Allen Olson-Urtecho: VR for Youth Mental Rehabilitation

Kim Bullock speaks with Allen Olson-Urtecho, Founder of Studio Bahia, about his journey towards creating affordable VR for youth populations and the motivation behind Studio Bahia.

BIO

Allen Olson-Urtecho, the founder of Studio Bahia, established this 501c3 nonprofit in response to children as young as 9 years old committing suicide and self harm in refugee camps. This heartbreaking reality fueled his unwavering commitment to offering accessible and affordable world-class therapies. Allen's innovative contribution includes the creation of Lili, a mobile virtual reality headset now in production. With a background of living in 10 countries and backpacking through 80, he assembled a diverse team, ranging from 7 PhDs in virtual reality to 15 high school interns, to make a lasting impact on the world of therapy and support.

The following is a transcript of the episode:

Kim Bullock

Welcome back to Psychiatry XR where we aim to inspire worldwide conversations around the use of extended reality in psychiatric care. I'm your host for this episode, Kim Bullock, and I'm joined by my co-host, Jessica Hagen. 

And we are so fortunate to have with us today, Allen Olson-Urtecho, the founder of Studio Bahia, who established this 501(c)(3) nonprofit in response to reports of children as young as nine years old committing suicide and self-harm in refugee camps. This heartbreaking reality fueled his unwavering commitment to offering accessible and affordable world-class therapies. Allenn's innovative contribution includes the creation of Lily, a new mobile virtual reality headset. Now in production. With a background of living in 10 different countries and backpacking through the 80s, he has now assembled a diverse team ranging from seven PhDs in virtual reality to 15 high school interns, in order to make a lasting impact on the world of therapy and support. He is also a PhD student and candidate in the Institute for Doctoral Studies in the Visual Arts and Main. Welcome, Allen. 

Allen Olson-Urtecho

Thank you, wonderful to be here.

Kim Bullock

Well, maybe we could start off by talking about how we met, you somehow heard about the Stanford psychiatry immersive technology consortium and began coming to our meetings and became an integral part of helping our behavioral health VR researchers innovate solutions needed for their work. And I've been so thankful and grateful for your involvement, and you often provide content free of charge to us to allow small clinical trials to get off the ground that wouldn't otherwise. And I really also admire your use of indigenous psychology and design. And so glad we have this chance to take a deeper dive and focus on you. And I know you've been a world traveler and your parents like mine, were in the Peace Corps. And I was really wondering how actually, you did get involved with refugee camps, when you first came up with the ideas to create these solutions? And then also how you've built trust to engage in these communities that you're affiliated? Are you involved with organizations or NGOs or still with the Peace Corps? Tell me how that works: how you.. how you're embedded in these communities? 

Allen Olson-Urtecho 

Thank you for that question. I started off with reading a newspaper article in The Guardian. And the newspaper article covered children as young as nine years old, committing suicide, self-mutilation in refugee camps. And I followed up the research with some other documents that went into more detail into the problem. And the reason for this. And so I read that article and it had a very deep impact in me. It just struck so deep and something inside of me just said enough, this is unacceptable. At the time that I read that article, I was an investigator. I work in art insurance. For the last decade, I had investigated fraud, theft, forgery in art insurance, before that I was a federal investigator. But I'm one of the top people in the world that do that. It's a specific type of investigations. It's very unique, as you look at the number of different dimensions in a work of art investigation can be technical, art history, can be provenance. And so I'm a pretty good investigator. 

Kim Bullock 

Wow, fascinating. 

Allen Olson-Urtecho

And so I read that article, it struck me. And I began to do an investigation, which is what I'm trying to do. And I started visiting refugee camps. I started talking and interviewing urban refugees, talking to United Nations Refugee Camp administrators, and starting to get a picture of how it comes to be that we have children in safe space, suffering so much that it would lead them to take their own lives or to harm themselves. 

Kim Bullock 

Were you just allowed into refugee camps? Or did you have connections? 

Allen Olson-Urtecho

Somehow, I know, I was able to talk my way into meeting a lot of people. I came with good intentions. I also should mention that out of college I worked at the World Bank and International Development.

And so I had bosses and friends that were Chief of Staff for the Secretary General of the United Nations, for example. And so networks of people and the World Bank does international development is basically an international consultancy firm for the best experts in every field in the world. The IMF is more like the bank itself and so on. And so I have contacts and I move really well around the world. I have lived in 10 countries, I backpacked over 80 countries. And my father built and designed US embassies. He is an American architect. My mother is a school teacher and a lawyer from Honduras, from Central America. 

Kim Bullock 

Oh, this makes so much sense now. Yes. But essentially, I move around the world, as a trained investigator on top of backpacking everywhere, I can go anywhere, I can, yes, talk to people, I'm a very pedestrian investigator. I talked to people and I listened to people mostly. And I find out what the deficiencies are as far as resources and so forth. With treating posting refugee population. In this case, it was a refugee population of over 6 million, so scattered around 12 countries, but a lot of what the UN was doing was reactive. When you're overwhelmed with so many refugees, you do the best you can, and you try to at least fulfill the basics, just food, first aid, and so forth. But efforts were being made to alleviate some of the suffering because you have 30, to 40%, PTSD rates inside of refugee camps. And so the European Union was sending psychologists into the camps. And it was a very difficult effort. Because these particular refugees don't have the tradition of speaking about their most intimate problems with a stranger. Here in the United States, you might stop at a bus stop, and people tell you all about their lives and their cousin's lives and states, we will just talk to you about everything, it's a very easy place to be an investigator, by the way, but in other places, they won't come into the intimacy of problems. Also, in refugee camps, the women would not speak if a man was present in group therapy, or because of different social, economic, or tribal differences, they would not speak and find that camaraderie that you might find in group therapy. So these practices known more commonly in the Western world, were not working, right. They actually barely work in the United States, by the way, but so I thought to myself, I looked at the refugee coming into the camps. And I saw that they came in with a bag of clothes, and a mobile phone. And these are school teachers, sports coaches, athletes; it's the whole spectrum of society, moving themselves out of Syria into neighboring countries. And they have very sophisticated mobile phones, just like us, they're just normal middle-class people. And so I thought about the mobile phone, but instead of an app, which seemed to be a very common response.. I thought, Google Cardboard, why don't we try embodied therapies, something that's language-neutral.

It's something that people can kind of come to understand, through ghosting behaviors, and also experiencing. And so it's kind of a bit acultural in the beginning was very acultural. Later on, we actually moved away out of Western psychological practices, we move way out into India, China, and other places where you have more ancient practices of embodied art. Virtual reality is basically an embodied art form.

Allen Olson-Urtecho

So I thought, Let's do Google Cardboard. And let's start manufacturing some of these little Google Cardboard, the very basic model, and let's get some standalone apps for each therapeutic experience. It can be relaxation, to reduce anxiety, it can be a little bit of escapism, because they're inside a refugee camp, which, you know, five times the population that the refugee camp should have. So people overcrowded 30 to 40%, PTSD rates, there can be some escape.. there can be gardens. So we started designing that way. Got it? Yes, that was the beginning of Studio Bahia. Then I formalized that as a nonprofit.  

The whole thing was mostly research. And so we started gathering refugees into Facebook groups and WhatsApp groups, because there's a lot of their communication styles. And then it was a lot of finding out about what therapies and what experiences they would like to see. And so a lot of it was aesthetically their landscapes, their own landscapes, peaceful landscapes, and also some distractions as well. Yeah, that's design thinking. Yeah, that empathy, that first step. I love that. There was the process that we were going through. And at the same time, I was gathering a great team of people from around the world to be able to produce these productions based on their needs. Well, that's when the pandemic hit.. So that's the first stage of Studio Bahia. And is that very different from what I did as an investigator, I gather teams of technical art historians, conservators, experts, artists, I gather a team of people. And that's what I did before, actually. So I gathered a team of people to be able to build this. And they're a wonderful group of people. And we've grown as a community. And so that's the first stage up until the beginning of the pandemic.

Kim Bullock

Got it. Well, how did you find out about our Stanford Psychiatry Immersive Technology Consortium? Because I think you began coming before the pandemic?

Allen Olson-Urtecho

I did. I showed up at Stanford, I joined your meetings. And so it was pretty quick and easy to find out who was the best in the country. And where did they gather, you know, competence and expertise and kind of an open meeting format, which is really a gift Dr.Bullock. Because it's the only meeting I go to regularly, monthly. You have people that are from high school interns, or to, you know, just people who want to learn from various fields and being able to bring those people together and converse and exchange notes. It's just wonderful. Yeah, from a design perspective, too, I could see how that's valuable. What Stanford projects have you been involved with in the clinics? I know you've done quite a few things. Yes, it's been wonderful meeting people. And I'm very grateful to Stanford because it feels like the best institution and the implementation of technology in various fields. And so just meeting people through your meetings, and we've had a chance to do a production with the C brain Lab at Stanford. And that was a fascinating project that lasted a year and a half. And basically, it's for early detection of dementia and Alzheimer's. And a lot of what they requested us to do in the production is to bring some of these practices like radio, that were done in the 70s, psychological exercises to diagnose these diseases early, and transferring those into virtual reality. And so the benefit with virtual reality essentially, is that you have a lot of sensors, we did all sorts of sensors, heart rate, blood pressure, eye tracking, we actually implemented artificial intelligence in the eye tracking, breeding cognitive load. And so that was a wonderful project, our team got to exercise itself. And we have other projects with Stanford, Iit Hyderabad, in India, UC Davis, medical school, Santa Clara University. And so we're nonprofit, and we make ourselves available to different universities. We've also equip some universities on how to build a lab, in their universities in Ohio, in Delaware in different places, so that they can be used by different departments and universities. How to do a kind of low cost, you know, put some soundproof crates on the walls, and you know, buy this headset, buy this laptop. And so at the same time, we're learning what is the best methods for, you know, alleviating pain and suffering, but also healing. And so we get very close to universities and into the most recent research. And we follow the findings and outcomes of these. I think in the future, we'll be designing more therapies based on those findings, because there is a lot of research around the world that is not actually turned into therapies, because it's not commercially viable. Yeah. 

Kim Bullock

Yeah, I wanted to ask you, you know, I'm not from industry, but you're able to do things with such minimal cost for us researchers and give us things for free. Do you have investments? Or how do you bring all this value to as poor researchers who have no budget or have a very minimal budget? How does that work? 

Allen Olson-Urtecho

Yes, well, we do charge for productions. And I think we charge about less than half of what a commercial company would, just so that we can help advance the research of people around the world. And so we charge like $50 an hour, and we bring in a bunch of PhDs in our team. And so they, for one, the PhDs in our team feel thrilled to be able to work with other PhDs in actualizing research and you know, seeing the research through to its outcome and proving this works. This doesn't work. And so our team loves it. Like you can't get rid of us when you hire us. We'd like hanging out. Yeah.

Kim Bullock

Is this part of the PhDs program? Like is there some training component where they're getting credit for their training as well? Is there some efficiencies built in?

Allen Olson-Urtecho

No, I think it's just people with PhDs who want to work in the field that they studied. Yeah, you know, we have a PhD in audio engineering in virtual reality. And so being able to actualize sound, which gives you the greatest presence inside of virtual reality. So that the visual sound, and mirroring the sound that's normal to us in our everyday gives you the greatest sense of presence. So having a PhD in that subject and how to design that sound is fantastic. There isn't another PhD in audio engineering in VR in the world. And so bringing these people into our team and having them be able to exercise this learning that they have is, is for them a gift. And then we also have people with PhDs. And Eva has a PhD in VR narratives for therapeutic purposes. And so we have a nurse, which knows, she has a PhD in virtual reality and writes protocols on how to bring virtual reality in the hospital settings. And so the protocols are the most important factor in bringing VR in hospitals, but also actually the greatest obstacle, because if you don't have the protocols to show how, when and who to use virtual reality with to a specialist, then you're not going anywhere. Yeah, you have to have the evidence. These people in hospitals need these protocols. So that's Tammy, and then incredibly talented people, and being able to exercise what they do more often, because it's not very often that they get to see a whole research project through to its ends. Yeah, and you can do it with us. And we do this for researchers. And we're very happy about that. Because at the same time, we're learning the most cutting-edge research that there is in the world, as far as virtual reality and healing methods and so forth and diagnostic methods yeah. I think the VA is forcing a lot of them to because the VA is very good at getting free stuff. And, and they have a great program at this time. But they're also a great place for innovation, you know, they invented things like the smoking patch. And it's actually a very good place to provide your free product, and trial it with professionals. And I'd recommend that to companies out there that are startups to be able to reach out to them, but also do work in a center the design around some of the research being done by PhDs and institutions and collaborate with them. It's a win-win. Yeah, one of the biggest barriers we have in implementing as clinicians, VR is acceptability. So I'm wondering about your thoughts and how you take evidence-based psychotherapies that are well established and actually integrate or enhance those with VR? Because it seems like that would be the way to get more clinicians using this. Do you ever use that in your design, kind of start with what's acceptable? And then just kind of enhance it and use that as your base? The evidence based psychotherapies? Yes, I think that's a lot of what current research involves,

The production we did for Stanford is an example of that, where you take established psychological diagnostic exercises, and you put them inside a virtual reality. And then you add a lot of sensors. Yeah. And I think that's the best way to start. Yeah, because I think what happens if you get too innovative, too creative, you know, then it's too new, it's too strange. It hasn't been established or proved, and then they can be turned off to it. So glad you're doing that. I think that's also another thing that we bring is that we're able to talk to people all over the world. And so, for example, for production at Stanford, we were able to find out that a team in Scotland had just completed research, and had a pre-publication ready. And we're able to talk to them and save probably six months of work. Yeah. Because we're like, okay, they did this, let's avoid that. That's not working. And how do we design in a way that's probably the most cutting edge? It's frontier work, basically. And so I think academics would do well to communicate and talk to people in India and Indonesia, other countries that are doing similar research, yeah. And collaborate and then kind of avoid replicating.

Kim Bullock

Yeah, you're a great example and model of communicating and networking and using diverse channels of communication to innovate and make change. Is there one project or one or two, that you're most excited about or you feel like have the biggest impact or potential?

Allen Olson-Urtecho

That's a great question on this research side of using virtual reality with institutions and so forth. We were requested therapy for irritable bowel syndrome recently. And this affects about 15 million Americans and probably more. Yes, exactly. Probably more. It's just not diagnosed as such. And so, some recent findings show that adverse events in childhood might be the reason for this. Yeah, the ACE scores need to add adverse childhood events survey. Yes. And so I think what it is, is that the trauma is kind of embodied in a certain part of your body, but in the simple way, and it's in the stomach area. And this area has been found to have a lot of, it's almost like another brain, obviously, where you're connected with your mother, pregnancy and so forth. And that trauma stays there. And it creates all sorts of problems throughout life. This is what I'm getting. And so what we are looking at is, okay, so what kind of therapies could we apply to this and, and get underneath to reaching the problem? The trauma itself is a defensive quality that people have, right. And so the type of approach is going to be very unique. I think for us, it's almost revolutionary to do this, because it actually could apply to other traumas that are embodied somatic. Yeah. 

Kim Bullock

Yeah. What? What's the intervention? Can you describe it? Or is it top secret? Or?

Allen Olson-Urtecho

No, it's ongoing, because this is a recent request that came to us in December, and we're just like this, this will require all of our skills and a number of tools in virtual reality that have not been done at such a Yeah, it's a complex problem. And it needs a complex solution. Yeah. Right. Overcoming the defense that you have as an individual with regards to that trauma, and somebody approaching it, but putting that inside of virtual reality. So what happens with irritable bowel syndrome is that they begin to lose this interoception quality, where the environment affects your body. And your body reacts through emotions to that environment coming in to your body. And people with irritable bowel syndrome have a reduction of that. Yeah, many psychiatric disorders. That's the problem. Yeah.

And so we look at the therapy and virtual reality, it's a multi-stage process. It’s not just one part. It's like seven parts to it. And reintegrating the person with that therapy. And so I've interviewed a couple of people. And I found a very interesting program called the map method.

Kim Bullock

So you're focusing on increasing awareness of interoceptive sensations. That's one of the stages. Okay. 

Allen Olson-Urtecho

And there's other stages that come into the recent research that I had to do is how do we create that kind of that addressing of the trauma without the visuals, the visuals, that is exposure therapy? Because I don't find and I just never liked exposure therapy. And so we found a model. Yeah, that's what I do. 24/7. That's why I like the work. I don't know that it's a cultural thing. I think because it's far more common in Anglo Saxon countries like Canada, the UK would do these things. And I think in other countries that I've lived in, you will be arrested for doing the kind of exposure therapy that is done around here. And are you talking about for trauma focused therapies? Yeah, for for for even trauma, but for fears, general fears, it's not addressed. We don't address fears like that in other parts of the world, by the way. Yeah, maybe you need to do it in a different way. We don't do this kind of like, I think it's a bit Anglo Saxon to kind of, you know, if it doesn't kill you makes you stronger kind of mentality. We don't do that. But there's desensitization that occurs in a different kind of procedure. But I would argue there is a desensitization that goes on but our modality might not be culturally relevant or the way that we do it, but I don't see it in other countries. You don't see it in India or China because yeah, it's not acceptable. It's acceptable. It's scary. Yeah, it's not modality. Yeah, welI I would be very careful because it has helped so many people and in this country or when it's acceptable and culturally relevant, it can transform people's lives. So yeah, I want to defend exposure therapy. Yes. And there's decades and decades of research. Yeah, yes. That's fine. That's fine. I think in virtual reality, it's a different medium. It's a lot more powerful. Yeah, there's so many different disorders and or problems, and it may not be the right way. It's also that there isn't enough research, to filter through the people for which exposure therapy will work. A lot of people end up re-traumatized. And I think the problem is a lot of researchers forget about doing the research on the re-traumatized population. And they only look at the positive outcome. Yeah. And 40% of people don't respond to it. I don't think they all get harmed, but it may not work. I think there's a lack of research on who it harms. Yeah. And I don't think people look into that they just look at the positive. While there's a huge amount of population that might be harmed by it. That's true. And so culturally, we don't do it. I don't see it around the world. I see. little startups in Australia and Canada. Yeah. In the UK and in the US that I don't see it anywhere else. Yeah, interesting. Thats sort of culturally not acceptable. Now, there's a lot of different therapies you can do. For example, we found some research in the north of England, a temporal recalibration for people with schizophrenia, autism, Parkinson's. And so that was basically using slow motion within virtual reality to be able to temporarily recalibrate people who are having these episodes either autism. And so what we did is a slow motion machine where you're just walking through a landscape, I would say that's exposure and desensitization, but in a different format. Okay. I'm not a psychiatrist. But I will admit, I stay away from it. Because I think virtual reality is so powerful and doing exposure therapy, you have to be a lot more careful than people are. 

Kim Bullock

And maybe our definition of what is desensitization? Yeah, maybe we're talking about desensitization versus prolonged….I think you're talking about prolonged exposure, not exposure therapy in general.

Allen Olson-Urtecho

I think that just any exposure from virtual reality within that context can be so deeply powerful that it doesn't have to be repeat therapies on that exposure. It's just one is enough to become ingrained. And, but I wouldn't diss exposure therapy anymore, because I get in trouble. But I don't think it's culturally… Yes, I agree. Something that we do around the world, in the United States, I find it's a bit of a free for all, and you can do all sorts of stuff. But I think it gets you arrested in a lot of the world to do the kind of exposure therapy that's done. Yeah. I think there needs to be different ways to do desensitization, culturally, yes. And there's totally different ways you don't have to do desensitization for trauma are finding lots of different evidence based therapies for that. Yeah. I think for irritable bowel syndrome, what we found is a narrative developed by a French lady. Who uses his traditional Chinese five elements, and Kundalini and chakras and mixes.. and then they do a dialogue with a person that is a map method includes things like the superconscious, that is a healing methodology within you. And I tried it just because I go around trying these things. And it was remarkable. I've been doing yoga for 10 years, and it actually changed my yoga from one day to another, it expanded my arm. So it was like there was psychological blocks in there. And so this is just research, by the way, whether we use it in the end, it will depend on.. you know, is it working properly. But we're doing it inside of virtual reality. Transferring that therapy into virtual reality, I think would have great effects. And unlike that, it takes ancient practices, you know, if something 6000 years old, yeah. I don't need the Americans to say it's okay. Yeah, that thing has been around 6000. You were going with it. So. And I think we can agree that there's vagal modulation, it's the autonomic nervous system, whether you do it through exposure or our narrative, that it's a recalibration of the nervous system, which to me, it's a kind of desensitization or rebooting in a sense. I'm learning a new language with you, Dr. Bullock. And so in this particular practice, the individual draws upon the trauma themselves. It's not articulated.. Kinda like EMDR. It's a little like that. Yeah. Yes. Similar to that in a way. And so they're drawing upon this and themselves in a way that's kind of strengthening to the person themselves. Yeah. And so we thought, This is good. I like this. And I'm just sharing that because it's in our radar right now. We're trying to figure out how to do this. It is with some Stanford doctors and physicians.  And so we're exploring it. And I think we have a lot of potential to actually come up with something that is not just something trialed and think we can design something. We have enough research…30 years of virtual reality research out there and be able to bring that together in a way that's compact and have positive outcomes. Yeah, yeah. can be measured and studied. Yes. So sometimes they ask us for therapy, you know, at Studio Bahia They come doctors come to us, and we really take it seriously. We like we go into it for months. Yeah. We actually had the Mayo Clinic ask us for research. And it took us two, three months for weight brain surgery. Yeah. And it just to find out, how do we approach this properly? That yeah, what kind of aesthetics do we use? What kind of headset? In the case of that Mayo Clinic we recommended a handmade Japanese headset? And it's specifically useful for eye diseases and so forth. 

Kim Bullock

Yeah. And you go outside the box. 

Allen Olson-Urtecho

Yeah.

Kim Bullock 

For the sake of time, and maybe we'll have you again, this is such a fascinating talk. My last question would be any training suggestions, you would suggest young, immersive designers or behavioral health solutions, innovators, what they should consider? I'm sure people who want to do exactly what you're doing, what would you suggest them to do for their career? Early career? 

Allen Olson-Urtecho

Thank you. Great question. I think there is a an embodied quality, to be embodied in your landscape is very important. Like I grew up in countries where people walk to the supermarket, they engage in this kind of dialogues consistently and here in the United States, our urban designers have done a terrible job. And so people don't walk and talk with each other. So it's probably the most disembodied country I've lived in. And so you need to reconnect your body within the landscape in this country. And generally speaking, you want to do that if you're a designer, you spend too much time behind a computer. And one of the ways to do that is doing yoga, which is an embodied art form. So virtual reality is an embodied art form. So go and find the most embodied art form that exist.And that one would be yoga, and so Tantra, Kashmir, Shaivism, things like that, that get you really in touch, and that are tried and tested rituals and practices. 1000s of years old. 

Kim Bullock

Wow. That's the most unique advice we've had on this podcast. I love it. I love it.

Allen Olson-Urtecho

Yeah, I wanted to share one last thing is just that we have our product coming to the market, we created and manufacture these little headsets. This is our final colors. They're so beautiful. Yeah, we'll be available later in the year. And so I'll send you a couple of to all of these. So you can try it. And it's all embodied therapies, by the way, wow. They're mostly free of language left that we do very embodied ways of healing. But thank you so much. Thank you for your meetings. Dr. Bullock, they're wonderful. I wouldn't be here without those meetings, actually, you know, having a center that holds in the country where you can have this open dialogue and interdisciplinary collaborations. It's an interdisciplinary team you need for virtual reality and for research, and so I don't think I'd be here with that those great meetings.

Kim Bullock

Thank you. I'm so glad to hear that. Alright. That's it. For this episode of Psychiatry XR, we hope you gained a new perspective on the use of extended reality in healthcare and thanks for listening. This episode was brought to you by psychiatry XR, the psychiatry podcast about immersive technology and mental health. For more information about psychiatry XR, visit our website at psychiatry xr.com. Be sure to subscribe to the podcast and tune in again next month. If you'd like to hear another guest about XR and psychiatric care. You can join us monthly on Apple podcast, Twitter, Spotify, or wherever you get your podcast. Psychiatry XR was produced by myself Kim Bullock, Pfizer Arshad, and Jessica Hagen. Please note that the podcast is distinct from my own clinical teaching and research roles at Stanford University, and the Department of Psychiatry and information provided is not by any means any medical advice and should not be considered or taken as replacement for medical advice. A big thanks to Austin Hagen for music and audio production, and David Bell who edited this podcast. See you next time.