Using Virtual Reality for Positive & Lasting Behavioral Change

BehaVR’s CEO Aaron Gani and CCO Rory Channer join this episode of Reach Radio to talk about digital therapeutics, the neurological power of VR and its huge implications for access to care for anxiety, fear, chronic pain, maternal care, and addiction.

Listen to the full episode here: https://podcasts.apple.com/us/podcast/vr-for-positive-lasting-behavioral-change-aaron-gani/id1535706217?i=1000528759474

Episode Transcript

Thanks for tuning in to Reach Radio. A podcast for public health professionals looking to expand their network, be inspired, and discover resources and tools that help improve the experience of public health professionals and patients and their communities.

Fran: “I’m your host Fran. Hi everyone, welcome to Reach Radio today we have the honor of meeting with Aaron Gani, the founder and CEO of BehaVR LLC. Aaron is joined by his colleague, Rory Channer, the company’s Chief Commercial Officer, and together with a team of talented Technologists and behavioral specialists they’re busy creating digital therapeutics for stress anxiety and fear extinction through the unmatched neurological power of virtual reality. They’re driving adoption of the world’s leading digital Therapeutics for Behavioral Health and demonstrating significant clinical efficacy along the way. Aaron and Rory tell us a little bit about your organization and the work that you guys are doing.”

Aaron: “Yeah, happy to Fran, so we are BehaVR, about a four year old company and what we are completely focused on is increasing awareness and access to care for behavioral health and we are doing it with digital interventions, but specifically using virtual reality. And we can get into that in a little bit, but we believe IN virtual reality as a medium because of the way our brains process that experience — it has particular utility and effectiveness in areas related to fear and anxiety disorders, and sort of threat processing in the brain, so we think we can get right at the heart of some of these massive issues that are like a medical morbidity across so much of our not just mental health, but our physical health as well”

Fran: “So that sounds really intriguing, I mean if you, you know, as a layperson, right, just a general public in a way it sort of sounds a little sci-fi-ish, right. And I would imagine if you’re working with non-for-profit organizations, that may be out of their focus in this space, you know, they might have some apprehensions, or they just don’t know, so what do you say to them about this type of technique, this type of approach?”

Aaron: “Well one of the things that we will often say, obviously we first want to make sure people are understanding the problem that we’re looking to address, right, and then when you when you’ve align with people in your your focus on yes we we collectively want to focus on Behavioral Health then it turns to this issue of okay but like why virtual reality and kind of what is that right is that really new and experimental and you know this because of your work at HP but it’s actually not really that new, so we’ve had virtually reality in University settings for search settings and even a few earlier commercial attempts to make it a you know a commercial product over the last couple of decades and we’re fortunate to work with some of the Pioneers like Dr. Walter Greenleaf at Stanford he chairs our scientific Advisory Board I love to call him The Godfather of medical VR. He’s been working on this, literally, for a couple of decades and we’ve proven, we collectively, the big we, right, we humans have proven in those research settings time and time again the power and utility of this medium. And it as I said is sort of rooted in how different it is as an experience, this multi-sensory simulation, verses so much of what we do digitally is just a 2D screen, right? It might be your phone, it might be a big desktop computer, it may be even a big screen TV at home, all of those are 2D screens that our brains sort of go: well that might be interesting, but it is ultimately separate from me, it’s not happening to me, I am just sort of watching this thing, I might be very engaged in it, but it’s not about me, its about whats happening inside that screen. With VR it’s very different, you go inside it, it comes in through your brain sensory pathways and that’s a completely different like neurological path and effect. So, so what we try and tell people is look it’s it’s not that it’s that bleeding edge or new. What’s new is for the first time we’ve got the full stack of technologies we need from cloud computing to health data interoperability to analytics to mobility. And then the, the top layer that was really changing in 2016 was really driven by Facebook’s acquisition of Oculus which kind of set this market on fire like, okay it’s time, we have the technology now to put consumer grade, simple, convenient, comfortable experiences of virtual reality into the mainstream and so that’s, that’s why, that was that convergence of the right problem finally had the full stack opportunity and when, when we kicked off in 2016 to do what we’re doing and every year the technology just keeps getting an order of magnitude better, cheaper, faster, more comfortable and so yeah so we’re able to take all those Decades of research and make it a real a real product and real experience”

Rory: “I was just going to add, if I may Fran, I think that the other thing that may have been or has recently happened, so 2020 might be the marker where consumer adoption and attitudes towards VR changed. So we’re seeing a very different sort of use cases around VR that we didn’t see before. So with the latest version of Oculus where Facebook outsold you know itself in about seven weeks on the first version, I think the, the the consumer itself is using VR and thinking about VR in a different kind of way, so that sets up another kind of key component of acceptance. And I think in the next 1–2 years we’ll see much more much much more mainstream.”

Fran: “So Rory, this is really important right? ’Cause I mean when you think about it, there are a couple of words that Aaron said that just were like oh the bells went off like simple, convenient, talk to us a little bit more about that. ’Cause I, I would imagine that folks would think like you know, wow, virtual reality. It just sounds so complicated, but it’s not right?

Rory: “Yeah, it doesn’t feel like that now, it did I think. So I mean, I, you know I bought a quest back in December, November, December and I’m that guy, right? I’m not an easy guy to get consumer electronics adopted by and it was dead simple and it was just you just put it on and it’s it’s almost, I don’t want to mix the corporations and metaphors, but it’s a bit like an apple experience for VR. It’s, it’s that simple. Everything kind of works the way you expect it to work. You can navigate your way through seamlessly and experience, once it’s on, and what you find is this sense of there’s a sense of awe about it, so it’s a very different experience. Generally, you kind of feel like you’re getting into a thing that is different and new, and interesting and exciting, and I think as as the developers of apps for VR start to evolve, I think we’ll see lots of use cases this this particular use case, obviously is a very critical one for the world, behavioral health, and the science backs us up and obviously as Aaron says but I think we’ll find that there’s lots of different applications for VR around the corner beyond behavioral health.

Fran: “Absolutely and I just, you know, but just staying with behavioral health, right? I kind of, in my mind, seemed like 2 sort of buckets if you will, right? And you got one of the sort of the therapists, the providers of these behavioral health services having an opportunity to integrate the technology into their into their practices, and on the other side sort of the self care model, where would you guys say that you belong and and sort of those two ends of the spectrum?”

Aaron: “I love that question because we are actually coming at it from both directions Fran. So we, we believe that digital solutions are really critical to improve access to care, right? Sort of democratize access, so more people have, have the ability to, it’s not just about sort of access and affordability, which is critical. It’s also about still overcoming stigma. Like well, I’m not in such bad shape that I need to see a psychiatrist or psychologist, but maybe I’m just not feeling so great. I’m stressed. I’m struggling with dealing with this life situation. There’s a lot of indication that onboarding myself to a digital solution is sort of, you know, easier right? There’s less friction. It’s like, yeah, I just need a little bit of help I need a boost, right? So we believe that there is definitely an on ramp for people where digital should be the first line of defense. However, we don’t actually think the digital by itself is quite enough for many people, human clinicians, therapists, somebody operating on top of license. Whether it’s just sort of a coach or a counselor, right after clinical psychologist, psychiatrist, etc. Or in some cases, other related therapists like a physical therapist, let’s say in the case of chronic pain and biopsychosocial approaches there, those human clinicians are critical as well. So the way we’re going to market is both in a nutshell. We both onboard providers or clinicians onto our platform with a set of training and really helping them see this not as a gadget or a technology, but part of who they are as a therapist. So this is an extension of how they provide care to their patients. That’s sort of one side of the, of the model. The other side is let’s get as many individual consumers on there as we can, whether we reach them through a traditional kind of direct to consumer channel or maybe because their employer or their insurance company sponsored them in. So in that way we can maximize the access, get lots of people with digital first and maybe digital only, but where people need to kind of triage up to some human clinician who can take over. We can do that, and it’s all connected. So that clinician still sees you know all of Fran’s history. Oh Fran’s back for her fifth session and this is what she’s struggling with. This is how she’s improving and so on. So that’s how we think about that and approach that.”

Rory: “Yeah, and a couple of just to add again Aaron a couple of thoughts. You know, if you took your best and I’m not downgrading any of these, but if you took your best app, visual therapeutic app and you were in that therapist’s office, it’s unlikely, I think the therapist would say: oh yeah, go use that while you’re waiting or go use that app instead of using me, it’s unlikely. What we’re seeing with VR is that it’s very likely that you would use one of our VR applications with your time in the office. That makes sense, so it becomes part of the therapeutic alliance between patient and provider. So I, I think it changed. It’s a change in, it’s not the kind of the phone app it’s a change, its different. Another example might help. We have hospitals now using our stress product to help nurses struggling with coping with the COVID stress. So a nurse on a COVID ward it’s pretty tough as we can imagine and got up and thought that they do but in the sense of them being able to take product home and use it at home and have a room on the ward where they can go and decompress using our stress product is a really nice one-two punch right? So it’s again, it’s a different incoming product.”

Fran: “You know there’s so many things that I would love to like dive into here. I mean mine went from. Well, number one because you folks want to dive into it, right? If they have a tendency towards forming habits, might the VR itself become a habit? And then I’m just curious about that. You know that patient journey in general and I love Rory the way you started to give us sort of a glimpse into the describing that sort of how it gets introduced and where it goes. So you really see that combination of the two, but are there some challenges in adoption and early observations around the behaviors of the users themselves? You know, I presume a lot of positive, but any challenges as well that you’ve observed and that you’re looking for partners to join on with you to address?

Rory: “Well, just. I mean, this is, just looking at my kids for a second, they’ll be on the cell phone for probably 4, 5, 6, 10 hours if you let them, right? It’s not the same with VR. You don’t want to be in there for that long ’cause he doesn’t feel like that, right? It doesn’t feel you feel like you wanna move back. And I think one way to think about this is it’s a boost to who you are, right? It’s like a recharge you can go in for 15–20 minutes and get an awful lot of recentering happening with your behavioral health. I think it’d be an interesting question to ask, you know some of the headset manufacturers and seeing how much time are people spending in here. I, I don’t think they’re spending hours and hours and hours, it’s my guess, but Aaron you probably thought there as well.

Aaron: “Yeah well certainly our programs are designed for 15 to 20 minutes sessions. We have a variety of content types when you’re in our experiences, but there’s, there’s educational content about the particular indication or condition you’re dealing with. There’s motivational content like patient stories and narratives, and sort of meet other people for unrecorded basis in there, initially of hearing their stories of how they overcame these challenges to build your own sense of belief and self efficacy and then there’s your activations and what we call our safe protocol, which is stress, anxiety and fear extinction. Unfortunately on our podcast time granted today, we don’t have time to unpack all of that, but I will just simply say it is ideally aligned with that neurological power VR, and that’s that threat processing sort of model that I described. We have a particular approach that Doctor Pete Bucher, who is our Chief Medical Officer, has designed. He’s an orthopedic oncologist turned mind body medicine, PhD, and so our S.A.F.E. protocol sort of gets at in layers that stress and diffusing chronic activation of the stress response. Helping people deal with anxiety and sort of fear of non present threat rumination racing mind, that sort of thing. Building mindfulness, practice and emotion regulation skills and then fear extinction which is really through our exposure engine. So think exposure and extinction which is a pretty well understood process that’s typically done through like talk therapy. With VR the therapist gets an ability to very precisely control a simulation of an environment or an experience that’s designed to trigger that arousal and that fear response and then to through what’s called extinction basically you’re laying down these new neural pathways that decreased the emotional intensity and the salience of those experiences. So VR because of that multi sensory nature is perfect for that. So the other thing I’d say though about this is for all that power and this sort of novel what feels like a novel technology to people. I just wanna go back for a moment. You asked about simplicity. Like is this something that people can just get? And what’s really remarkable is it’s actually, there’s less of a technology experience or interface when you’re in VR, so we track lots of data on our platform. We have this whole cloud connected platform and as every individual consumer or patient is in there we are able to track, you know, all their responses and their biometric feedback and sort of what they engage with and what they don’t or what they avoid etc. And what we see is there is no correlation with satisfaction or likelihood to recommend right, sink in that [intelligible] score, no correlation with age, so people from their 20s up through their 80s. Not every single person loves it, but the proportion, most do, but the proportions that distribution are the same right across age groups, which initially we found so fascinating and surprising. But as we talked to more and more of our patients, it sort of made sense. You know, you could be 85 years old. I had my dad in there. My dad is 85 and struggling a bit with, with dementia and later life challenges. He can’t work a smartphone. He was fine in VR. We all know how to look around. Point, you know, it’s just it’s sort of natural interface and that technology experience or interface just disappears.”

Fran: “I love that. That makes it so inviting. Right? Especially for those who just, you know, aren’t aware. I think sometimes I mean come on guys I have to admit sometimes we’re in a bubble, right? We’re kind of in this world of technology, and essentially that’s what Reach is all about trying to, you know, break that down and helping those listeners who are out there who have maybe heard about it. Or maybe not right. I have guests who’ve come on and they’re behavioral health specialists and consultants, and they’re, you know, some of the things that they described, like being right on the front lines of dealing with individuals with substance abuse challenges. As an example, you know they share some of those real realities. What would you say to them is sort of the opportunity that they have by integrating Virtual reality based behavioral therapy into their program?”

Aaron: “Yeah, well, it sort of relates to your other question too about challenges. There are still challenges in the industry, not least of which is our reimbursement system here in the U.S., right? So you have these wonderful people, clinicians, and other staff members who are trying to do their best every day to help their patients. But they have to deal with this system, which is it is what it is, right? Nobody intended it to be this way. But we have all these layers of sort of administrative bureaucracy and sometimes different incentive structures and the like, and so often we’ll deal with clinicians and they early in the discussion, they’ll say, hey, can I get paid for this, is this reimbursable? And there’s really 2 two things at work here. What we would say to those clinicians is: today there are not well established reimbursement structures or regimes for purely digital therapeutics. That’s today. We do think that’s changing. There’s a lot of work on foot, you know, the Digital therapeutics alliance, and others and work in Washington to make that to help get us over the hump. But until then, what we do with our programs we try and design these as something that helps them do what they do in a much more efficient way. So it’s like a force multiplier, right? So yeah, you could personally take that time with each one of your patients or or you know residents in your facility and try and educate them about all this content. And maybe try and guide them through mindfulness, practice or other things. But you’re super busy. With our platform we can be a force multiplier for you and support the things that you do get paid for. They really get paid for their time, but they can reach more patients in that same amount of time and then the other side of the equation is, and this is still an industry challenge and it is for us, but we’re making real progress here, you know, insurance companies they do have this need to both drive better health and save money. That’s just they need both. And you know, I was 12 years in technology and innovation roles at Humana. A great company I was the chief technology officer there by the time I left and found BehaVR, but I get that sort of at a deep level that what payers need. They need to see it as a clinical outcomes and that this can save their money because that’s part of their business model is to help these people be healthier so that they can consume less health care services so that there is less spending and everybody wins. The taxpayer and yes, the insurance company, but most critically the patient. So we’re approaching this like: look we need that clinical evidence and evidence of economic outcomes. That’s how you get these things paid for.”

Fran: “And you’re showing that right? You guys are showing the evidence. So what do you look forward to with all the progress that you have made in the advocacy work that you’re doing?”

Aaron: “Well Rory you just joined us from, from other domains, maybe talk about what excited you to come and join us.”

Rory: “Thanks Aaron. Yeah, that’s a good question, I’m just thinking that one through. But initially what popped into my head was access for many. I think that’s, that’s one area that we, we believe that we can have an enormous positive dent on, on society. You know, 20-ish percent of the US population struggles with mental health disorders. It’s a very large number, Im sure the viewers know that stats better than I do. And a very large chunk of those people never ever get the help that they need for a variety of reasons: stigma. But as important is access. You know, the affordability of care. I think this product has an enormous potential to rebalance that problem and rebalance it in a way that isn’t difficult for people to use, is an interesting, more easy to adopt, can get support from so you think of it’s actually not that easy to find, a behavioral health specialist, to go to their office to take that step through the first door and so on right. So we think this is an enormous power to make that easier as well as provide support for folks that never get that far. So I think, that for me is probably the biggest kind of exciting moment for BehaVR.”

Aaron: “And I would, I would add one thing Fran, just a I’m a lifelong technologist. I’m a bit of a geek, so like you just have to bear with me on this, but we have our programs today which are targeting specific conditions or indications. Right program for chronic pain, pain neuroscience education our Nurture VR for maternal mental health. Helping new mothers through third trimester and fourth trimesters as its called in pregnancy, our centered VR which is for general chronic stress and we have other things on the road map and in the pipeline. But each of those sort of as if you want to think of them as episodic moments like with a specific time in your life when you’re struggling with the XY or Z. Beyond that what we’re also working on is the next level of connection sort of person to person connection so if the three of us were all maybe we met through this platform, but we’ve all struggled, let’s say with chronic pain. We can be there to support each other, and if you think of bringing people together and driving connection and peer to peer support as well as kind of patients to clinicians support in essentially endless virtual worlds, right? So we could, we could meet with each other in virtual reality on a rooftop in Paris, even though we’re actually scattered around the US or on the moon or in a beautiful nature setting, or in a 3 dimensional environment where we’re just interacting with things that are teaching us or guiding us through. So it’s, it’s not obvious when you first think about these things, but this is where everything on these 2D screens, smartphones and the like, it tends to be a cognitive experience, right? It’s generally, it’s digitizing cognitive behavioral therapy and sort of thinking about your thoughts and that’s great like those are good things. With VR because it is so experiential you’re opening up new avenues I talked about the exposure therapy components and when you bring physicality into it and the body as well as the mind we’re dealing with the cognitive the spiritual the physical the emotional all in an integrated way and if our behavioral mental health really is the summation of how we have been shaped by our experiences well if we put ourselves in a new set of really kind of engineered experiences which are guiding us on this healing journey or healing path, that is really exciting. So we can’t do all that today. Some of that is sort of strategic and vision, but we think that some of the power of this medium in a connected kind of cloud connected world.”

Fran: “It’s very powerful and you know it sounds like it would require quite a few stakeholders right to come together to make that possible. Are there any particular ones that you’d like to give a shout out to today that you’re eager to embark upon that journey with?”

Aaron: “Well, you know this is a bit of a cliche, but it’s only because it’s so true. It’s just we can’t do this without all these wonderful people that are helping us, right? It’s just all about the people. And we’ve been, we’ve been blessed. We have some incredible partners, Senator Bill Frist who is you know, so distinguished and prolific in the industry for driving innovation and helping companies. I was fortunate to meet him right around the time we founded the company and he joined our mission as a founding partner and has been a fantastic investor and advisor and now board member and then we had the I mentioned Dr. Walter Greenleaf who chairs our Scientific Advisory Board, Dr. Hunter Hoffman at University of Washington, Zach Rosenthal with Duke and then we have these incredible commercial partners. We have a model where we team up with clinical domain experts in some particular field, take what they know, their years of evidence based work and research and translate that into these VR programs. And we in essence, co-create programs with them so we have a set of teammates, like Larry Benz and Adrian Low, evidence in motion and confluent health. Dr. Rob Lewis and Dr. Alison Brooks at Hoag who helped us create nurture, our perinatal program. Dr. Kumar Subramaniam, and Dr. Neda Gould at Johns Hopkins who helped us create CenteredVR . Sumitomo Dainippon Pharma is our partner social anxiety program. So these people. They’re more than just supporters they’re, they’re collaborators, co-creators with us. And so what we find is by opening the, the approach and the platform up in that way we get a lot of things, but the most important is we get the passion in the brain power of all those people. So we’re creating something altogether.”

Fran: “I love that, and I mean those are some powerful names that you’ve given right, some powerful folks. It might intimidate some folks. So tell us about the community at large if somebody was like: you know Fran I’m digging what these guys are saying, there’s something here and I would like to try this for my practice, is it realistic for them to do that? And if so, how do they engage with you? How do, how do they come into the world of VR for behavioral health?”

Aaron: “We think a lot about this issue of access. And so while we recognize some people, some people we’re trying to reach will have the means to say I’m gonna have my own VR headset at home. I’m gonna do all this in the comfort of my own home and so on, many others won’t have that option. Our programs are designed to be used, yes at home, if you have your own headset, but also in a clinician’s office if you don’t and we and Rory, maybe you can speak about this. We, we’re pretty active with trying to work with not just clinical organizations, but many of them have charitable foundations associated with them as well, but we’re, Rory why don’t you to speak to that and your work there.”

Rory: “Happy to, and I think you know also, the answer is doesn’t matter the size of the size of the provider network if its 1 provider we can help them, if it’s 100, we’d love to help them as well, so it’s it’s not it’s not a huge barrier to access, actually, try to make it as affordable as possible. Part of our mission of being, you know there for everybody, you have to, it can’t be millions of dollars to go start using VR for helping the patients and your practice. So we will take you know, one practitioner at a time or hundreds as I mentioned. But to Aaron’s point, yes, we, we’re very interested in foundations that can help support communities that can’t afford the devices for now. I think there will come a point where everybody probably has one, like they have a smartphone. But we’re, you know, maybe a couple years away from that. But in the interim, yes, if we can help others get access we’ve got to do that. And we’ve been talking to, for example, hospital foundations who are very eager to focus on Women’s Health and our nurture product, perinatal product is a phenomenal solution to not only having enough time with experts. So if you think when you go into the OB’s office, you maybe get a minute or two with the OB, and you know you gotta, you gotta move quickly there, but our product allows you to really understand what’s going on with your mental health and your behavioral health during your pregnancy. Really understand what’s happening to your body and understanding the relationships that those around you again, as Aaron said, are designed from with incredible experts and what we’re learning about that product, the power of other things that can occur can be the intervention and can be there for you, it is also something we’re working on. So I’ll give you an example: about 1/3 of women struggle and suffer from pelvic health issues postpartum, and there’s no support for them really. In, in the system that we have today, but there’s no reason why we can’t educate and explain to them that the trip to PT you know within six weeks of giving birth can save you an awful lot of problems down the line and we can, we can facilitate that. And so I think this kind of ability to use access in a different and kind way to educational access as well, we really want to do that, and so you can think through how foundations could help us get this program out at great scale.”

Fran: “I love it. I love how you guys have brought the science to this, right? Evidence based applications of the technology you’re working with the best of the best in terms of the innovation to create it. And you’ve also created a path through which the broader community can participate, and that’s really key, right? ’cause presumably that’s where you want to go if you wanna get to that full 20%, you gotta create that accessibility in addition to just, you know, in addition to having it available for all. So I think this is really exciting. So with that, how can our listeners get ahold of you? What’s the best way to contact you?

Aaron: “So certainly you can find us at our website Fran, so it’s BehaVR B-E-H-A-V-R like virtual reality dot com. I’m, I’m glad you pointed that out Rory, because it’s, it’s sort of an obvious and simple thing, but it is important we’re actually working hard to make this easier and easier and cheaper to buy, right? So we want even a single practitioner. Let’s say it’s just a clinical psychologist in her office and she’s like, hey, I’m just one little person. No problem, she’ll actually find it’s like a really low price point to get involved. Something in physical therapy and Women’s Health and so on. So that’s important. One of the things I want to say about our mission and access that’s maybe lost a little bit of the details. And I just wanna make sure we don’t lose it. We didn’t talk a lot about this, but this is this cloud connected, very dynamic platform. So in real time from our cloud platform we call it the dynamic experience engine, we are deciding what’s happening in your VR headset right now, even if you’re in your home, or in a clinic or what have you, so we could greatly personalize the experience from one person to the next. Now we’re not done with this work because we’re still in early stage company and everything takes more time and money to get there. But we can very much personalize these experiences to start to think about different levels of health literacy, different languages like different cultural competence, and having people experience things that feel more tailored for them. So this isn’t just the standard talking head, you know, and every time now I’m not saying we’re perfect at this, yet some of our programs are still to sort of, you know, like monolithic and sort of a one path route, but in other cases we’re actually getting quite dynamic and using different people, different genders, different ages, and we haven’t yet cracked on language but we’re just about to do some localization in different languages, so I’m really excited about that because access is not just, you know is it in my community or can I afford it or does my therapist have it? But does it speak to me.”

Fran: “Exactly. Yes, that’s an awesome point to raise and we see that across so many other technologies, right? This assumption that you build it and it’s going to fight everyone in it and it doesn’t. You know, you wonder, well, what’s the disconnect? And it’s that personalization and bringing it really local to the individual. I love that. That is awesome.”

Aaron: “So as Rory said we are working hard to make this more accessible to more clinicians. Our platform now we’ve gotten to a point where for as little as $100 per month for a clinician or a thousand dollars a year, they can be on our platform for a given indication. So like helping their patients with chronic pain, helping new mothers with maternal mental health, all they need is their subscription, one or more headsets for use in the clinic, and they’re off and running. And in fact we have indications I would say we are perfect data on this, but a lot of the feedback that we’re getting from our partners in the field is: This can actually help them engage their patients more successfully and keep them coming back longer. So that’s something that just from a business aspect many therapists will struggle with is: Well, I could, I could help Fran if Fran would keep coming back, but in fact she doesn’t, right, and so it’s helping the patients. It’s helping on the business side of the ledger as well to sort of help these practices well grow and thrive and we’re trying to make that just as, as easy and affordable and kind of simple to take advantage of as we can.”

Fran: “And I think that’s really interesting. One model that I’ve seen on the, on the pain management side right is where essentially the patient comes in. They go into sort of a quote, unquote lounge, right where they go in, and they said in their in their their their pain management VR therapy session. They do that for whatever set of minutes whether it’s 15 minutes or so, and then they moved from that environment into the session with their pain management specialists. Do you see a similar kind of model already developed, or have the opportunity to be developed within you, know behavioral therapy as well?”

Aaron: “Yes to a degree, but we also see some evidence that treating these programs, these interventions as sort of filler is not ideal, right? So if someone sort of if it’s being presented as well while you’re waiting, why don’t you do this thing like it’s some sort of diversion or distraction or entertainment that doesn’t really position this that well for the patient, and in fact may be associated with, you know, we’ve seen some clinicians, and this is where we’re learning evolving for those clinicians who aren’t well trained and don’t sort of internalize that this is a part of who they are and what they do, they may view it as well: I don’t know this thing my boss bought, and I guess it’s helpful. I’m not really sure what it is, right? That’s not the way to do this. What we want, and this is where we’ve learned. And we’ve and we’ve moved strongly in this direction, when a clinician signs up to our platform, they’re getting trained on this program. How do you incorporate this into their like therapy toolkit so they really bought in and they’re like you know Fran we’re going to work together, you’re my patient in this example, we’re gonna work together directly, but I also have this set of virtual reality programs which are going to teach you new skills, help you build your emotion regulation, pain management skills, etc. Whatever you know, the case may be, so it becomes again an extension of the clinical care they provide. We think that’s a better positioning.”

Fran: “So not only have you positioned it such that it’s affordable, and you know, and it’s easily accessible, but you have also set up therapists to be successful, right? You have a kind of an on boarding process that you’ve created to ensure that they are successful in integrating into their practice, this whole offering.”

Rory: “Yes we built and again to everything Aaron has said we’re always working hard on it right. Could be the thing with the company we can do more and are doing more, but we had a behavior engagement system that we can help surround the experience itself. So think everything from education onboarding, how to make a party a practice and how, to how to build a business around it, how to use it within the therapeutic alliance between you and the patient. But also the experience for the patient themselves. So if they are finding it for the first time, or using it for the first time, what’s the education and the awareness that we create around that. So we, we’re working very hard at awareness and engagement and making sure that it’s easy for people to accept and use and want to use and refer to others to use, etc. So there’s, there’s a system that is.”

Fran: “I really like that, you know, as you were speaking there Rory, I start to think about, you know when you go through a directory and you’re trying to find a resource, right? So in this case, we’re trying to find a therapist, a right therapist for you, you know? Or it’s like when you go find a hairdresser, right? If they’re gonna tell you what kind of techniques they have, right? It would be awesome to see therapists start to list, you know, VR therapy. As you know, one of those things that they offer in their clinics.”

Rory: “We think that’s coming. Yeah, there’s a lot of movement behind: I want to be a VR therapist, so again building certification programs and working with you know third party training organizations, well known renown University type organizations to build that into practice operations and make people aware of this is a thing and an important component of their practice.”

Fran: “It’s so phenomenal. It’s really amazing guys. Well guys, any you know. Usually I ask my my guests to identify a resource to share with us some tool or some resource that you have just found to be, you know, phenomenal and perhaps something that’s underutilized and share that with our audience. Any takes on that? Anything you like to let folks know about?”

Aaron: “OK, I’ll go ahead. So this is a little narrow perhaps, but if you have a listener that is saying, you know. I just want to know more about these digital tools and what’s the state of regulatory regimes and reimbursement and what ,what is out there and how do I get involved. I would point them to the Digital Therapeutics alliance. This is a really interesting group that it’s comprised of many companies like our own that are creating products but not just companies like our own, right? So other stakeholders in the system who are really trying to not help any one company. This is not just sort of like economic advocacy for these companies. It’s to say how do we increase understanding and awareness about this whole space right? Again, from the regulatory to the reimbursement, to different varieties of therapeutic interventions that are out there. So yeah, the Digital Therapeutics alliance is, I think, a good resource.”

Fran: “That is awesome and we definitely check it out. Guys I’d like to thank you so much for your time today. Rory, Aaron, It’s been amazing and I look forward to following the progress of your organization as you continue to do great things within the space of a mental health and as I understand potentially even broader and beyond. So thank you so much for your time today.”

Rory: “Thank you Fran lovely to talk to you.”

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