Date of Award

2024

Document Type

Dissertation

Degree Name

Doctor of Psychology (PsyD)

Department

Graduate Department of Clinical Psychology

First Advisor

Kenneth Logan, PsyD

Second Advisor

Carilyn Ellis, PsyD

Third Advisor

Steffanie Altenbern, DHSc, MSW

Abstract

Virtual reality exposure therapy (VRET) is currently a practical, empirically based treatment used by researchers and clinicians to treat a variety of mental health concerns. However, its ability to meet the needs of financially vulnerable and underserved populations, such as the houseless community, is still unknown. This study addresses the knowledge and treatment gap by offering VRET to the houseless adult population in the Pacific Northwest area, hypothesizing that exposure to VRET would decrease participant symptomology while increasing overall well-being and affinity for the method. Furthermore, it is hypothesized that attrition rates will be the same or lower while retention rates will be the same or higher than that of the general population. A free 10-week VRET was offered to participants of a houseless population to assess these hypotheses. Outcomes were measured through self-report and evidence-based measures conducted before, during, and after each VRET session. Results suggested that VRET significantly changed symptomology, providing overall improvement and lessening the intensity and presence of anxiety and post-traumatic stress disorder (PTSD) symptomology. Satisfaction with this method started high and was maintained throughout treatment, indicating an overall affinity for VRET among this population. Mixed results were found when assessing participant well-being, gauged by PTSD and anxiety treatment outcome measures. However, this could have been skewed due to lower retention rates, a common barrier for mental health services among the houseless population, resulting in missing data. Lastly, attrition rates were compared to the national average, which was higher than the expected houseless average due to barriers. Attrition rates after the initial intake were lower than average for anxiety and average for the PTSD group, indicating that the houseless population returned for VRET on average more than is expected among the national average of even the general population. This study offers this population critical, evidence-based, efficient, and cost-effective mental health treatment options, filling the gap in research for the mental health community regarding whether VRET is a beneficial intervention in improving mental health outcomes for the houseless population.

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