Virtual Reality (VR) in forensic psychology: Interests and issues in research and practice

Due to practical and technical imperatives, forensic psychologists often use self-questionnaires (SQ) in order to assess concepts of empathy, cognitive distortions, aggression or impulsivity. Although useful, SQ present limitations including, among others, distortion, social desirability and weak ecological validity. In this context, Virtual Reality (VR) can challenge these limitations by the creation of artificial, yet controlled, environment where inpatients or inmates can navigate under the supervision of trained healthcare professionals. Through a literature review, we aim to highlight the improvement in assessment and therapy through VR.
Summary (500 words)
Virtual Reality (VR) in mental health
Mental health problems are highly dependent on the environment (Freeman et al, 2017). Psychiatric diagnoses are still largely based on clinical interviews or on questionnaires (van Bennekom, de Koning, & Denys, 2017). Although useful, SQ exhibits limitations including, manipulation, social desirability and low ecological validity. The validity and reliability of psychiatric diagnosis, needs new assessment methods (van Bennekom, et al., 2017). Indeed, VR is considered as an efficient approach (Valmaggia, Latif, Kempton, & Rus-Calafell, 2016), through a controlled generated-computer environment in which individuals perceive stimuli and interact, similarly to the real world (Lidner et al., 2017). VR is an interesting tool for the provision of psychological treatments (Fodor, et al, 2018) such as anxiety disorders (Eichenberg, 2011), schizophrenia (du Sert, et al, 2018) or alcohol dependence (Trahan, et al, 2019).
VR in forensic psychiatry
Ethical considerations in assessment in forensic psychology are both numerous and complex (Ward, Gannon, & Vess, 2009). In this regards, VR ameliorates assessment of notions such as paraphilic interests (Renaud et al., 2014), empathy (Benbouriche, Nollet & Trottier, 2014), or recognition of emotions (Seinfeld et al., 2018). All these last contribute, at least indirectly to appropriate and prosocial behaviors (Marshall, Hudson, Jones, & Fernandez, 1995). However, a major challenge of VR is to define and implement a structural framework in daily practices (Benbouriche, Renaud, Pelletier, & De Loor, 2016). Healthcare professionals aims to reduce psychopathological symptomatology and risk of violent behavior (Arboleda-Florez, 2006) through therapeutic programs. However, the therapeutic effectiveness of VR with violent and sexual offenders remains a matter of doubt, due to the lack of empirical data (Kip et al., 2019).
VR in Research and Practice: Limits and Future Perspectives
VR actually presents several limitations: (a) material accessibility, (b) lack of psychometric evaluation (Parsons & Phillips, 2016), (c) adequacy with offenders characterictics of motivation or intellectual disability (Kip et al., 2019). However, alternatives with less engaging strategy such as Augmented Reality, superimposing virtual elements to reality (Baus & Bouchard, 2014) should be considered.
Future perspectives are numerous in both forensic research and clinical practice. The joint use of VR with eye-tracking would outline ocular pathways with cognitive and attentional focus, in the treatment of predatory behaviors visual stimuli. Finally, virtual environment represents a promising approach for the ability of emotional, cognitive and behavioral regulation, a major focus of CBT among offenders.