How VR Can Both Cause And Cure Gambling Addiction

Virtual reality has long been romanticized as the ‘technology of the future’. But now that VR is finally maturing and more and more of us are using it to communicate, be entertained, and even train for our jobs, many are concerned it also poses a high potential for addiction.

Someone playing at a Virtual Reality casino
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Others however, are using the very same technology to help people overcome their dependencies.

How VR Therapy Works

Changing behavior requires practice. But what do you do when facing the problem head on puts you in a high-risk situation?

For those struggling with gambling addiction, you might go see Stéphane Bouchard of the Université du Québec’s Cyberpsychology Laboratory.

Bouchard, who has been studying VR for nearly two decades, has developed a virtual reality program helping problem gamblers face and overcome their compulsions. So far his team’s research has been highly fruitful – through their initial trial studies they’ve seen a success rate of around 60%.

The treatment is based on the principles of cognitive behavior therapy (CBT), a form of action-based psychotherapy. VR works in conjunction with traditional CBT methods while also allowing therapists to access the gambler’s emotions and thought patterns without having to go to an actual casino.

Images from a popular Virtual Reality CBT gambling addiction treatment
Image Credit: Stéphane Bouchard

Therapists first encourage patients to discuss risk factors and what sort of triggers initiate the urge to gamble, trying to mentally picture themselves in a casino if they can.

However, sometimes patients don’t have the self-awareness or imagination to mentally put themselves into a gambling situation vivid enough to identify their potential triggers. And for the same reasons AA meetings don’t take place in bars, you also wouldn’t want to take a patient to an actual casino and put them in a position where they might feel overwhelmed with the urge to gamble.

That’s where VR comes in.

Images from CBT Virtual Reality gambling addiction treatment
Image Credit: Stéphane Bouchard

When patients put on a pair of Bouchard’s $600 goggles, they are suddenly in the middle of a real-enough casino environment that has all the familiar gambling-associated sights and sounds. The patient can move around, look at and play on different machines, and even take out virtual money from an ATM.

As they interact with this new but familiar-enough environment, the therapist sees what the patient does and can ask questions about what is going through their mind. Through this they can observe what particular situations most arouse excitement and put them at-risk of gambling uncontrollably.

An image from VR Gambling addiction treatment
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In subsequent sessions, the goggles are used to help the patient further increase awareness of their thoughts and actions and to help practice relapse strategies.

“It’s easy to control relapse in my office but it’s more challenging when they’re in front of a real slot machine,” says Bouchard. “We can then challenge them–‘if you feel a strong urge now in this virtual reality, imagine what would happen if you go to a real casino?’ If they say, ‘I think I can control myself,’ that’s good, and we can play the VR simulation with the goal of control. We want to get to a point where my patient could actually learn to control what’s happening, control themselves, get out of the situation if they have to. All of this has to be practiced.”

Is It Safe?

While the success in trials has been encouraging, do these results translate to real-world situations? Bouchard says yes and that even though patients know deep down they’re not in an actual casino, their behavior is still close enough to what it would be in a real-world scenario.

“The reason is problem gamblers have a specific emotional bond with gambling. They’re addicted to it, which is different from other people. If I show you our virtual casino environment, I’m sure you’ll immediately comment on the lack of realism or on a small detail,” he says. “But if you present it to a patient, they appraise that with their emotions as gamblers: they immediately see the potential of winning and where in the casino they would go. These reactions are highly conditioned in the brain’s reward system.”

An image of how Virtual Reality Healthcare works
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Even though they may not look like much to the average person, these small details light up an addict’s brain in FMRI scans as if they were actually gambling.

VR’s negative physical effects are also well publicised: motion sickness and nausea from FPS video games like Resident Evil 7, increased heart rate, and even VR sex that likely further increases porn’s effects on the brain.

So is there a concern that the gambling simulations and its details are ‘too real’ and could possibly trigger a relapse in a recovering patient?

An image representing Virtual Reality sex
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“We have data in our favor showing that in their imaginations and in virtual reality, we are not triggering urges that are out of control,” Bouchard says. He cautiously adds, “I think it’s safe to say it’s not a major source of concern but clinically and ethically for us as therapists, it has to be in the back of our minds all the time.”

The Other Side of The Casino Chip

Even given the effectiveness of Bouchard’s program, it still might not be a match for how the online gambling industry is using the same technology.

Right now, a handful of VR casinos allow gamblers to play slots, poker, and other games for real money. Those applications are the obvious ones, but given the rate the technology is progressing, it’s not unrealistic to expect that live dealer VR tables (instead of cartoon projections), augmented reality (AR)-based games that turn your kitchen counter into a craps table, and the ability to virtually ‘attend’ the same horse race you wagered on will soon be a reality that feels just that: extremely real.

An image from in-game action of Virtual Reality Poker
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Like in porn, some parts of the casino industry are quick to apply new technology to their purposes before we can fully understand their power and potential consequences.

As VR’s gambling usage explodes over the next several years (a 2016 report from Juniper Research estimates VR casinos will be generating $520 million by 2021), so too will the need for programs like Bouchard’s.

Future Applications

While technology as a whole continues to progress at a rate our brains probably aren’t prepared for, others are looking to use it to help people overcome addictions and disorders beyond just gambling.

The success rate in using VR to treat anxiety disorders is about 80-85%, which has not gone unnoticed in this emerging field. Similar programs are already being used to treat schizophrenia, eating disorders, and even victims of rape and PTSD.

While Bouchard stresses that VR is a supplement to therapy for problem gamblers and not a replacement for it, the virtual casino environment is available for free to scientists, clinicians, and even casinos as a service they can offer their players.

“There’s a definite increase in the access and the potential of virtual reality. “What we’re doing now isn’t science fiction anymore.”