Citation

Paul M, Bullock K, Bailenson J. JMIR Ment. Health 2020; 7(11).

Copyright

(Copyright © 2020, JMIR Publications)

DOI

10.2196/24331

PMID

unavailable

Abstract

BACKGROUND: Major depressive disorder (MDD) is a global problem with an increasing incidence and prevalence. There has additionally been an increase in depression due to the COVID-19 pandemic. Behavioral activation is considered an evidence-based treatment for MDD. However, there are many barriers that could hinder one's ability to engage in behavioral activation, with COVID-19 "shelter-in-place" and social distancing orders being current and large impediments. Virtual reality (VR) has been successfully used to help treat a variety of mental health conditions, but it has not yet been used as a method of administering behavioral activation to a clinical population. Using VR to engage in behavioral activation could eliminate barriers that pandemic precautions place and help decrease symptoms of depression that are especially exacerbated in these times.

OBJECTIVE: The following case report examines the feasibility, acceptability, and tolerability of VR behavioral activation for an adult with MDD during a global pandemic. This participant was part of a larger pilot study, and the case serves as a description of the VR intervention.

METHODS: The participant engaged in a weekly 50-minute psychotherapy Zoom session for 4 weeks, in which a modified behavioral activation protocol was administered using a VR headset to simulate activities. Data on mood ratings, homework compliance, and headset use were obtained from the headset. Acceptability, tolerability, and depression symptoms were obtained using self-report rating scales.

RESULTS: The intervention was feasible, acceptable, and tolerable, as reported by this participant. The participant's depressive symptoms decreased by five-points on the Patient Health Questionnaire-9 over a month, with a beginning score of 10 (moderate depression) and a final score of 5 (mild depression).

CONCLUSIONS: The implications of these findings for future research are discussed. © Margot Paul, Kim Bullock, Jeremy Bailenson. Originally published in JMIR Mental Health (http://mental.jmir.org), 03.11.2020. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Mental Health, is properly cited. The complete bibliographic information, a link to the original publication on http://mental.jmir.org/, as well as this copyright and license information must be included.

Language: en

Keywords

adult; Behavior; human; COVID-19; Depression; male; case report; Intervention; bipolar disorder; psychotherapy; suicidal ideation; pandemic; Major depressive disorder; suicide attempt; major depression; Telehealth; Case report; Virtual reality; bulimia; mental health care; clinical article; fluoxetine; mirtazapine; self report; family history; Caucasian; Pilot study; Feasibility; Article; feasibility study; Acceptability; mini international neuropsychiatric interview; social media; Patient Health Questionnaire 9; cognitive behavioral therapy; cannabis use; medication therapy management; program acceptability; program feasibility; virtual reality exposure therapy; Patient Health Questionnaire 8; coronavirus disease 2019; social distancing; Behavioral activation; VR