US Army targets Second Life and virtual worlds for healthcare

An interesting article published by the Official Home Page of the US Army came to light recently highlighting the use of virtual worlds as a part of studies into providing better healthcare and support to US soldiers and veterans.

For the last three years, Colonel Valerie Rice, Director of the US Army Research Laboratory’s Human Research and Engineering Directorate located at Fort Sam Houston, in San Antonio, Texas, has been spearheading a team studying the use of Mindfulness-based Stress Reduction (MBSR) as way of teaching army personnel and veterans how to manage PTSD and similar disorders which have resulted from their military service. The work is part of a broader series of research activities funded by the US Army aimed at providing suitable care and support for those afflicted by PTSD.

Colonel Vice Rice
Colonel Valerie Rice

Mindfulness –  “being in the moment” – is a means of stress and anxiety relief using age-old techniques such as meditation and yoga to help focus and clear the mind. It has become a popular means of therapy and support in many areas of life.

The studies being undertaken by Dr. Rice and her colleagues have a twofold purpose. Firstly, to determine the effectiveness of MBSR techniques in helping US Army personnel and veterans deal with PTSD and related issues. Secondly, to identify whether a programme using these methods could be reasonably and effectively adopted by the Army for widespread use.

In this latter regard, MBSR is seen as a particularly worthwhile means of assisting service personnel and veterans because not only is it a proven means of treatment in civilian life, but also because instructors do not need to be qualified healthcare professionals; they only need to have successfully completed a comprehensive training and certification programme. This significantly eases the challenges involved in leveraging it for more widespread deployment and use.

MBSR is also something ideally suited to leveraging the use of virtual worlds, notably Second Life and All These Worlds LLC, which bring with them unique opportunities and benefits which are not necessarily achieved with courses and therapy conducted in the physical world.

The Mindfulness studies take place as 2-hour weekly sessions over a period of eight weeks apiece, and involve some 66 participants at a time, 36% of whom were soldiers on active duty, and the remaining 64% veterans. Half of each batch of participants meet face-to-face in real life, the other half in a virtual world environment.

In both the physical and the virtual environments, sessions are experiential in nature; participants in the study meet, go through various exercises designed to focus the mind, ease tension, and reduce stress. Classes as cumulative, each building on and reinforcing the last, providing techniques participants can carry with them into their daily lives. There are also opportunities for discussion and feedback on individual’s experiences with the techniques, and so on.

Those participating in the virtual classes are encouraged to physically perform the exercises rather than just perform them with their avatar. There is a high degree of interaction between session leaders and participants, and courses include homework sessions – exercises participants are asked to carry out when away from the sessions.

A US Army MBSR session being held in All These Worlds (via
A typical US Army MBSR session being held in All These Worlds (via

Virtual world environments are seen as a particularly beneficial for conducting sessions due to the level of anonymity they offer. There is still something of a stigma attached to seeking help for disorders such as PTSD which can make individuals shy away from any involvement in actual behavioural health classes due to misplaced feelings of embarrassment, inadequacy or shame. The use of what is essentially an anonymous avatar in a virtual environment helps eliminate these feelings, and any associated stress or anxiety which might otherwise be experienced.

The multiple ways in which participants can provide feedback through a virtual world is also seen as beneficial. Giving voice to the feelings, responses and emotions one is experiencing when in a public forum is not always easy. But in a virtual environment, a participant can, for example, opt to give their thoughts and feedback via IM to the session leader, who can in turn relay the salient points to the class in a way that also doesn’t cause the individual any additional stress or embarrassment. Even the use of voice morphing is seen as advantageous, as it again offers participants relief from any fear that their voice might otherwise be recognised.

Participant in both the physical and virtual studies receive "homework" assignments (via
Participants in both the physical and virtual studies receive “homework” assignments (via

Additional benefits in using virtual worlds are those of accessibility and the ability to establish social networks among peers. Writing in Advanced Computational Intelligence Paradigms in Healthcare 6, Jacquelyn Ford Morie, the founder of All These Worlds, and who also one of Dr. Rice’s collaborators in the study, notes:

Today’s returning soldiers are most likely geographically dispersed, which may make it difficult to get to centres where medical help is typically aggregated. In addition, a social support structure may be lacking, leaving veterans unable to socialise with comrades in person on a regular basis … Online shared virtual worlds, however, are easily accessed from any personal computer, and can support the formation of social networks, facilitate access to care, and provide social activities between soldiers where geography is no barrier.

Jacquelyn Ford Morie. All These Worlds, her company, has also provided virtual environments for the US Army's MBSR studies
Jacquelyn Ford Morie. All These Worlds, her company, has also provided virtual environments for the US Army’s MBSR studies

She goes on to note that most service personal today are comfortable with using technology and in playing computer games, so accessing virtual worlds should not present them with significant barriers to entry or from engaging with online communities.

Dr. Rice and her team report that taken as a whole, the MBSR courses have seen positive results across both actual and virtual sessions, with participants registering lower blood pressure, reduced anger and increased calmness in their lives, as well as  exhibiting increased energy levels and faster reactions. Her team also note that anecdotal evidence suggests that those who have participated in courses are still practicing techniques six months later.

However, the team also acknowledge that further research into the overall effectiveness of MBSR with military personnel is required before any definitive findings on its overall applicability to widespread use within the US Army can be determined.

Even so, despite the fact that such formal determination has yet to be reached, the work carried out to date is encouraging, and stands as another fascinating example of how virtual worlds can be used for the betterment of our health and welfare.

Related Links

With thanks to Ziki Questi for the initial pointer to the US Army article on this research.

7 thoughts on “US Army targets Second Life and virtual worlds for healthcare

  1. Interesting post. Have sl friend who severed two tour of duties in Iraq. She said the US Marines medical support suggested sl to help with PTSD. She very involved with sl, is sl dj and said it seems to be helpful. Not sure if she went through program talked about in this post. Cool that sl can be helpful for this.


  2. As much as I love SL, I have deep doubts as to the efficacy of virtual worlds as tools for mental health care. There is too much technology between the patient and the caregiver. It’s much easier for a patient to lie, to conceal symptoms and behaviors, or to create illusory ones.

    I think Col. Rice and her colleagues have just found a way to justify having fun in SL on Uncle Sam’s nickel.


    1. I think we’ll have to disagree – and I suspect the likes of Virtual Ability will tend to disgree with you as well.

      The work being carried out through this study isn’t about healthcare treatment in the traditional sense (hence why the instructors do not need to be qualified healthcare professionals). As the article notes, it’s about providing the participants with the mental tools and capabilities which enable them to better deal with their condition for themselves and when divorced from medical care (when at home, when visiting family, when out shopping – any stress or anxiety-building situation in which they may find themselves and which they might otherwise be unable to control or believe they are unable to control).

      Of course some people may come away from the programme without having participated in it as honestly as might have been hoped – but that’s also true of the physical world sessions as well. The latter might be somewhat easier to spot, but that doesn’t reduce the chances of it happening – or of any challenge to such a response resulting in a very negative outcome. In this respect the virtual environment does potentially offer significant advantages over physical sessions simply because the technology does provide a level of separation for the participant; they are not moving completely out of any comfort zone they have created for themselves and are thus potentially more receptive to what is being taught than might otherwise been the case.

      As it is, we’ve seen self-help work very well in virtual worlds and yield genuine, positive results in plenty of other studies, so why shouldn’t this approach work?


  3. I just completed an 8 week program as part of the veteran research for SL. I went into it somewhat skeptical. After 2-3 sessions I became very comfortable with it and saw that the techniques provided by the instructors were reducing my stress. I can tell you that if I would have had to finish work and then drive somewhere at 1800 hrs. to do it, I would have probably skipped some sessions. SL is convenient, and it works, I kinda like that! You start to get a sense by seeing your avatar there that you are really there. The term “Mental Health Care” encompasses a huge arena. I don’t think the application of MBSR through SL is claiming to address “Mental Health Care”. Dr. Rice and her colleagues are using SL to teach MBSR
    ( Mindfulness Based Stress Reduction ). I would not have been very quick to agree to the training if it involved alot of logistics. Lets face it, veterans like to save time, $$, gas, and enjoy the opportunities and convenience provided by technology as much as anyone. ( That’s why online degrees are flourishing!) I can tell you from personal experience this works, and works well. The research is ongoing, and they are taking the time to do it right.


    1. Vince,

      Many, many, thanks for your feedback on the programme, the MBSR research Dr. Rice and her colleagues are carrying out and, most importantly of all, relating your own experience as someone who participated in the study / programme. It’s genuinely good to know of the positive inpact the techniques are having on those experiencing them first-hand, and I hope this continues to be the case for you in the future.


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