@Article{info:doi/10.2196/24331,
author="Paul, Margot
and Bullock, Kim
and Bailenson, Jeremy",
title="Virtual Reality Behavioral Activation as an Intervention for Major Depressive Disorder: Case Report",
journal="JMIR Ment Health",
year="2020",
month="Nov",
day="3",
volume="7",
number="11",
pages="e24331",
keywords="virtual reality; case report; major depressive disorder; behavioral activation; VR; depression; COVID-19; behavior; intervention; feasibility; acceptability; telehealth; pilot study",
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. Trial Registration: ClinicalTrials.gov NCT04268316; http://clinicaltrials.gov/ct2/show/NCT04268316 ",
issn="2368-7959",
doi="10.2196/24331",
url="https://mental.jmir.org/2020/11/e24331",
url="https://doi.org/10.2196/24331",
url="http://www.ncbi.nlm.nih.gov/pubmed/33031046"
}