Interaction and presence in the clinical relationship: virtual reality (VR) as communicative medium between patient and therapist

The great potential offered by virtual reality (VR) to clinical psychologists derives prevalently from the central role, in psychotherapy, occupied by the imagination and by memory. These two elements, which are fundamental in our life, present absolute and relative limits to the individual potential. Using VR as an advanced imaginal system, an experience that is able to reduce the gap existing between imagination and reality, it is possible to transcend these limits. In this sense, VR can improve the efficacy of a psychological therapy for its capability of reducing the distinction between the computer's reality and the conventional reality. Two are the core characteristics of this synthetic imaginal experience: the perceptual illusion of nonmediation and the possibility of building and sharing a common ground. In this sense, experiencing presence in a clinical virtual environment (VE), such as a shared virtual hospital, requires more than reproduction of the physical features of external reality. It requires the creation and sharing of the cultural web that makes meaningful, and therefore visible, both people and objects populating the environment. The paper outlines a framework for supporting the development and tuning of clinically oriented VR systems.