Virtual Standardized Patients (VSPs) are computer-based training simulations that expand access to experiential, evidence-based mental health training at low cost and scale. This paper presents three phases of user-centered design studies to develop a VSP for Safety Planning Intervention (SPI) in the Department of Veterans Affairs (VA) and Department of Defense (DoD). VA and DoD mental health staff, trainees, and subject matter experts participated in qualitative interviews, prototype usability testing, and beta testing. Results identified key design features for effective training. Usability ratings of the prototype and beta were good, with higher ratings among trainees. Critical improvements were made to performance feedback, and users helped refine dialog clarity and training tasks. The resulting SPI VSP is now poised for a pilot randomized trial to evaluate training outcomes relative to routine training. If effective, it may provide a scalable, cost-effective way to improve dissemination of a promising suicide prevention intervention.

This pilot study assessed the utility and acceptability of the VirtuSphere, a cutting edge navigation platform designed to enhance presence in virtual environments. The VirtuSphere includes a 12-ft hollow sphere within which the user stands, and it rolls within a wheeled platform, in any direction, according to the user's steps. The pilot was a within-subject crossover design comparing the VirtuSphere to standard game controller navigation. The comparison was based on locomotion in Virtual Iraq, a virtual world resembling Iraqi war zones. Participants were 10 active duty soldiers not suffering from posttraumatic stress disorder. Results indicated that there were negligible differences in sense of presence, simulator sickness, and satisfaction across the two navigation systems. Although the VirtuSphere may provide entertainment value, these results do not provide initial support for the use of the VirtuSphere to improve constructs thought to be important to behavioral health applications of virtual reality. Potential improvements to the design of the VirtuSphere are discussed.

Deploying Active Duty Service Members face multiple psychological health risks, including posttraumatic stress disorder (PTSD). Despite a significant proportion of Service Members with psychological health needs, a number of barriers prevent access to education and treatment services available to them. These barriers include perceived stigma, physical access barriers, and psychological barriers. Web resources provide important information regarding psychological health issues and available resources but have limitations in the learning experience they can provide. Virtual worlds platforms, such as Second Life, offer unique affordances that may reduce some barriers to accessing psychological health education and care. They may allow for a unique immersive and interactive learning experience augmenting current web resources. One such virtual world environment, the T2 Virtual PTSD Experience, is described. The T2 Virtual PTSD Experience aims to educate military service members, veterans, family, and peers about the causes, symptoms, and help available for combat-related PTSD. Reactions from visitors have been positive, with many reporting improved understanding of PTSD and motivation to seek care. Future directions for leveraging virtual worlds in the service of psychological health care are discussed.

Posttraumatic Stress Disorder (PTSD) is reported to be caused by traumatic events that are outside the range of usual human experience including (but not limited to) military combat, violent personal assault, being kidnapped or taken hostage and terrorist attacks. Initial data suggests that at least 1 out of 5 Iraq War veterans are exhibiting symptoms of depression, anxiety and PTSD. Virtual Reality (VR) delivered exposure therapy for PTSD has been previously used with reports of positive outcomes. The current paper is a follow-up to a paper presented at IEEE VR2006 and will present the rationale and description of a VR PTSD therapy application (Virtual Iraq) and present the findings from its use with active duty service members since the VR2006 presentation. Virtual Iraq consists of a series of customizable virtual scenarios designed to represent relevant Middle Eastern VR contexts for exposure therapy, including a city and desert road convoy environment. User-centered design feedback needed to iteratively evolve the system was gathered from returning Iraq War veterans in the USA and from a system deployed in Iraq and tested by an Army Combat Stress Control Team. Results from an open clinical trial using Virtual Iraq at the Naval Medical Center-San Diego with 20 treatment completers indicate that 16 no longer met PTSD diagnostic criteria at post-treatment, with only one not maintaining treatment gains at 3 month follow-up.

Post Traumatic Stress Disorder (PTSD) is reported to be caused by traumatic events that are outside the range of usual human experiences including (but not limited to) military combat, violent personal assault, being kidnapped or taken hostage and terrorist attacks. Initial data suggests that 1 out of 6 Iraq War veterans are exhibiting symptoms of depression, anxiety and PTSD. Virtual Reality (VR) exposure treatment has been used in previous treatments of PTSD patients with reports of positive outcomes. The aim of the current paper is to present the rationale, technical specifications, application features and user-centered design process for the development of a Virtual Iraq PTSD VR therapy application. The VR treatment environment is being created via the recycling of virtual graphic assets that were initially built for the U.S. Army-funded combat tactical simulation scenario and commercially successful X-Box game, Full Spectrum Warrior, in addition to other available and newly created assets. Thus far we have created a series of customizable virtual scenarios designed to represent relevant contexts for exposure therapy to be conducted in VR, including a city and desert road convoy environment. User-Centered tests with the application are currently underway at the Naval Medical Center-San Diego and within an Army Combat Stress Control Team in Iraq with clinical trials scheduled to commence in February 2006.