Shen YI, Nelson AJ, Oberlin BG. Virtual reality intervention effects on future self-continuity and delayed reward preference in substance use disorder recovery: pilot study results. Discov Ment Health. 2022;2(1):19. doi:10.1007/s44192-022-00022-1
This pilot assessed the efficacy and feasibility of a virtual reality (VR) experience for substance use disorder (SUD) recovery that combines schema theory and episodic future thinking (EFT). Previous research has shown that individuals with SUD are less motivated by future rewards or punishments. This lack of focus on future events is theorized to influence decision-making so that future consequences are ignored. EFT has been used to shift individuals’ perspectives so their future selves are less ambiguous and worth considering when making decisions in the present. The current pilot VR experience attempted to use this technique to promote abstinence behavior in individuals early (< 1 year, > two weeks) in their SUD recovery. The VR experience comprised five short scenes where users were (1) acclimated to the VR landscape, (2) given simulated “time travel” and VR avatar engagement instructions, (3) had a conversation with their future-self avatar (+15 years) who relapsed, (4) and their future-self avatar (+ 15 years) that maintained abstinence, and finally (5) a debriefed by the present-self avatar. The 21 participants (71.4% male, 90.5% white) reported that the VR headset and experience were positive (6.4 out of 7). The experience extended the time into the future participants consider consequences when making decisions and increased delayed reward preference in delay discounting tasks. In an exploratory analysis, the authors found that 86% of participants maintained drug abstinence for 30 days following the VR experience. Additionally, none of the participants used their drug of choice (alcohol), and general marijuana and methamphetamine use declined by 71.6% and 68.6%, respectively. This pilot supports future randomized control trials and encourages innovation for new digital interventions for SUD recovery.