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 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 virtual reality 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.The following case report examines the feasibility, acceptability, and tolerability of virtual reality 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.The participant engaged in a weekly 50-minute psychotherapy Zoom session for four weeks, in which a modified behavioral activation protocol was administered using a virtual reality headset. 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.The intervention was feasible, acceptable, and tolerable, as reported by this participant. The participant's depressive symptoms decreased by five-points on the PHQ-9 over a month, with a beginning score of a 10 (moderate depression) and a final score of a 5 (mild depression).The implications of these findings for future research are discussed.Clinicaltrials.gov NCT04268316.
View details for DOI 10.2196/24331
View details for PubMedID 33031046