Stress is increasingly being recognized as one of the main factors that is negatively affecting our health, and therefore there is a need to regulate daily stress and prevent long-term stress. This need seems particularly important for adults with mild intellectual disabilities (MID) who have been shown to have more difficulties coping with stress than adults without intellectual disabilities. Hence, the development of music therapy interventions for stress reduction, particularly within populations where needs may be greater, is becoming increasingly important. In order to gain more insight into the practice-based knowledge on how music therapists lower stress levels of their patients with MID during music therapy sessions, we conducted focus group interviews with music therapists working with adults with MID (N = 13) from different countries and clinical institutions in Europe. Results provide an overview of the most-used interventions for stress reduction within and outside of music. Data-analysis resulted in the further specification of therapeutic goals, intervention techniques, the use of musical instruments, and related therapeutic change factors. The main findings indicate that music therapists used little to no receptive (e.g., music listening) interventions for stress reduction, but preferred to use active interventions, which were mainly based on musical improvisation. Results show that three therapy goals for stress relief could be distinguished. The goal of “synchronizing” can be seen as a sub goal because it often precedes working on the other two goals of “tension release” or “direct relaxation,” which can also be seen as two ways of reaching stress reduction in adults with MID through music therapy interventions. Furthermore, the tempo and the dynamics of the music are considered as the most important musical components to reduce stress in adults with MID. Practical implications for stress-reducing music therapy interventions for adults with MID are discussed as well as recommendations for future research.
Light therapy is increasingly administered and studied as a non-pharmacologic treatment for a variety of healthrelated problems, including treatment of people with dementia. Light therapy comes in a variety of ways, ranging from being exposed to daylight, to being exposed to light emitted by light boxes and ambient bright light. Light therapy is an area in medicine where medical sciences meet the realms of physics, engineering and technology. Therefore, it is paramount that attention is paid in the methodology of studies to the technical aspects in their full breadth. This paper provides an extensive introduction for non-technical researchers on how to describe and adjust their methodology when involved in lighting therapy research. A specific focus in this manuscript is on ambient bright light, as it is an emerging field within the domain of light therapy. The paper deals with how to (i) describe the lighting equipment, (ii) describe the light measurements, (iii) describe the building and interaction with daylight. Moreover, attention is paid to the uncertainty in standards and guidelines regarding light and lighting for older adults.
Alcoholgebruiksstoornis (AUD) is een groot probleem. Alleen al in de USA zijn er 15 miljoen mensen met een AUD en meer dan 950.000 Nederlanders drinkt overmatig. Wereldwijd is 3-8% van het aantal sterfgevallen en 5% van alle ziektes en letsels toe te schrijven aan AUD. Zorg staat voor uitdagingen. Zo krijgt meer dan de helft van de AUD-patiënten binnen een jaar na behandeling een terugval. Een oplossing hiervoor is de inzet van Cue-Exposure-Therapy (CET). Daarbij worden cliënten blootgesteld aan triggers d.m.v. objecten, mensen en omgevingen die zucht opwekken. Om op een realistische, veilige en gepersonaliseerde manier deze triggers te ervaren, wordt Virtual Reality ingezet (VRET). Op die manier worden coping-vaardigheden getraind om verlangen naar alcohol tegen te gaan. De effectiviteit van VRET is (klinisch) bewezen. De komst van AR-technologieën roept echter de vraag op om mogelijkheden van Augmented-Reality-Exposure-Therapy (ARET) te onderzoeken. ARET geniet dezelfde voordelen als VRET (zoals een realistische veilige ervaring). Maar omdat AR virtuele-componenten in de echte omgeving integreert, waarbij het lichaam zichtbaar is, roept het vermoedelijk een ander type ervaring op. Dit kan de ecologische validiteit van CET in de behandeling vergroten. Daarnaast is ARET goedkoper te ontwikkelen (minder virtuele elementen) en hebben cliënten/klinieken gemakkelijker toegang tot AR (via smartphone/tablet). Bovendien worden nieuwe AR-brillen ontwikkeld, die nadelen zoals een te klein smartphone-scherm oplossen. Ondanks de vraag vanuit behandelaars, is ARET nog nooit ontwikkeld en onderzocht rondom verslaving. In dit project wordt het eerste ARET-prototype ontwikkeld rondom AUD in de behandeling van alcoholverslaving. Het prototype wordt ontwikkeld op basis van Volumetric-Captured-Digital-Humans en toegankelijk gemaakt voor AR-brillen, tablets en smartphones. Het prototype wordt gebaseerd op RECOVRY, een door het consortium ontwikkelde VRET rondom AUD. Een prototype-test onder (ex)AUD-cliënten zal inzicht geven in behoeften en verbeterpunten vanuit patiënt en zorgverlener en in het effect van ARET in vergelijk met VRET.
Alcohol use disorder (AUD) is a major problem. In the USA alone there are 15 million people with an AUD and more than 950,000 Dutch people drink excessively. Worldwide, 3-8% of all deaths and 5% of all illnesses and injuries are attributable to AUD. Care faces challenges. For example, more than half of AUD patients relapse within a year of treatment. A solution for this is the use of Cue-Exposure-Therapy (CET). Clients are exposed to triggers through objects, people and environments that arouse craving. Virtual Reality (VRET) is used to experience these triggers in a realistic, safe, and personalized way. In this way, coping skills are trained to counteract alcohol cravings. The effectiveness of VRET has been (clinically) proven. However, the advent of AR technologies raises the question of exploring possibilities of Augmented-Reality-Exposure-Therapy (ARET). ARET enjoys the same benefits as VRET (such as a realistic safe experience). But because AR integrates virtual components into the real environment, with the body visible, it presumably evokes a different type of experience. This may increase the ecological validity of CET in treatment. In addition, ARET is cheaper to develop (fewer virtual elements) and clients/clinics have easier access to AR (via smartphone/tablet). In addition, new AR glasses are being developed, which solve disadvantages such as a smartphone screen that is too small. Despite the demand from practitioners, ARET has never been developed and researched around addiction. In this project, the first ARET prototype is developed around AUD in the treatment of alcohol addiction. The prototype is being developed based on Volumetric-Captured-Digital-Humans and made accessible for AR glasses, tablets and smartphones. The prototype will be based on RECOVRY, a VRET around AUD developed by the consortium. A prototype test among (ex)AUD clients will provide insight into needs and points for improvement from patient and care provider and into the effect of ARET compared to VRET.
It is essential to look for new forms of care, with an emphasis on Prevention, Relocation and Replacement (Health & Care Knowledge and Innovation Agenda 2020-2030). Especially when it comes to Alcohol Use Disorder (AUD). Globally, more than 5% of all illness and injury are attributable to AUD. Treatment is challenging; 47-75% of AUD patients who are clinically detoxified relapse within one year. Recovry aims to prevent an unhealthy lifestyle due to (alcohol) addiction by developing and testing a Virtual Reality (VR) self-prevention tool (relocating and replacing care treatment). Although research shows that VR is used successfully in health care and in the treatment of alcohol addiction, especially through the creation of presence, it has not been tested for effectiveness and implementation (as an adjuvant in a clinical post-detoxification phase of an AUD- therapy). The question of whether virtual-humans should be used in a VR treatment and whether 3600 recorded VR or computer generated (CG) VR should be selected before. The use of a virtual human in VR has expected advantages (more effect) but also disadvantages (more costs). The expected advantages and disadvantages of 360o VR (cheaper, faster, more personal) and CG VR (more flexible and interactive) also cause choice and implementation problems. Recovry is the first project in which a VR tool is (further) developed in which an AUD treatment can (and will) be tested for the effect and effectiveness of adding virtual humans in CG and 360o VR environments as part of preventive care for patients with an AUD. This project thus serves as a prelude to cooperation in the Netherlands around a more effective implementation of VR in the (self) care system and thus the active and independent integration of former AUD patients in society (“more people, less patients”).
