Sammeli Liikkanen: Finland-based VR Solution for Chronic Pain

Jessica Hagen and Faaizah Arshad speak with Sammeli Liikkanen, Director of Digital Medicine at Orion Corporation in Finland, about the pharma company’s recent digital therapeutics VR software solution for chronic low back pain and its visions for the future of pain health.

BIO

Sammeli Liikkanen is a pharma and healthcare professional with a strong flavour of digitalisation in his background. He currently heads digital medicine activities at Orion Pharma. Working in different roles within and outskirts of Orion, he’s known as innovative, resilient, and determined in everything he does. He loves working with people, yet his biggest personal satisfaction comes from challenging objectives and paradigm shifts. He touts himself as a true entrepreneur and a change agent. When not building his well-being, he loves football and boxing, likes to travel, read old-fashioned paper books, and play and listen to music.

The following is a transcript of the episode:

Jessica Hagen

Hello, and welcome back to Psychiatry XR. I'm your host, Jessica Hagen, and I'm joined by my co-host Faaizah Arshad.

Faaizah Arshad

Hi, Jessica. Great to be here.

Jessica Hagen

We're happy to have Sammeli Liikkanen as our guest today. Sammeli is the Director of Digital Medicine at Orion Corporation in Finland, which is a globally operating company that develops, manufactures, and markets human and veterinary pharmaceuticals and active pharmaceutical ingredients for global markets. Sammeli is a pharma and healthcare professional with a strong flavor of digitalisation in his background. Aside from heading the digital medicine activities at Orion, Sammeli works in different roles within and on the outskirts of Orion. Sammeli, thank you so much for joining us today.

Sammeli Liikkanen

Hey. Thanks, Jessica. Thanks, Faaizah. Absolute pleasure to get connected and meet you guys.

Jessica Hagen

Can you tell us about your role at Orion and how you've been a part of the company's digital transformation, especially in regard to virtual reality and its pain offerings?

Sammeli Liikkanen

Yeah, what a wonderful question. I could talk the whole half an hour about this background. I've been working in the pharma digitalization for more than 10 years. So it all started in 2010 when creating solutions for Parkinson’s disease patients. But at the moment, in the last five to three years, I've been concentrating on the true digitalization of a pharmaceutical company, all the way from the beginning of protein target identification and the research and development process, the renewal of clinical trials in new formats, but then also the digital therapeutics as the new modality, which has emerged in the last maybe five years, as we call it. The digital therapeutics, which has been concentrating on the virtual reality-based treatment modality is something that we have been researching for maybe five years at the moment. So it's kind of like, you know, trying to change a little over 100-years-old pharmaceutical company into something completely different. It's a bit like trying to teach your mother and father how to use the new iPhone. A bit tricky but possible.

Jessica Hagen

Orion announced its completion of a clinical trial regarding its digital therapeutics VR software solution for chronic pain. The pharma company developed a VR treatment program under the codename ODD403. Can you tell me why Orion, a large pharma company in Finland, decided to explore VR as a potential treatment option?

Sammeli Liikkanen

It was back in 2018. When our pain research guys and the pain development guys were thinking how we might be able to help the people suffering from pain. And you know, the prevalence of chronic pain is massive. It's been estimated that one in five persons in this planet suffers from chronic pain, which is defined to be lasting more than three months. It's not only the acute pain, but chronic pain, that's a huge unmet need and the current treatment solutions to medications are, to put it, mildly suboptimal, so that they only work with certain subpopulations, only certain kinds of patients. And they have massive consequences or side effects and the adverse events. So one could say that the pharmaceutical industry hasn't been performing perfectly when it comes for the treatment of pain and that there's a great unmet need existing. And we were thinking, ‘Is there something else that we could do? Is there something that we could try, other than the pharmaceutical modalities?’ And, at the time, I was working as the chief data officer in the company, and I was researching virtual reality and extended reality, how we might be able to exploit them. And so we get connected with pain research people, the virtual reality research, and then we had a very funny meeting back in ’18 in London. We had couple of external experts. We had Professor Christopher Eccleston from the University of Bath, we had Professor Andrew Rice from the Imperial College, we have Mick Morris from a large game company. We had Alasdair and Robert Thong, who are pharmaceutical innovators and healthcare innovators. And then you know, a couple of brainiacs from our company: the head of the pain research and development, Dr.'s J. Raymond Bratty and Carina Stenfors. So, we got connected and were thinking, you know, maybe because US Army was able to help their own patients in the acute pain with the SnowWorld solution, is there something that we could learn from the virtual reality? And we've figured out that, hey, we might be able to do a really scientifically and clinically credible solution with a fraction of money and time, but still, it might be as efficacious as the pharmaceutical treatment, but the side effects I expect it to be a lot less than that with the pharmaceutical treatments. So we put together, we ideated that, yeah, let's give it a try. And this is kind of like the beginning of this whole project. So then we got together with Professor Ecclestone and Professor Rice, we found a partner who did the interviewing of the patients, interviewing of relevant stakeholders, like the caregivers, the physicians, and the therapists. We understood that chronic pain is something completely different than what we thought and it's a very individual experience for the patient or the people who are suffering from chronic pain. We learned great deals about that. And then once we finally figured out that, yes, it's not actually the chronic pain that we're trying to treat. We are trying to treat the consequences of the chronic pain. Then it sort of like clicked. So, we figured out that we have a unique approach, which nobody else is willing to approach at that particular point. And we have a unique modality that we're trying to use. And we also have a unique approach methodologically wise. So, we were definitely, pharmaceutical companies were not that savvy when it comes for design thinking and discussing with the patient from an empathic point of view. So that's when it all started. And we realized that we're doing something really remarkable here.

Faaizah Arshad

So, Sammeli, I think you bring up a really interesting point about how you're trying to target not the pain itself, but the consequences of the pain. And so can you elaborate what you mean by that? What consequences are you able to target with virtual reality that maybe other treatments are not addressing?

Sammeli Liikkanen

Oh, what a wonderful question. So, as you can understand, acute pain is something that is trying to protect you. So burning yourself, or you know, get out of the situation. That's the role of the acute pain. It has some meaning. But when acute pain lasts longer than three months, it kind of like burns the mark in the brain. And the problem is that, even if the reason for the acute pain is dealt with and it disappears, the burning mark in the brain stays. That's kind of like the definition, how I see the chronic pain. It's a burning mark in your brain. And in many cases, it has this psychological aspect. It's not physiological anymore, but it's psychological. And what we decided to do is to at the end of the chronic pain patient journey, if you can say so that there's a condition called kinesiophobia, the fear of movement, which is mainly controlled by the emotional system in the prey. And now what virtual reality is able to do, it has many different aspects. First of all, virtual reality quite beautifully, hijacks — this is a dangerous word — but it actually happened, it hijacks the limbic system to a certain limit from your brain. So kind of like your limbic system thinks that it's in the virtual reality and has all the senses coming into the brain that being provided by the virtual reality immersion. However, your prefrontal cortex understands that it's not in the virtual reality, it's actually fictional thing. So it's kind of like safe. It's been able to be controlled by the person, but yet the limbic system is being hijacked. So what we can do, we can enable treatment practices and psychological vehicles to the limbic system in a completely different way, we can kind of like, in a way, bypass the praying block barrier, without causing any difficulties in the brain. So we can kind of like reprogram the prey by using the virtual reality. But also, we think about the golden standard of treating the fear of movement and the kinesiophobia. So at the moment is being dealt by the cognitive behavioral therapy. But even then, in the countries like Finland, where healthcare is absolutely best in the class, we are having a huge lack of therapists. So there are too many patients and there are too few therapists. So we need to be able to scale this treatment and the access to the treatment up. And we can scale it up by giving them the possibility to treat themselves time and place independently. And virtual reality, also, is not able to democratize the access to the treatment and scale up the treatment possibilities by using even the similar resources. But it also enables us to give the cognitive behavioral therapy in situations and environments, which are not just possible in the real world. Imagine the things that we can do in the virtual reality, which we can't do in the real world. So the exposure therapy, for instance, which were kind of like using exposure, and then kind of like trying to push the people back into light by using the virtual reality. So the possibilities are like endless.

Faaizah Arshad

Right. And is that true for any sort of pain? Like is the treatment applicable to any kind of chronic pain or are you targeting a particular kind because you've talked about how, of course, you're not only addressing the physical pain but more of like the psychological and cognitive. What pain particularly we're talking about?

Sammeli Liikkanen

Our first pain population is chronic low back pain patients. So our solution is a 12-week program containing psychologically designed treatment modules and program structure. We're using physiotherapy physical exercises, which are designed by the physiotherapists, who are kind of like specialized in this target population. And we're also using gamification and engagement techniques, where we have been exploiting the know-how of Finnish game industry. So coming from Finland, you have to know something about games as well. So we have kind of like combined CBT, the physiotherapy, to gamification and the virtual reality in a beautiful 12-week long program, which is aimed to, not by relaxation or meditation, but more like pushing the people back into life. The brand name of the product is called Rohkea, and its meaning brave in English. So we're really asking the people to be brave and kind of like get back into life, get active, be brave. 

Jessica Hagen

And have you studied the efficacy of the virtual reality experience as a combination therapy as compared to by itself?

Sammeli Liikkanen

We did a clinical trial where we had three cohorts. The one cohort was this active treatment, as you can imagine. The second cohort was placebo sham, and the placebo sham was a virtual reality treatment, which had been stripped of any therapeutical content. They still use the same device. They still use the same framework environment that the active ingredient also was put into, but they were not having any therapeutical content. So you could say that it was close to the relaxation therapy. But then the third cohort was standard of care. So we didn't touch the treatment at all. And this is the structure of the clinical trials. So we anticipated that the virtual reality will have an intrinsic efficacy into this target population. They are that despair people that they are benefiting from anything that will first of all, distract them, and will kind of like put them into some kind of a treatment path. And we did see some kind of efficacy in the placebo sham as well, but it wasn't as significant as the active treatment. It made all the sense to the pain experts. And yeah, the standard of care was continuing as it was, the placebo sham got a bit of an efficacy. But the active treatment was statistically and clinically significant improvement compared to the placebo sham and the standard of care group.

Jessica Hagen

Some people might argue that a clinical trial run by industry poses conflicts of interest and can result in biased conclusions. Why didn't an independent group assess and report on the performance of the virtual reality experience?

Sammeli Liikkanen

One of the problems when it comes for the digital therapeutics and the acceptability of digital therapeutics by the clinical clinicians is that they are not seen as clinically credible and believable enough. And the digital therapeutics industry has a lot to do to increase the objective data to prove that it really works. So what we wanted to do was really to run a double-blinded, placebo-controlled clinical trial to exactly prove the point that we are not subjectively proving this valid. We are objectively proving this valid. We indeed wanting to avoid where somebody says, “Yeah, we don't believe that data.” So this is as well done clinical trial as any pharmaceutical product would be proven with us. A couple of our external experts are saying that this is by far the best clinical trial structure. And they have seen the digital therapeutics been providing so far. So it really is something that I am proud that our clinical team, especially Dr. J. Raymond Bratty who designed the study structure, was able to design, and we want to be able to defend the data and the results. It's not only the clinical data, we do have commercial pilots ongoing and we have another clinical study that has been used when developing the solution and that is open structure clinical trial where we have co-developed the solution in the clinical settings together with the patients. So we have developed the iterations of the iterations with real patient so that it makes sense. We have been able to prove the safety first in the one use settings then the multiple uses at the clinic at home, and so on so forth to test to make sure that we are having a real efficacy and we are having real safety data. And now when you combine this to the commercial pilot data, where therapy clinics are using the solution together with their patients, well, that's the real independent validation of the final product with their customers or people who are using their clinical services. So we've got absolutely nothing to do with that. And so far, the feedback has been encouraging. So even the most skeptical people who are saying like, “Yeah, well, let's see, let's see. I’ll give it a try,” are coming back after a few weeks and reporting, “Hey, this is actually pretty cool — I'm actually benefiting from this.” And that's the best feedback and best validation that you can have. But let's talk about limitations that the data is still very limited. I would love to have hundreds and 1,000s of patients using this solution, so I could get enough data to prove it in the population level. We don't have a population level data yet. I would love to see that 100% of the chronic pain population would benefit from this. But the truth is that there's going to be certain people who are benefiting from this and there are going to be certain people who do not. There's actually, when we're talking about virtual reality, there's a certain subpopulation of people who are very rational, their limbic system is not being hijacked by the virtual reality because their prefrontal cortex is running the show over the limbic system. So if you have ever heard or seen places where people have tried a virtual reality when walking the plank, above the skyscrapers, so I've seen hundreds and hundreds of people trying this experience, and I can see the vast majority, maybe 90-95% are absolutely terrified. They, some people are absolutely refusing to walk the plank because they just can't stand it. They're too scared. But then there's a handful of maybe few percentage of the population who are walking the plank and saying, “So what?”

Jessica Hagen

This isn't real.

Sammeli Liikkanen

I'm not buying this. By the way, I have tried it. And I can tell you my pulse was, I think the average pulse of what I was trying was like 165-270. And boy, I was sweating.

Jessica Hagen

Yeah, I’ve tried that as well. And it is, it's an experience.

Sammeli Liikkanen

It is. We have actually, for the demos, when we have shown the water plank to prove the point that virtual reality actually has an impact into your brain, we're using the real plank.

Faaizah Arshad

So it seems like you've looked at both the benefits and the limitations of the treatment. Can you talk more about which subjects or kinds of people could and could not benefit from the treatment? You mentioned that as being a limitation, whereas some people might be seeing positive outcomes from Orion's technologies, but others seem to not be experiencing those benefits. And so what are those differences that you're seeing?

Sammeli Liikkanen

Like mentioned, there's a certain subpopulation who are over rational, and they're having difficulties in accepting the fact of virtual reality, and so they're kind of like missing the emerging power of virtual reality. That is definitely something I've been desperate to find out more data and research about, this particular subpopulation. But I haven't found so far. A person who is mentally so closed, that he's not willing to hear, listen, or discuss about emotional aspects of chronic pain might not be the suitable person. So I can easily understand that a person who is just unwilling to try anything wouldn't benefit from there. So it takes a certain level of motivation and autonomy, to use the virtual reality device over the 12 weeks. I can easily imagine the people who are getting easily bored, so that they're like, “Yeah, I'll give it a try for a few weeks, and hey squirrel, I can see a squirrel.” So they're not interested in the treatment program as well. It's hardly going to be 100% compliance with this kind of a treatment with the big population. But when you think about the pharmaceutical treatments, the compliance is never 100%. Not even the cancer products. There needs to be a certain level of reminding and notching and pushing, and we haven't seen you in three days, how about going back to the treatment pathway, and so on and so forth. So, but the jury's still very much out there. We don't have the hundreds of 1,000s of future data to give you the actual picture. And that's the really interesting thing in the future — how this will be accepted and how this will be further developed. 

Faaizah Arshad

Absolutely.

Sammeli Liikkanen

Because coming from a pharmaceutical company, usually when the product is out there in the market, it's ready. And that's it, you very rarely do any changes for the actual product. However in this, we can constantly adjust and improve and iterate and develop and make it better, more accurate, and more suitable. And the most beautiful thing is that in the future, we can personalize the treatment. Now, I'll tell you a couple of examples. There's a lot of gamification elements in the treatment, and a lot of levels have been designed to be compatible with game philosophy. So we can adjust the difficulty of the level based on the personal outcomes and data. We can access the treatment pathway to be more compatible with this kind of a person who is suffering this kind of a chronic pain. Now it's more like one path, and we can personalize the experience. Now we do have also a virtual avatar in the program. It's kind of like trying to be present the therapists in the program. Her name is SAMI. And the name comes from Semi-Automized Mentoring Intelligence, by the way, the voice is “she.” So don't mix it with Sam. It’s SAMI at the moment. And, but the beautiful thing is that at the moment, it's a female voice. And in the future, we can decide to have a male voice or the female voice. And we can have different kinds of how SAMI looks like and how SAMI behaves with each person. And once again, a beautiful example comes from cultural differences. In the U.S., you can give feedback to people saying awesome, you did magnificent work really, really good work. I mean, keep up the good work. You go give it a try in Finland, I think somebody will smack you. That the similar feedback, which go like awesome, doing great work in Finnish would be set. Okay. That's it.

Jessica Hagen

So, it's culturally appropriate then. You take that into consideration?

Sammeli Liikkanen

Yeah, we have to. The psychological language and the way how people are using the psychological language in their giving the feedback is very much cultural. If we come into Finland and say this kind of feedback in Finnish — you're awesome, you're doing really well, we're so proud of you, keep up the good work — that the majority of the Finnish people would say, like, hit off. That's why we're the happiest country in the world.

Faaizah Arshad

And since this is Psychiatry XR, you know, many clinical settings and behavioral health settings, they recognize the benefit of digital health, and they want to use it within psychiatric care. So, is Orion's technologies being implemented in hospitals and clinical settings yet? Or do you see that happening in the near future? Where in the timeline is that currently?

Sammeli Liikkanen

Okay, so at the moment, what we have in our hand is the first marketable product. So, since the clinical trial we have completely replaced and changed the experience to be graphically something amazing compared to something which is good. Back at the time, it was something that people were saying, whoa, and now that I look back at the time from the technical perspective, I'm saying like, oh, my God, I'm so ashamed that we use this kind of version. So we have placed it in reverse, which is credible from the game standards, graphical standards, experience standards, the user experience, the UX, the whole program has been redesigned to be something which is fantastic. So now it's ready to be marketed. We have commercial pilots ongoing in Finland in, you know, therapy clinics. So we are getting the feedback. And now we're looking to commercialization path in EU and U.S. I can't say you anything now. But you might be asking the same question a few months.

Faaizah Arshad

Okay, and how affordable do you see the Orion VR treatment solution being? 

Sammeli Liikkanen

How affordable? Are you asking numbers? Very affordable.

Faaizah Arshad

Okay.

Sammeli Liikkanen

Now, the pricing depends solely on the business model, which will be decided, you know, region by region. And in some regions, we can use several different business models. If it's a direct to customer business model then it's a different pricing obviously, when it comes to the, you know, going to the clinics and their customers. So it depends solely on the business model and the country. The only practical difficulties to discuss with the clinics is the logistics of the VR device itself. Now, as much as I would love to say that the virtual reality device is a globally accepted device at every home, it is not. ‘23 we're expecting for instance, the release of Apple VR devise, we're expecting the prevalence of the device as you know in every home to be increasing a lot. And then it becomes a lot more affordable because then we are talking not only about the software and the treatment solutions next to the device, but we've also we've been discussing about the possibility to lease the devices to the clinic so that they can loan the device to their customers for the treatment program.

Faaizah Arshad

Got it. 

Jessica Hagen

That is one really interesting topic to pinpoint also is, where do you see the challenges existing when it comes to adoption of virtual reality as a therapeutic treatment option in psychiatric or behavioral health?

Sammeli Liikkanen

Number one, there's still a certain amount of healthcare professionals who are having difficulty in believing that digital intervention might have a consequence on the biological target. So they're having really huge difficulties in believing that, yes, it actually works — despite seeing the clinical trial data and and publications that are peer reviewed. They're still having kind of like, you know, intrinsic skepticism towards digital intervention being believable. Second, is definitely the prevalence of the virtual reality device. Now, the good news is that it's actually easy to use. So, in our clinical trials I think the oldest one was 76 and the youngest one was 25. And we did not experience any usability issues when it comes, for instance, the age. So, you don't have to be Einstein to use a virtual reality device. But then the third one, it's a strange one. Unless you try the virtual reality experience, it's difficult to understand what it's all about. So if we can share, like YouTube videos in two dimensions of people, and this is how it looks like people like, yeah, it doesn't look convincing. It's not something amazing. But when the same experience is being shared by them using the virtual reality device, then they're like, oh my God, I was never able to expect this kind of an experience. So seeing is believing in this. And I think the companies, the digital therapeutic companies have yet to figure out how to convince people how powerful the immersion can be. This is one of the trickiest things. And once we get the younger and younger generation of physicians, and also people expecting the healthcare services in virtual reality out there in the world, I think the situation maybe three to 10, 15 years is absolutely different. And despite people will be laughing a lot for this metaverse concept and the kind of like hype around it. The reality is that there are going to be generations after generations coming out of the schools and the universities and they are then expecting metaverse to be part of the real life. So they're spending a lot of their lives in coming decades in metaverse instead of the real life. And they're willing to get some services, selected services through virtual reality instead of real life. They don't want to travel anywhere. For some services, they want to get the same experience from the virtual reality. But these are probably the main obstacles. I could talk about the insurance coverage about certain treatment types and the lacking of the reimbursement codes in the health care systems. But that's boring. It's a system problem, and it will change in the coming years anyway. I was really happy to hear a few weeks ago, Highmark, I think in Pennsylvania, they took the virtual reality treatment for chronic low back pain in their coverage. So that's a really huge victory for the result of our prediction.

Jessica Hagen

Yeah, and there's actually a bill that's going through Congress right now, that’s the Access to Prescription Digital Therapeutics Act. That is also looking at reimbursement for prescription digital therapeutics.

Sammeli Liikkanen

Yeah, that's, that's massive. That is absolutely massive. And I hope really, that this bill is going to be dealt by using the bipartisan tactics, so nothing to do with the politics. It's got everything to do with the people's health and life and well being.

Jessica Hagen

And from a pharma perspective, where do you see VR’s place within the digital therapeutic space as time passes and technology improves?

Sammeli Liikkanen

Pharmaceutical companies will exploit virtual reality in various ways in the future. When it comes to the pain, pharma companies will educate healthcare professionals and patients by using virtual reality. That's easy. That's kind of like being accepted by the marketing function in various pharmaceutical companies already. But then those pharmaceutical companies who are willing to treat the pain patients and other people suffering from pain in a holistic way, are probably going to exploit more and more the virtual reality and the extended reality possibilities. What I'm also anticipating is that the combination of virtual / extended reality into some pharmaceutical treatment, so that the idea is not to improve the pharmaceutical treatment efficacy, but the idea is to improve the virtual reality penetration by using the pharmaceutical dope is probably something that we will see. So there's already been some discussions whether we could enhance the virtual reality treatment efficacy by kind of like helping chemically the reprogramming of the prey.

Faaizah Arshad

I think you bring up a really good point of just the continual need to make sure that these technologies are, are efficacious, and that they're really personalized and individualized and addressing the patient's needs as they should be.

Sammeli Liikkanen

Absolutely. I mean, these are people that we're talking about. Above all, they're not patients, they're not customers, they are people. And as long as we do not understand who these people are and what are their hopes and fears and kind of like real life situations, we are unable to help them for real. So the user engagement, the person engagement is something that motivates me greatly when trying to develop and enhance the virtual reality treatments and experiences. So you really need to engage people. Just imagine how willing you would be able to try something for over 12 weeks, unless it's engaging, it's fun. There might be some embedded humor in the experience, which we are planning, by the way, how about if Sami told you a joke.

Faaizah Arshad

And hopefully by like addressing those particular personal needs and making sure that it is engaging with the user, we're also simultaneously taking into account accessibility and making sure that all populations and like you said cultural competency, like including all of these important factors is so important for like a holistic.

Sammeli Liikkanen

Absolutely, absolutely. We need to be able to accept that there are cultural differences also in the concept of pain, how people and the system is perceiving the pain. So pain, the chronic pain is very different in, say, California then it is in Finland. Then in, say, Beijing there are different perceptions of the pain and how people behaving when they are suffering from the chronic pain. And when it comes for the sustainability, to enable as many people you know, getting the access into the treatment as possible, then the virtual reality is definitely something that will help us democratizing the treatment access.

Jessica Hagen

Sammeli, thank you so much for your insight. Is there anything else that you'd like to share with our listeners today?

Sammeli Liikkanen

No, not really. I mean, I'm kind of willing to underline the fact that I've been underlying several times. So despite the clinical validation of the efficacy is critical. The user experience, the person experience is something that is the bread and butter of a successful digital therapeutics. So understanding that patients are, above all, human beings and also the caregivers and those who are trying treatment is so critical. If you do not understand this, you are out lost in the sea and probably won't hit the nail.

Jessica Hagen

Yeah, really concentrating on that patient centricity is very important.

Sammeli Liikkanen

Absolutely.

Jessica Hagen

Thanks again for your time, Sammeli. We very much appreciate it.  

Sammeli Liikkanen

Thank you, Jessica. Thank you, Faaizah.

Jessica Hagen

That's it for this episode of Psychiatry XR, we hope you gained a new perspective on the use of extended reality in health care and thank you for listening.

We're also grateful for the support of the International Virtual Reality Healthcare Association, who's offering our listeners 50% off when you register for the 7th annual Virtual Reality and Healthcare Global Symposium taking place March 3rd through 5th at Penn Medicine in Philadelphia. To learn more about the conference and register to attend, visit health23.ivrha.org. Use the discount code “psychiatryxr” to receive 50% off your registration.

This episode was brought to you by Psychiatry XR, the psychiatry podcast about immersive technology in mental health. For more information about Psychiatry XR visit our website at psychiatryxr.com. Be sure to subscribe to the podcast and tune in again next month to hear from another guest about XR use in psychiatric care. You can join us monthly on Apple Podcast, Twitter, Spotify, or wherever you get your podcasts.

Psychiatry XR was produced by Dr. Kim Bullock, Faaizah Arshad and myself Jessica Hagen. Please note this podcast is distinct from Dr. Bullock's clinical, teaching, and research roles at Stanford University. The information provided is not medical advice and should not be considered or taken as a replacement for medical advice. This episode was edited by David Bell, and music and audio was produced by Austin Hagen. See you next time!