In the fall of 2019, Asher Marks, MD and Amanda Garbatini, LMSW at Yale New Haven Children’s Hospital, launched a groundbreaking clinical trial involving the use of virtual reality to conduct support groups for adolescent and young adult oncology patients. Adolescents and young adults (AYAs) with cancer face unique challenges that younger and older patients may never experience. For an AYA, the cancer diagnosis comes during an inherently vulnerable developmental stage, magnifying the feelings of isolation associated with the diagnosis and treatment of cancer. Asher and Amanda recognized that many of their patients were craving social and peer support to make connections with others who understand what it is like to be a teen with cancer. Support groups help foster these connections, but in-person support groups are difficult for patients to participate in due to immunosuppression, prolonged hospitalizations, geographic constraints, and other responsibilities to their families and jobs. Virtual reality (VR) allows for the creation of a therapist-curated, computer-generated reality.
This pilot study looks at the use of social VR to facilitate support groups for AYA patients. During the intervention, four AYA cancer patients use Oculus Quest headsets, from the comfort of their own homes or hospital beds to participate in six virtual, professionally-facilitated support groups. The patients and the group facilitator meet in a secure virtual space once per week for 45-60 minutes. Impact of participation is measured by CD-RISC (The Connor-Davidson Resilience Scale) and PROMIS (Patient-Reported Outcomes Measurement Information System) surveys assessing participants’ resilience, depression and anxiety pre- and post- participation.
Prior to entering the virtual space, the patients and the facilitator design a basic avatar that will represent them within the virtual room. When a person is speaking, their own voice is transmitted and the avatar’s mouth moves to mimic actual speaking. Because faces are not seen in the VR support group, patients can choose to remain anonymous. Many patients have expressed comfort in the anonymity aspect, stating that they feel they can be more open and honest.
Early results have been promising; showing both, anticipated benefit and unexpected challenges. We are seeing trends toward reduced depression, loneliness and anxiety, as well as an opportunity to engage a patient population that has otherwise been unable or unwilling to participate in support groups in person.
In light of COVID-19, in-person support groups for immunocompromised patients have been stopped, leaving a number of patients without the means of obtaining social connections and peer support. Given the early results of the clinical trial, Asher and Amanda have plans to grow this program, to reach more people, and to provide a safe, effective and engaging way for patients to receive group therapy and peer support.