Transcending Self Therapy Virtual Reality Expansion: Effect on Engagement, Completion and Temporal Usage Patterns.

Area of Science:

• Digital Therapeutics
• Virtual Reality in Healthcare
• Substance Use Disorder Treatment

Background:

• Transcending Self Therapy (TST) is a cognitive behavioral therapy adapted for substance use disorders (SUDs).
• The TST program was integrated into an immersive virtual reality (VR) platform (TST-VR) with modules for psychoeducation, mindfulness, and TST principles.
• A previous feasibility study informed the expansion of TST-VR from 4 to 10 modules.

Purpose of the Study:

• To evaluate the impact of expanded content in TST-VR on user engagement.
• To test the hypothesis that the 10-module TST-VR would increase engagement metrics like total time and program completion.
• To explore patterns of TST-VR usage, including time of day and module adherence.

Main Methods:

• Fifty-eight military veterans undergoing SUD treatment were assigned to either the 4-module or 10-module TST-VR program.
• Usage data, including total time in headset, time of day, and module completion, were collected.
• Engagement was assessed by comparing usage metrics between the two TST-VR versions.

Main Results:

• Veterans in the 10-module TST-VR group demonstrated higher average total time in headset and greater likelihood of completing all modules compared to the 4-module group.
• Exploratory analysis revealed significant overnight usage (midnight to 6 AM) in a minority of users across both groups.
• Time spent in the initial tutorial did not predict overall module completion, even in a population potentially new to digital devices.

Conclusions:

• Expanding VR content in TST-VR, following user-centered design, enhances patient engagement and adherence in SUD treatment.
• VR platforms can serve as on-demand therapeutic resources, accessible outside standard clinical hours.
• Further research is warranted to understand how larger virtual environments can improve SUD treatment engagement.