Medicolegal and ethical concerns in genetic tests communication.

In this perspective, we discuss the promise of virtual reality (VR) as an immersive therapeutic (ITx) delivery device. We note that the goal of therapy is to change psychological and physical responses to environmental conditions, thus, to unlearn unhelpful cognitive and physiological patterns and to replace them with adaptive patterns. Learning and unlearning, and by extension therapy, involve structural and functional changes in the brain. We review the neurobiology of learning and show that VR can deliver content that broadly engages multiple learning systems in the brain in synchrony, thus having the unique potential to increase the effectiveness and speed of therapeutic change. We keep the review high level thus making it approachable for non-neuroscientist clinicians and other health care professionals. Next, we examine an application of VR in the delivery of chronic pain management therapy. We discuss the strengths and weaknesses of current therapies such as pain education and cognitive behavior therapy (CBT) and suggest that VR has the potential to deliver self-administered, accessible, low risk, in-home chronic pain therapy. We briefly review research testing RelieVRx, an FDA-authorized 8-week self-administered behavioral skills VR program for chronic low-back pain (cLBP), noting the strengths and weaknesses of the data. This provides an example of the promise of VR for therapy and leads us to predict that ITxs will continue to develop as our knowledge of their effectiveness in addressing mental and physical health conditions (including chronic pain) grows.