Transcending Self Therapy-Virtual Reality (TST-VR) and Substance Use Disorder (SUD) Treatment Completion in Veterans

Transcending Self Therapy (TST) is an integrative Cognitive Behavioral Therapy (CBT) for substance use disorders (SUD). Virtual reality (VR)-based enhancement of treatment for mental health disorders holds potential as an innovative and immersive adjunct to standards of care. However, outside of cue-conditioning applications, how VR may assist SUD treatment is not well understood. The aim of this study was to examine the association between engagement with a VR version of TST and residential SUD treatment completion. In a program evaluation, 51 consecutive military veterans admitted to a residential SUD treatment program were afforded access to VR equipment programmed to enable ad libitum exploration of a virtual wooded retreat with stations that reinforced psychoeducation concepts of TST, meditation, and other therapeutic activities. Administrative records were reviewed, and treatment completion data were collected for veterans who opted to receive a TST-VR headset (n = 36) and those who did not (n = 15). Engagement with the VR gear and program was related to treatment completion. Veterans who opted to accept the VR program and related training in its use were significantly more likely to complete treatment than those who did not (86.1% vs 60.0%; p = 0.039). These data suggest that either VR-based reinforcement of TST concepts improved the treatment experience or motivation for change, and/or that individuals with poor general treatment motivation are unlikely to choose VR-enhancement of SUD treatment and complete treatment in general. Both possibilities have important implications for VR SUD treatment research.