University of Twente Student Theses


Integration of Virtual Reality within aggression regulation treatment in forensic mental health care : a qualitative study

Tintin, G. (2022) Integration of Virtual Reality within aggression regulation treatment in forensic mental health care : a qualitative study.

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Abstract:Forensic mental health care (FMHC) aims to protect society and prevent recurring offensive behaviour such as aggression. Risk assessment instruments are used to identify risk factors that trigger FMHC patients’ aggressive behaviour and provide them with a personalized toolkit to manage these triggers. The specific risk factors that must be considered are acute dynamic risk factors, also known as triggers. The identification of triggers within current treatment such as ‘Aggression Regulation (AR) – customised’ consists of conversations between the therapist and the patient. This lacks context which makes it difficult for the patient to reflect on what triggers their aggressive behaviour. ‘Triggers & Helpers’ is an innovative VR solution that assists in in identifying triggers during therapy to eventually provide patients with a personalized toolkit to manage these triggers in their daily life. However, it is not yet integrated into current treatment and rather used as an add-on. Integration of VR within current treatment process can be achieved by co-creating and tailoring the implementation process to the requirements, skills, and attitudes of FMHC therapists. Therapists (n = 10) working in outpatient care within two Dutch FMHC organisations participated in a semi-structured interview to explore their experiences and ideas about the integration process of the VR intervention ‘Triggers & Helpers’ within ‘AR – customised’. The inclusion criteria for this study were therapists actively working in FMHC that extensively use ‘AR – customised’ and are trained in the usage of VR. In order to recruit therapists, convenience sampling supplemented with snowball sampling was used. Both deductive coding, based on the 11 pre-existing modules of ‘AR – customised’, and inductive coding was used during the data analysis as well as the method of constant comparison. The results of this qualitative study provide insight into the added value VR could have in treatment combined with ‘AR – customised’ for FMHC outpatients within two Dutch FMHC organizations. The use of the VR intervention ‘Triggers & Helpers’ could be of added value in all modules of ‘AR – customised’ to increase interoceptive awareness, enhance helping thoughts and self-reflection, enhance coping skills, and identify triggers, coping skills, prepare the patient for societal situations, provide a preview of VR, enforce the patients’ social participation, or enforce the patients’ ability to set boundaries. This VR intervention could be introduced to every patient following ‘AR – customised’, however the attitude, adherence, and diagnosis of the patient must be considered regardless. Additionally, both the therapist and patient must be able to use the VR. There must be sufficient trust between the patient and therapist in order to ensure a safe environment within the treatment room. Whereas the literature mentioned the preference for a protocol with specific scenarios, the participants of this study preferred a flexible workbook with practical suggestions on how to co-create a VR scenario with the individual patient because the VR scenarios must fit the experiences of the individual patient.
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Subject:77 psychology
Programme:Health Sciences MSc (66851)
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