and self-reported interviewing self-confidence. RESULTS Trainees attended 95% of lab-based VR-JIT sessions and found the intervention easy-to-use, helpful, and prepared them for future interviews. VR-JIT trainees demonstrated significantly greater improvement on role-play interviews compared with wait-list TAU controls (p=0.04) and demonstrated a large effect for within-subject change (Cohen’s d=0.76). VR-JIT performance scores increased significantly over time (R-Squared=0.76). Although VR-JIT trainees showed a moderate effect for within-subject change on self-confidence (Cohen’s d=0.58), the observed difference between conditions did not reach significance (p=0.09). CONCLUSIONS Results provide preliminary support that VR-JIT is acceptable to trainees and may be efficacious for improving job interview skills and self-confidence in veterans with PTSD.

Virtual reality job interview training and 6-month employment outcomes for individuals with schizophrenia seeking employment

“…The observed improvement in interviewing skills in this cohort is consistent with the evaluation of VR-JIT in other clinical populations (Smith et al, in press-a; Smith et al, 2014a; Smith et al, 2014b). Also, our findings that trainees with schizophrenia had greater odds of receiving job offers and higher doses of training were related to fewer weeks of job searching replicated the results from a recent 6-month follow-up study of a cohort primarily diagnosed with mood disorders or PTSD (Smith et al, in press-b).…”

“…Four trainees and three controls with schizophrenia completed prior RCTs of VR-JIT (Smith et al, in press-a; Smith et al, 2014b) and their data were included in all current analyses to optimize statistical power with final sample sizes of n=21 trainees and n=11 controls. Participants were re-contacted after 6 months and asked to complete a follow-up survey.…”

“…Symptoms were assessed using global ratings from the Scale for the Assessment of Positive Symptoms and the Scale for the assessment of Negative Symptoms (Andreasen, 1983a, b). For the 7 participants who completed prior studies (Smith et al, in press-a; Smith et al, 2014b), we used ratings and notes from the Mini-International Neuropsychiatric Interview to inform symptom ratings and SCID diagnosis.…”

“…Recently, two randomized controlled trials (RCT) evaluated virtual reality job interview training (VR-JIT), which demonstrated acceptability and efficacy at improving interview skills and self-confidence for individuals primarily diagnosed with mood disorders and veterans with post-traumatic stress disorder (PTSD) (Smith et al, in press-a; Smith et al, 2014b). Moreover, VR-JIT trainees sustained their self-confidence and were more likely to receive job offers than controls when evaluated six months later.…”

Head-Mounted Virtual Reality and Mental Health: Critical Review of Current Research (Preprint)

“…75 studies were identified. VR has been used as a form of exposure treatment for: social anxiety disorder [22][23][24][25]; PTSD for military veterans [26,27], world trade centre attack [28] and assault victims [29]; a range of specific phobias, with interest in fear of flying [30,31]and fear of spiders [32][33][34][35][36]; and OCD [37][38][39]. The virtual environments that VR operates within have been the focal point of anxiety research, with some studies looking specifically at the role of audio, visual and bimodal stimuli [40][41][42] Malbos et al [48] found that when treating anxiety for agoraphobia VRET was just as effective in reducing anxiety as VRET with CBT combined.…”