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hi, welcome to mental health matters. i'mshannon eliot. today we will be taking an in-depth look atthe coming home project, an innovative initiative that uses a virtual world to provide camaraderie,support, and resources for returning troops. dr. jackie morie is the project lead for thecoming home project and a senior researcher at the institute for creative technologiesat the university of southern california.



down dog yoga bethesda schedule

down dog yoga bethesda schedule , she has worked in the field of immersive technologysince 1990, focusing on effective and meaningful applications of virtual environments. dr.morie has been published and speaks internationally on games, immersive worlds, and avatars. welcome, jacki. thanks so much for joiningme today.


>>thank you, shannon. >>can you kick us off by describing the cominghome project? what is its purpose and how does it work? >>the coming home project was an idea we hadto look at how virtual worlds that many people were starting to use could be used by returningveterans who were coming home from conflicts with a lot of mental health issues. and alot of them don't live near veterans' centers, so they couldn't really go in for this, andthere's this stigma attached to getting mental health help. so the anonymity and privacyof the virtual world coupled with its social capabilities coupled with what we could putinto it in terms of stress release activities,


we thought would be a really good way forthese veterans to get some help without having to put themselves out on the line. >>so what are the project's components? ifi were a veteran experiencing this, what would i see and hear and feel? >>when you would go into the virtual worldof second life, you first of all have to have an invitation to come into this area thatwe've made, which we call chicoma island, even though it's a fairly large area. thearea is made to be a very wooded space. it's got a lot of waterfalls, water aspects. it'sgot a shoreline. we made something that looks like a hunting or ski lodge, which would bethe gathering place, the social center for


the island so that veterans could come andhang out there by the fireplaces, out by the water. they could watch the birds fly andeven do a little fishing in the virtual world if they wanted. so we made it so that it wasas far removed from the kinds of environments that they were experiencing on their deploymentsbecause being in those same kinds of environments -- either physically or virtually -- tendedto stress them out. so we wanted something that would calm them. so you would go intochicoma island and you would go into the veterans' lodge and you would see this beautiful huntinglodge. but there are other areas on the island as well. we have a welcome center that tellsyou what you can do there. we have some virtual human agents, who are sort of autonomous programswho can give you a tour of the space and tell


you what you can find there and what you cando there. we have a labyrinth that you can walk and a guide that tells you how to walkthe labyrinth. we have some stables and some other kinds of fun things for people to do.but there are some areas that are specifically devoted to stress relief. >>how many veterans are using it at the moment? >>right now it's still in the proof of conceptstage. we've had some veterans from an in-world veterans group that was self-formed. and thisis a group that when we started the project, there were about 300 veterans. now there'sover 1600. and they come from all conflicts, all ages, and all services. so when we needtesters, we get them to come work with us.


and what's interesting about that group isthey use their space; they have their own small island. they use that space like a bfwhall for the 21st century. the people coming back from the recent conflicts don't havea centralized geographic location. most of them come from rural areas. they don't havea place where they can meet with their buddies, so this serves that purpose for them. so wedon't have actual users yet because we are still in the middle phase of a research project,but there are veterans who are very invested in the virtual world. >>so i'm curious about the use of these avatars.can you tell me a little bit about what they are and why they are so significant in thisprocess?


>>an avatar is the representation of you inthe virtual world. so in this one it's a 3d representation. most people start by gettinga default avatar and trying to customize it so it looks like them, so it resembles themin a physical aspect in some way. but often that turns into customizing it so it reflectssome aspect of your interior self. so some of the veterans i know have wolves for avatarsor have big biker guys for avatars. it's a wide range. but this particular virtual worldwe're working in offers that. it offers you to be anything you want to be. so people takeadvantage of that and use it to really get in touch with aspects of themselves. so forexample, say a veteran has been really injured and can't walk. they might have an avatarthat sort of mitigates that and is very powerful


>>so i recently had a chance to go into secondlife and experience the coming home project myself. let's take a look. well jacki, thanks so much for having me in-worldwith you. >>it's my pleasure. >>so where are we right now? >>we're at what we call chicoma lodge, whichis a lodge that we built for the veterans so that they could have a place to gatherthat was very much different than the desert scenes they were getting in the middle east.so we made this into a hunting lodge, skiing lodge type of facility with a lot of waterand a lot of green.


>>it's beautiful. do you mind if we take aquick look inside? >>that'd be great. >>just like in the mountains. >>so you can see here that we have a signthat says this is our mindfulness based stress reduction workshop. and you can see who isrunning it. these are two experts from the san diego mindfulness center. and they havebeen working with us for about four years now to develop techniques that allow themto do the same sort of program for mindfulness that they do in the physical world in thevirtual world. >>that's impressive. not an easy task.


>>it's taken some real thinking about it andwe've had to refine as they've held classes. so we came up with this area. each of thesecushions is like a meditation cushion, but you can sit on it. and if you're sitting ona cushion, the person leading the mindfulness has control of your avatar. so you can actuallywatch your avatar go through the poses that are typical of a mindfulness session. sometimesthey're yoga poses. sometimes you lay down to do a body scan. and if there was a facilitatorin here running a mindfulness class, he or she would be able to tell our avatars to alllay down, so we would be listening to his voice and then watching our avatars in thestandard position that you'd have in a regular mindfulness class.


>>and how many people at a time can this classaccommodate? >>well we can put as many of these cushionsout as we want. i think 16 would probably be an upper limit. we are actually runningclasses right now for a longitudinal study that we're doing with dr. valerie rice atfort sam houston. so she has about 8 people per session and we are in our third or fourthsession. we'll be doing these for about a year so we get a good number of subjects forthe study. >>that's so exciting. >>we're really excited to see if we can provethat delivering mindfulness in a virtual world is as effective as delivering it in the realworld.


so this is where we have the homework pods.it's not as beautiful as the lodge, but what it affords is privacy. what it does is puta virtual reality sphere around us so that we can have a beautiful scene while we'redoing our homework. and if we click in front of us, you see the homework menu. >>yes. >>so you can choose which of the sessionsyou want to do for homework. so there's a number of them that the people who are runningthe class have recorded so that you could do a 45-minute body scan or just a 10-minutewisdom meditation while you're in here and be in one of these environments. so you canchoose which environment that you would want


to be in. it's amazing how much it affectsour psychological being. you wouldn't think that 3d graphics or being in this kind ofworld would do that, but it really does have an effect. so if you're in a nature scene-- let me just change this here to the grand canyon environment -- there is something aboutbeing in this scene that changes the way you feel about things and if you are able to walkthrough it and hear the sounds. in our area here around the lodge, you can be standingby a tree and hear a woodpecker or chipmunks might be running around, so there's all thatsort of subtle ambient sound that really helps you feel like you're there. >>that's great. thank you for sharing thiswith me.


>>oh, you're welcome. we love sharing thisbecause we think it's a very exciting development. >>so that was really interesting. i understandthe virtual world has a stress reduction center that includes mindfulness activities. whydid you guys choose to focus on mindfulness? >>when we started working in the virtual world,nobody knew if it was going to be beneficial in the ways that we envisioned it. so we wantedto start with something that had been proven to work in the physical world. so mindfulnesshad 30 years of evidence-based research to support it. and then we thought that was anexcellent way to start. >>what other stress release activities doveterans experience in-world? >>we have a couple. one is a storytellingtower that they can look at stories from classic


warriors, like the cheyenne dog warrior orthe samurai warrior. and that's an interactive exhibit, kind of like a museum exhibit, exceptwhen they get to the top of the storytelling tower, having seen the scenes from the warrior'slife, they can then talk to that warrior as an ai (artificial intelligence) agent andthat warrior can answer any questions they have -- historical or personal. how did youfeel when you killed somebody? they can ask all kinds of really pointed questions in aconversational way with this agent who is a storyteller. so that's one. we have a running path that we put it. nowwe had a military social worker say, "couldn't you put a running path into the virtual world?"because when they come back, if they can't


run, they really miss it. and we thought,sure, but the way you navigate your avatar in the virtual world is to navigate the upkey. and we didn't think that would be very satisfying. so we came up with this conceptof using your ordinary microphone that you would use to talk to other people in the virtualworld. we wrote a function that recognizes your breath. and so it recognizes the rhythmof your breath. we gave you a little biofeedback device so you see this bar going up and downand as long as you can match your breath to the rhythm of the up-and-down bar, then youravatar will run. and it will run around the entire island, which takes about 10 minutes.so it's all about deep breathing, but it's in the context of this fun activity of running.and we did a study on this and we found that


you were much more relaxed at the end of the10-minute run. so that's some of the other stress release that we have. and then we have the mindfulness center. thatlooks like a gazebo at the rear of the ski lodge, and that is filled with yoga cushionsand different kinds of things that the instructors need to be able to give that class withinthe virtual world because there are differences from the physical world. but the gazebo isin a very nice location and there are paths that you can walk for your mindfulness walking.there are yoga poses that we've built into those cushions so the instructor can haveeveryone stand up and do a mountain pose or do the relaxing pose for a body scan. so weput a lot of the functionality that would


be natural in the physical world into thatgazebo so that the instructors have full control of the class in ways they would be used toin the physical world. that was a big challenge. >>sounds like it. you mentioned that one ofthe draws of having avatars is that you can be anyone you want to be. you can have yourinner self come out. are there ever any challenges with that or any complications? does thatcomplicate the real world? for instance, the person you said who might have struggled withwalking in reality can suddenly walk in this virtual world. but does that contrast leavehim sad in the real world when he can't walk in the real world as he did in second life? >>i think it's more of an outlet and a wayto manage those challenges in the physical


world, so they're not bound by those challengesanymore. i assume there's some small risk to people getting addicted to being in thevirtual world, but it's something that i think provides more of social outlet. it providescamaraderie. rather than being isolated, you are actually with people. i think rather thanpeople becoming addicted to the avatar, they would instead be able to explore differentparts of themselves. they can always turn it off. it's not likely that they're goingto become addicted to these characters because they are in some sense part of them. so ifwe're addicted to ourselves, then maybe we get addicted to our avatars. but i think interms of psychological health, they fill a very important need that we have, that wemay not be able to get any other way. and


i think also in the future when we use thesevirtual worlds for what i call an advanced form of tele-health care, the expressionsof the avatar may be a very big psychological tell for a therapist back at a clinic or anoffice so that they can get a sense of what's going on with that person. now that's nota proven thing yet, but i envision a day when that will happen. >>so what are some advantages and disadvantagesof having veterans engage in virtual therapy vs. in-person therapy? >>the biggest advantage to having this therapyaccessible in the virtual world is that you can do it from anywhere. you only need a computerand an internet connection. you are in there


with other people. those other people caninclude your therapist or a group that you are in. so that's one of the big advantages.you don't have to travel to a center to get this help. the disadvantage is if there is a crisis situation,then it's harder for the therapist or comrade to do something about that. i would like tosee a safety net of on-call crisis intervention specialists who can be reached in such anevent. so that's the biggest disadvantage, i think. there are so many benefits that are possiblethat we are going to continue to do research in this area to see if we can show peoplelike the va hospitals and therapists that


this is a really viable way to get to a patientin a way you can't do by having them come to the office once a month. so i see thisas spreading as the advantages are noticed and taken advantage of by the therapist. >>what are some success stories that havecome from this project? >>well because we're still in a research phase,we don't have it actively deployed to patients yet. but we are in the middle of a longitudinalstudy that is looking at the effectiveness of mindfulness therapy delivered via virtualworld as opposed to mindfulness therapy delivered via physical world. so we expect that that'sgoing to give us the basis to show the military that this can be deployed in this way. thestories we have from the people who are participating


right now include that it's easier to talk,they are more open, there's that sense of anonymity that gives them a feeling of protection.so even in a physical setting in a group setting, they might not say as much as they're sayingin the virtual world. >>who would not benefit from this project? >>well we don't know if everybody's inclinedto want an avatar and to be able to inhabit an avatar in the virtual world. there maybe some people who think it's kind of silly or can't really wrap their heads around it,so those kinds of people might not be the ones best served by getting therapy in thevirtual world. but it is true that today there are hundreds of virtual worlds and the biggestusers of these virtual worlds are kids ages


5-15. they think nothing of having avatarsfor this, that, this world, another world, and they're growing up this way. this is theirsocial outlet. so they ma be priming themselves to get more of the mental health or healthcare in virtual worlds in the future. today we're in a transition phase, so we've gotpeople who have never used such things and find them a little frivolous, but i thinkas we go along in time, this will become a standard thing. we're all used to using socialnetworks on the internet right now. i think virtual worlds are the 3d-embodied versionsof social networks. >>is this project and experience designedto be an ongoing experience for veterans or is it something that they do for three monthsand then transition out and they're back to


normal? >>i think that's up to each veteran. so ifthey're finding a social existence in the virtual world that is satisfying to them insome way, they may stay in the virtual world for that social experience beyond any therapythat they do. it would be good if they had access to different kinds of therapy whenthey need it, just like in the physical world, and maybe easier to get to than some of thethings that they have trouble accessing now. i think it's a personal decision. i thinkpeople can use it as a tool to get help over a discrete time period or they can find alot of other reasons to be in the virtual world and to stay there.


>>how do you see this project evolving inthe future? >>well my vision is it that it becomes anintegral part of advanced tele-health care. so just like now we have video conferenceswith our physicians or with our therapists, this would be a way to have an ongoing relationshipbut to meet your therapist or your doctor in the virtual world. so you're both in there.like i said, there's a lot an avatar can tell about what you're doing and feeling at thatmoment in time. so i see this as something that could be something that could be actuallyinstantiated as part of health care in america. it will help reduce costs. it will have allthe benefits that traditional tele-health care has. but it has these three advantagesthat that does not have. and those are the


environment. we can make it anything we wantso we can look at 60 years of research into what kinds of environments are psychologicallybeneficial to us and we can make those in the virtual world. we have the social aspectso you're never alone. you've got these support groups and there's always someone in thereyou can talk to. and thirdly, the avatar, which is a strong draw for many people, maybenot everybody, but it is something that gives you a way to show the real you to other people. >>are there any facilities interested in usingvirtual worlds with their patients? >>we actually have a collaboration with thenational intrepid center of excellence for psychological health and traumatic brain injuryin bethesda, maryland. so this is a place


where military people come when they wantto remain active duty and they've been diagnosed with some sort of mental health problem. andthey want to get that fixed so they can get back to active duty. they come and they staythere for four weeks with a family member, typically. and they go through all kinds ofpossible therapies that might work for them. now we've been talking about using the virtualworld therapy as a way to do continuity of care for their patients. so when the patientsleave, they don't really have a way to keep in touch with them. we built the entire facilityin the virtual world so that they can come into the virtual world and actually go tothe places where they were having their physical-based therapy when they were at nico. so it's callednico for short. and we haven't implemented


that yet. we've been working with them forabout a year to build the facility and to put educational material in it as a firststep so they can go in and review the kinds of things that they learned when they werethere. the second phase is where we are for the nextyear, which is to get the therapists and the medical professionals up to speed on usingvirtual worlds and to find out from them how they could best be used in their context sothat we can put those functions into the virtual world. then the final phase would be deployingit out to the patients and giving them the opportunity to continue their care that way.so we're very excited about that collaboration with the national intrepid center. we'll seewhere it goes and we hope that in three years


we can say it's a success story. >>virtual worlds are often thought of as lightheartedplaces, places for fantasy. are there examples of virtual worlds being used for more seriouspurposes? >>there are actually quite a few. there area number of educational institutions that are using it as a test bed for distributededucation. but there are also people looking at it for purposes such as mental health.there is a group called preferred family health care in missouri, and several years ago theytook their teen addiction program into the virtual world. they found that because theyserved such a large area, it was hard for the kids to get into the facility as oftenas they needed to be. so they gave them a


$500 computer and a webcam and sent them home.and they built a space in an open source virtual world and the kids had to come into that fortheir sessions. and they could follow them because of the camera. they found the retentionrates just went through the roof, so from maybe around 30 percent when they had to comeinto the physical facility to 90 percent of the patients finishing the 3-4 month program.and they were just amazed at how much more compliance from the teenagers just by puttingthe program in a virtual world. so that's one success story. club one, which is a physical fitness placein the united states, has a number of nutrition and exercise programs they provide at theirphysical locations. they built a center in


the virtual world and then they did a studywhere they did the same interventions for people in the virtual world as in the physicalworld. and they found that the virtual world cohort actually did better. they stayed onthe program. they lost more weight. and they think it might be because of the social support.so rather than having to go to a physical place for every session, you could go intothe virtual world any time you want and find someone who is in your program so you canget that kind of moral support on an ongoing basis. so those are just two examples. there area number of others. there's a ptsd island where you can learn about ptsd. there is anonline mental health group that is looking


at using virtual worlds for that type of thing.but more and more we are seeing studies that show that the virtual world is a viable placeto distribute this type of health care. >>well jacki, thanks so much for joining metoday. this has been absolutely fascinating and i wish you and the project the best ofluck in the future. >>thanks, shannon. >>to get in-depth information on the cominghome project, visit usc's institute for creative technologies website at http://projects.itc.usc.edu. to download and participate in second life,visit www.secondlife.com. to read the new york times coverage on thecoming home project, visit:


http://bits.blogs.nytimes.com. thank you so much for watching. we'll seeyou next time.




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