Introduction

Ornithophobia is a phobia of birds. Ornithophobia can prevent people from going places where there are birds, such as forest, parks or even just outside. Exposure therapy can be used to treat ornithophobia and virtual reality is an easily accessible and versatile way to undergo exposure therapy.

Description of application

This VR application allows people to have easy access to exposure therapy for ornithophobia. It places the patient in a virtual world where they have control over bird number and behavior.

Exposure therapy is one of the best ways to treat phobias[1]. Exposure therapy is a multistep process in which the patient is slowly exposed to their fear. Therapy may begin with something as simple as visualisation or drawing of their fear, then progress towards images or being exposed to the real thing.

Virtual reality can be used to replace or bridge between some of these steps. It can be used to enhance exposure therapy[2]. While simulations using the traditional tv screen might be a good first step, VR is a much more realistic experience because the user will be placed inside the computer-generated content, not sitting in the real content world looking in. Patients can be more willing to try virtual reality than going straight to their real-world phobia. Patients can feel a sense of safety knowing that it is not real. They are also more accepting that virtual reality might help them overcome their fear, unlike methods such as imaginal exposure[3]. Virtual reality will also give the therapist more control over the environment and allow them to better cater therapy towards their patient[3].

Someone with ornithophobia may be afraid a specific bird types, taxidermy birds, photos, feather or the sounds they make[4]. In some cases, people fear being swooped by birds. This application address some of these fears: bird type, bird sounds and swooping birds.

Interaction design

The main benefit of VR for ornithophobia exposure therapy is its ability to place people in a virtual world so that they can feel safe around birds. Being able to adjust bird types and behaviors to best fit the patient’s needs was the main priority for this project. In the future interaction with the birds such as holding or patting them could be implemented and might provide a useful step for some patients in their therapy treatment.

To implement control over the bird types, numbers and behaviors a simple interface was designed to be interacted with using rays from the players controllers. Check boxes were used to turn on or off different bird types. Although there are many different types of birds implemented in this application, there is a lack of birds that people are more commonly scared of, such as magpies, plovers and seagulls. These birds types should be added into future versions of the application.

A slider is used to control the number of birds flying around. This allows the patient to slowly increase the number of birds as they start to feel comfortable. A slider is also used to set the likelihood of being swooped by a bird. This can be used for people that have a fear of birds swooping and can be adjusted to a point where the patient feels comfortable. Finally, there are two buttons to pause or respawn all the birds giving the patient an escape if the feel uncomfortable (or they could remove the headset). Pausing all the birds might also help the patient with their therapy because it is a less real simulation of birds and allows them to get close to the birds if they like.

Bird sounds were also implemented in this application to make it more realistic and help people who are predominantly scared of the sounds birds make. Although there is no virtual interaction, to turn the sound off, the volume on the headset could be turned off or the birds reduced in number to decrease the likelihood of bird sounds being played.

Technical development

All interactions in this application were implemented using the oculus SDK[5] and is designed to work on Meta Quest devices. These devices use video tracking (inside looking out) to locate the headset in 3D space and position the patient inside the virtual world.

The joystick on the oculus controllers is used to move and look around the environment. Button A can be used to open a menu which will appear in front of the patient. Both controllers can be used to point at the menu and either trigger button can be used to select.

Check boxes are used to select the different bird types and sliders are used to determine the number of birds or the likelihood of being swooped. Changing the slider for the number of birds in the simulation will gradually increase or decrease the number or birds, ensuring that they spawn or despawn off screen. The pause button will stop all birds where they are and the despawn button will remove all birds from the environment.

The free asset Living Birds was used to implement the birds in this application. It handled most of the bird’s behavior, animation, models and sounds. However, there were many adjustments made to make it fit this application. The main difficulty was that the scripts were not designed to have their variables changed while the application was running. The swooping behavior was also added to the birds. The asset also had a feature to ensure that the birds avoided obstacles, which resulted in very unrealistic movement of the birds. I decided to turn this feature off because I found that birds flying though walls is less noticeable and distracting.

The application runs well when built as an APK file. However, the sliders do not work properly. Instead of moving the slider, a point along the slider must be selected. For this reason, the example video was taken by running the game inside unity’s editor. There is also a major bug that will result in the application crashing if the pause button is clicked whilst a bird is swooping.

Description of 3D models

Low Poly Free Vegetation Kit [6]

This free asset was used to create the forest environment to situate the player in. To create the forest, I simply used one of the example scenes and moved some 3D models to ensure there was enough space to walk around.

Living Birds [7]

This asset came with 7 different bird models equipped with animation and audio. These birds were an integral part of the application and used to expose the patient to different species of birds.

References

[1]        D. F. Grös and M. M. Antony, “The assessment and treatment of specific phobias: A review,” Curr. Psychiatry Rep., vol. 8, no. 4, pp. 298–303, 2006, doi: 10.1007/s11920-006-0066-3.

[2]        C. Botella, J. Fernández-Álvarez, V. Guillén, A. García-Palacios, and R. Baños, “Recent Progress in Virtual Reality Exposure Therapy for Phobias: A Systematic Review,” Curr. Psychiatry Rep., vol. 19, no. 7, p. 42, 2017, doi: 10.1007/s11920-017-0788-4.

[3]        D. Boeldt, E. McMahon, M. McFaul, and W. Greenleaf, “Using Virtual Reality Exposure Therapy to Enhance Treatment of Anxiety Disorders:  Identifying Areas of Clinical Adoption and Potential Obstacles.,” Front. psychiatry, vol. 10, p. 773, 2019, doi: 10.3389/fpsyt.2019.00773.

[4]        C. Clinic, “Ornithophobia (Fear of Birds),” 2022. https://my.clevelandclinic.org/health/diseases/22533-ornithophobia-fear-of-birds... is a fear of,this fear and enjoy nature. (accessed Sep. 17, 2022).

[5]        Oculus, “Oculus Integration,” 2022. https://assetstore.unity.com/packages/tools/integration/oculus-integration-82022... (accessed Sep. 02, 2022).

[6]        Proxy Games, “Low Poly Free Vegetation Kitv,” 2022. https://assetstore.unity.com/packages/3d/environments/low-poly-free-vegetation-k... (accessed Sep. 02, 2022).

[7]        Dinopunch, “Living Birds,” 2018. https://assetstore.unity.com/packages/3d/characters/animals/birds/living-birds-1... (accessed Sep. 02, 2022).