Protocol for a Virtual Reality-Based Intervention:
A literature review by Fatima Zahra Moumou (14E272E), Laila Amirdine Mohamed (16D093M) & Virginie Blanchet (18B588Q), M2 PEADID
Virtual reality for real distress :
Introduction:
« Despite the potential emotional impact and significant prevalence of loss during pregnancy, in Quebec there are no specific protocols for providing psychological and emotional support to those mothers », Corno, G., Bouchard, S., Baños, R. M., Rivard, M. C., Verdon, C., & de Montigny, F. (2020). Providing Psychological and Emotional Support After Perinatal Loss: Protocol for a Virtual Reality-Based Intervention. Frontiers in Psychology, 11, 1262. https://doi.org/10.3389/fpsyg.2020.01262
What about the authors?
The authors, because of their background and expertise, have legitimacy in the issue of caring for women after a loss during the perinatal period:
Frist, Giulia Corno is a postdoctoral Researcher at the department of psychology and psychoeducation at the University of Quebec at Outaouais. She is the coordinator of scientific activities at the cyberpsychology laboratory of the University of Quebec as well as member of the Center for studies and research on family intervention. She specializes in the use of new technologies in the field of clinical health psychology and positive psychology.
Stéphane Bouchard is for its part a psychologist specializing in the treatment of anxiety disorders and the use of technological tools in psychotherapy. He is also the founder of the cyberpsychology laboratory at the University of Quebec.
Rosa Maria Banos is a professor of psychopathology at University of Valencia, she is the leader of the Spanish excellence network research on psychological processes mechanisms and treatments for the promotion of mental health.
Marie-Christine Rivard is a technical director She works in the field of video games and is an expert in programming, design and 3D design.
Chantal Verdon is a professor in the Department of Nursing at the University of Quebec. Her work focuses on families, suffering, grief and relationships.
And Finally, Francine de Montigny is a nurse by profession and holds the Canada Research Chair in Family Psychosocial Health. Her research focuses on the experiences of parents and their life transitions, such as pregnancy, birth, infancy, late parenthood and nursing practices with families.
Through this review article, published in the Frontiers in Psychology journal (Volume 1262, page 11, 2020), Corno and al., discuss a novel approach based on virtual reality to help women deal with mental health complications following perinatal loss. This situation is sometimes inconceivable for some and is still taboo and not well recognized socially, especially in France, even though it is a common situation. Indeed, in France, one woman out of ten has already had a miscarriage. Despite this, the silence around perinatal loss persists not only among the women who experience it, but also among caregivers, politicians and researchers. This is why this phenomenon must no longer be minimized, it must be recognized, named, and research must be multiplied in order to better manage it.
Keywords: Perinatal loss, women mental health, complicated grief disorder, depression, virtual reality.
Work summary:
The author of the article proposes to extend the use of a novel approach that already have shown its benefits to psychological support. This approach is based on the usage of virtual reality. Carno et al., have focused their work for this article on women who have experienced the loss of an infant while being pregnant, referred as perinatal loss. Women who have had this experience present a variety of emotions and psychological distress (De Montigny et al., 2017b). It is demonstrated that one year after the perinatal loss, 20% of these women keep suffering from serious clinical symptoms (Boyle et al., 1996; Leon, 2001). The author stresses that “despite the potential emotional impact and significant prevalence of loss during pregnancy, in Quebec there are no specific protocols for providing psychological and emotional support to those mothers” (De Montigny et al., 2017b). The increase of new technological tools has provided psychologist with added value means to better understand and provide support to mental health related problems. Virtual reality, which has gained an exponential interest, has led to the development of an environment called “EMMA World”. This environment was developed to “facilitate the expression and coping with emotions in sress-related disorders” (Baños et al., 2009, 2011). This environment helps, through various sessions, gathering the women’s psychological state, building up an acceptance strategy of the loss and finally structuring future prospect for the women to attach to it after the sessions.
A structured methodology is proposed to help encompass the psychological state of the women’s participating in the study. This is done via six evaluations measuring perinatal grief, complicated grief, depressed mood, postnatal depression, anxiety and clinical global impression and satisfaction. The aim is to evaluate the efficiency of the proposed virtual reality assisted psychological treatment compared to a treatment-as-usual. The results of the study which targeted 40 women are not part of the present article.
Critical evaluation:
By and large, this article puts the ground of an experiment that aims at providing an adaptative virtual environment to help women find their way out of longing perinatal loss grief. The author explains the motivations of such a study by the absence of defined and recognized protocol for such a widespread issue. The set goal is thus very complex, but the outcome could bring a great support to an unfortunately too widespread grief. The lack of recognized protocol to help women suffering from perinatal loss grief feels as if it is something that women only have to live with it. Furthermore, this sad experience impact not only the mothers, but it also affects the father’s psychological well-being (Boyle et al., 1996; Leon, 2001). Indeed, this loss has psychological consequences in the woman, but also in the man, something that has been very little addressed in this article. Some authors like Dollander, 2014 warned about the need for grief and psychological intervention in the father in case of perinatal death. It is noted that some fathers may show more vivid and intense reactions such as irritability, impulsiveness, they may feel overwhelmed by helplessness, guilt, shame and so on. Therefore, the man should also be involved in these interventions and the intervention should be targeted at the couple. The emergence of the virtual reality allows psychologists to develop new ways of providing, maybe more effective, mental health related support to help the patients recover from posttraumatic stress disorder.
The studied subject is important socially and the context is well explained in this article; however, the experimental protocol does not appear clearly as to how the six evaluations are carried out, is it in the virtual environment our prior to the virtual reality immersion. Furthermore, while this latter part concerning the initial data acquisition of the women’s psychological state is well described, the most important part of the study, which is the construction of the protocol that will help building up the acceptance phase, is poorly addressed. Indeed, this part is only mentioned in the following terms: “through the use of EMMA World, women will be assisted in the elaboration and acceptation of loss” (Corno et al., 2020).
Conclusion
This article tackles an important and poorly understood social issue and propose the evaluation of an innovative way to provide psychological support. This new approach around virtual reality introduces, in our point of view, a new tool which provides an easily adaptable solution for a psychological treatment. This characteristic will help psychologist provide the most adapted treatment to the patient, this in turn will allow reaching better treatment results.
While lacking some important elements to allow us to understand some key details of the proposed protocol, the eagerness to search for the published results is clearly triggered. However, the results cannot be found on the public domain, we believe that the study is probably underway. Concerning the author, Giulia Corno is specialized in various psychology fields such as positive psychology interventions, Well-being, or prenatal mental care. She has also studied new technologies such as virtual reality. She has done for instance an interesting study on how virtual reality can provide support to elderly people, more specifically, the aim of that study was to assess cognitive functions of elderly people.
Vocabulary :
That curbs (page 550, first paragraph): Qui freine
To run counter to (page 550, first paragraph): Aller à l’encontre de
Dismayed (page 549, second paragraph) : Consterné, terrifié
Predicament (page 546, third paragraph) : Situation difficile
Cling (page 546, third paragraph) : Se cramponner, s’accrocher
Spur (page 545, fourth paragraph ) : Encouragement, stimulant
Associations in France that can help parents:
AGAPA (01 40 45 06 36): the association offers coffee meetings, discussion groups and individual support.
SPAMA (07 87 85 37 81): sets up a telephone support line and an online forum. It organizes coffee meetings and offers individual support to parents who wish to do so.
Fédération ” Naître et Vivre ” (01 47 23 05 08) : the association supports and accompanies parents who have lost an infant during pregnancy, at the time and/or after birth, up to 3 years of age. It also supports medical research on unexpected death (cot death) of infants.
Bibliography:
Dollander, M. (2014). Paternal perinatal grief and the virtual object relationship. Dialogue, 205, 103-114. https://doi.org/10.3917/dia.205.0103
Duran, M. (2021, November 27). Perinatal bereavement: how to cope with the loss of an infant? Santé Magazine. https://www.santemagazine.fr/grossesse/accouchement/deuil-perinatal-comment-faire-face-a-la-perte-dun-nourrisson/