To find yourself among people who give you their full attention. For the average person, this is basically a daily occurrence. However, it is a very stressful moment for a person with social phobia. Thanks to the Ekhi project, in which doctors from the Brno University Hospital and experts from Masaryk University in Brno are collaborating with the team lead by Tomáš Švec from the Faculty of Information Technology BUT, patients with various psychological disorders will soon be able to rehearse various situations or revisit stressful experiences in the safety of virtual reality. They will be accompanied by a psychotherapist who will be able to control the situation and correct the clients’ stress levels.

After the pandemic, the offices of psychologists, psychiatrists and therapists are starting to fill up with people who are experiencing post-traumatic stress disorder as a result of hospitalisation or severe coronavirus disease. A situation that is difficult for professionals to revisit with a client in a regular office, and thus often takes a long time to process, could soon play out again right before a person’s eyes in a matter of seconds. They will just put on a virtual reality headset and be back in the hospital ward, hearing machines or coughing and moving among the medical staff in protective suits. The therapist will not only see the same thing as the client, but will also be able to observe how the patient physically reacts to the situation. The moment it becomes too stressful for the person, the therapist can immediately change the environment to a calming forest.

The Ekhi project, which is the brainchild of Tomáš Švec’s team from FIT BUT, aims to create a technological and procedural framework for virtual reality used to diagnose and treat mental illnesses. “We are developing an application for virtual reality headsets, specifically the Oculus Quest, a web portal for control elements for the therapist, and finally a backend that connects the previous two parts,” Švec described. According to him, the whole system can be simplistically imagined as a filing cabinet in a hospital. “The human feeds it with data, other parts of the system take the data, read it and continue working with it,” he said, adding that the procedure is also consulted with other colleagues from BUT, for example from the field of artificial intelligence, machine learning or security. This allows them to create a system that is much more complex than what has been developed so far. “The idea of VR in therapy is not new. However, the available technologies did not allow for mass adoption before. Even now, virtual reality has been slow to appear in doctor’s offices. So, most of the studies have only been done on specific software developed for a specific problem. Researchers have found that virtual reality is at least comparable in its results to traditional exposure therapy. But it ended there and no one pursued it any further. We want to offer a set of tools with a variety of applications,” Švec added.

Virtual reality will facilitate exposure therapy

Ekhi is not intended for self-diagnosis or self-medication. “The whole system should work in co-operation with a therapist. The therapist has the ability to watch the patient’s experience in real time, monitor his biosignals and use these signals, such as heart rate or breathing rate, to decide on further action,” explained Tomáš Švec. Specifically, this type of therapy is called exposure therapy. “I say it is like going to the gym. Exposure therapy works by experiencing the same situation over and over again, perhaps gradually with a higher level of detail. And the patient gets used to the fact that he is not in danger,” Švec said. But at the same time, technology offers greater possibilities. In situations such as quarantine or long distance between therapist and client, the headset and software could enable the therapy to take place remotely.

Virtual reality scenarios are now created for social phobia and for post-traumatic stress disorder from Covid units. However, scenarios for other mental illnesses are expected to be added. “We want to make it as easy as possible to use the tool and as simple as possible to develop a new scenario. We will be happy if there are research groups that will find a practical application for our system in research on other mental illnesses,” Švec added. In addition, the authors are also improving the relaxation module.

Originally, Tomáš Švec, who is a doctoral student at FIT BUT, was supposed to work on something completely different. “Associate Professor Smrž had an idea about information technology that needed to be refined. Originally, he planned to focus on cybersecurity and recognising unusual human behaviour in, for example, online banking. But I wanted to steer towards diagnosis and treatment of mental illness and I am very grateful to him for making it possible,” Švec said.

The Ekhi project, named after the Basque goddess of the sun, is meant to symbolise hope for patients. Tomáš Švec hopes that virtual reality will one day become so established in the offices of Czech therapists that they will be able to use it for the prevention of mental illness. But for now, it is being tested by healthy volunteers. “The situation should trigger a stress reaction even in healthy individuals. In patients, this reaction is much stronger,” Švec explained. They have obtained a lot of valuable data, for example, during the Researchers’ Night, where interested people could try out the system. But they still welcome new volunteers. “If anyone is interested in helping us, we would certainly be happy to. The only thing that limits us is the necessity to perform the tests in Brno. But if that is not a problem, then those interested can contact us, for example, through the Project Ekhi’s Facebook page,” said Tomáš Švec.