P-health is an approach to health that, in theory, can be used for any kind of health concern. However, to discuss its feasibility, we decided to identify one possible area of intervention: addiction. The term addiction
indicates a recurring by an individual to engage in some specific activity despite harmful consequences to the individual's health, mental state, or social life. The term was originally reserved for drug addictions, but it is now also applied to other compulsions such as pathological gambling, compulsive overeating, alcoholism, and so on. Addiction is a disease [54
], a state of physiological or psychological dependence on something manifesting as a condition in which medically significant symptoms liable to have a damaging effect are present. Treatment of dependency is usually conducted by a wide range of medical and allied professionals, including addiction medicine specialists, psychiatrists, appropriately trained nurses, social workers, and counselors, and is focused on the individual's ultimate decision to pursue an alternate course of action. Behavioral treatments usually involve the planning of specific ways to avoid the addictive stimulus and therapeutic interventions intended to help a patient learn healthier ways to find satisfaction.
Literature on behavioral analysis and behavioral psychology shows that behavioral therapy, community reinforcement approaches, cue exposure therapy, social skills training, and contingency management strategies are useful approaches for the treatment of addiction [55
]. Following these indications, we are developing Eureka [56
], a Second Life island for addiction prevention and treatment. Eureka is a virtual immersive environment organized around three different but interconnected areas: the Learning area, the Community area, and the Experience area.
The goal of the Learning area is to use motivation provided by virtual worlds to teach users about how to improve their living habits. The Learning area is organized around different learning areas (), both without and with teachers (classes). In this area, users learn how to manage daily choices and activities, acquire general and specific information about addiction, and get the information needed to succeed, with daily tips and expert ideas.
The goal of the Community area is to use the strength of virtual communities to provide real-life insights aimed at improving living habits. The Community area is organized around different zones () in which users discuss and share experiences among themselves with or without the supervision of an expert (physician, psychologist, nutritionist, etc).
A screenshot from the Community area
In the Learning and Community areas, users enjoy support and guidance, learn how to make wise choices and live healthily, and benefit from the exchange of practical experiences and tips from other users.
The goal of the Experience area is to use the feeling of presence provided by the virtual experience to practise both emotional and relational management and general decision-making and problem-solving skills. This area includes different zones () presenting critical situations related to the maintenance and relapse mechanisms (Mall, Supermarket, Pub, Restaurant, Kitchen, etc). Each of these environments is experienced only under supervision.
A screenshot from the Experience area (In particular, the kitchen has been created for people affected by food craving.)
In all three of these areas, the user is helped to develop specific strategies for avoiding and/or coping with their problems. After the experience, the coach explores the patient’s understanding of what happened in the virtual experience and the specific reactions—emotional and behavioral—to the different situations experienced. If needed, some new strategies for coping with the situations are presented and discussed. In all three areas, type and intensity of care will vary depending on the type of intervention (eg, prevention vs treatment).
In our vision, Eureka could be an interesting starting point to test the efficacy of online virtual worlds in the prevention and treatment of different psychological disorders.