JMIR Publications

ABSTRACT

Background:

The delivery of evidence-based therapies targeting post-traumatic stress disorder (PTSD) has been the focus of the Departments of Defense in countries including Canada, the Netherlands and the United States. With over 66% of military members continuing to experience symptoms significantly impacting their daily functioning and quality of life after completing evidence-based treatments, more innovative, engaging and effective treatments are needed. Multi-modal Motion-Assisted Memory Desensitization and Reconsolidation (3MDR) is an exposure-based, virtual-reality supported therapy being utilized to treat military members and veterans with treatment-resistant PTSD. Given 3MDR’s demonstrated efficacy in recently published RCTs, there is both an interest in and a need to adapt the intervention for other trauma-affected populations and to improve accessibility to the treatment.

Objective:

The purpose of this initiative was to further innovate, develop, and validate new and existing hardware and software components of 3MDR to enhance the mobility, accessibility, feasibility, and applicability of 3MDR for other trauma affected populations, including public safety personnel (PSP), via international collaboration.

Methods:

This mixed-methods study utilized a (1) modified delphi expert consultation method, and (2) mixed-methods quasi-experimental validation study with the purpose of software validation amongst PSP (n=35). A team of international experts from the Netherlands, United States, and Canada met virtually on a weekly basis since September 2020 to discuss adoption of 3MDR in real world contexts, hardware and software development and software validation. Evolution of 3MDR hardware and software was undertaken followed by the mixed-methods software validation study with triangulation of results to inform the further development of 3MDR.

Results:

This study resulted in the identification, description, and evolution of hardware and software components and development of new 3MDR software. Within the software validation, the PSP participants widely acknowledged that the newly developed 3MDR software would be applicable and feasible for those trauma affected personnel within their professions. The key themes that emerged from the validation study amongst PSP (i.e. first responders and healthcare professionals) included: (1) occupational-tailored virtual environments, (2) individually tailored immersion, and; (3) beyond military populations.

Conclusions:

Throughout the modified Delphi consultation and software validation study, there was large-scale support for 3MDR. PSP participants perceived that 3MDR had relevance for trauma-affected populations beyond military members and veterans. The resulting hardware and software evolution addressed the recommendations and themes that arose from the PSP participants. 3MDR is a novel, structured, exposure-based, virtual-reality supported therapy that is currently utilized to treat military members and veterans with PTSD. Going forward, it is necessary to innovate and adapt 3MDR, as well as other trauma interventions, for increased effectiveness, accessibility, cost-effectiveness, and efficacy, amongst other trauma-affected populations.