Virtual Realty and Schizophrena: A New Twist on Social Skills Training



Social skills training is commonly used when treating an individual diagnosed with schizophrenia. However, there are disadvantages to using traditional social skills approach, particularly related to the individual’s motivation. Technology is increasingly used in the treatment of mental disorders. Studies have found Virtual Reality (VR) to be effective in the treatment of some anxiety disorders. Since the early 2000s, researchers are exploring the idea of using similar VR technology in the assessment and treatment of schizophrenia. In the domain of social skills training, VR technology could potentially improve the participant’s motivation during training. Additionally, the participant no longer has to rely on his or her imagination during social skills training as participants interact with virtual avatars to practice skills.


Park et al. (2011) developed a study to compare social skills training using VR role-playing (SST-VR) to traditional social skills training role-playing (SST-TR). Participants were recruited from an adult psychiatric inpatient hospital in Korea after receiving stabilization treatment for two to four weeks. Participants were randomly assigned to either the SST-VR group (n=46) or the SST-TR group (n=45). Symptom severity was assessed before and after social skills training. Both groups received 10 semiweekly sessions over the course of five weeks. Of the 10 sessions, five sessions focused on conversation skills training, three focused on assertiveness skills training, and two focused on emotional expression skills training. Sessions were conducted as 90 minute group sessions consisting of four to five participants in the group. The only difference between the two groups was the modality of role-playing. In the SST-VR group, participants interacted with virtual avatars in a virtual environment, whereas in the SST-TR group, participants interacted with therapist actors. Voice quality, nonverbal skill, and conversational properties were the primary measures assessed during training. Self-report measures of motivation and interest in the training were also assessed.


Park et al. (2011) found that SST-VR participants had more interest in participating in the training and had a higher attendance rate compared to the SST-TR group. The researchers found that overall social skills improved regardless of training received. However, when considering the subcategories, SST-VR participants showed a greater improvement in the conversational skills domain, whereas the SST-TR participants showed a greater improvement in the vocal and nonverbal domains. The researchers hypothesized that modeling skills demonstrated by the therapist during traditional role-playing and difficulty providing accurate feedback during VR role-playing due to the VR equipment blocking the participants’ faces led to the discrepancy in scores in certain domains. It is also important to consider the participants’ perception of the role-playing task. Individuals in the SST-VR group reported feeling less anxious and more powerful than normal when interacting with virtual avatars, which is a significant advantage over traditional role-playing.


Park et al. (2011) concluded that VR role-playing is unable to completely replace traditional role-playing at this time but could in the future with advances in technology.


Park, K., Ku, J., Choi, S., Jang, H., Park, J., Kim, S. I., & Kim, J. (2011). A virtual reality application in role-plays of social skills training for schizophrenia: A randomized, controlled trial. Psychiatry Research, 189, 166-172.


Danielle McNeill, M.S., M.A.
WKPIC Doctoral Intern





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