GETTING WITH THE PROGRAM: Therapist Heather Foley uses a customized virtual world called Simulated Environment for Counseling, Training, Evaluation and Rehabilitation (SECTER) to work with patients in the Kids in Transition program. Here she uses the playback feature to review a patient's behavior.
© CFG HEALTH SYSTEMS

When a troubled 13-year-old named Joe first entered the Kids in Transition program in 2007 in Camden, N.J., he hardly spoke to his therapist. Like many teens at this residential mental health treatment facility, he was admitted because he had trouble controlling his anger, had run away from home several times, and had a history of run-ins with the law, according to Heather Foley, a social worker with the program. Therapists typically encourage patients like Joe to get at the core of their problems via face-to-face role-playing—pretending to be in a situation and having the patient practice how to handle it. But Foley says this approach was a nonstarter for Joe, whose confrontational behavior and attention deficit hyperactivity disorder (ADHD) impair his ability to engage and focus in this way.

When that approach failed, Foley enrolled her young patient in a program that treats teens using something familiar to most of them: the virtual world, in this case a customized one called Simulated Environment for Counseling, Training, Evaluation and Rehabilitation (SECTER).

Joe is one of 20 teens who have been treated using the program that allows them to role play in a 3-D virtual world environment in which they communicate with therapists through avatars.

Foley says that once a week for eight weeks she and the boy sat at computers in her office and donned headphones so that they could communicate with one another's avatars through the Internet, just as gamers do in the virtual environments of Second Life and World of Warcraft. She notes that SECTER avatars can assume different postures as do humans when interacting with one another. Users can also add special features to their avatars, including facial expressions, hair and skin color, and different mannerisms. For instance, Foley says, Joe made his avatar do high fives and sport a swagger when it moved.

In addition to treating troubled teens, virtual environments have been used to help treat Asperger's syndrome (a disorder resembling autism), anorexia and bulimia, anxiety disorders, post-traumatic stress syndrome and alcoholism as well as physical disabilities in stroke victims.