C&R in Spain

➣ Daniel Stevens

With the national motto of “Plus Ultra,” meaning “Further Beyond,” it only seems fitting that cybertherapy found its way into the Mediterraneanbased country of Spain. With over 40 million inhabitants, Spain shares the highest prevalence for mental disorders in Europe with the United Kingdom. Thus, a heightened need for increasingly effective treatment for mental disorders has become evident in the Reino de España. Many laboratories and clinics in Spanish universities have developed virtual reality and advanced technology-based therapy treatments in order to better treat the increasingly large population of individuals who suffer from mental disorders.

History of Mental Health in Spain

The Proclamation of the Health Reform Law in 1985, which introduced modernity into the Spanish health care system, came with a humanitarian concern for large amounts of prevalent mental disorders in the population, ideally bringing the general care for the mentally ill to the same level of their industrialized European neighbors. Since then, mental health care has significantly improved, including the birth of advanced technologies to aid in the treatment of mental disorders.

Many agree that cybertherapy was first formally introduced to the world in 1992 at the first Medicine Meets Virtual Reality Conference; however, the use of virtual reality for the treatment of mental disorders has been distinct in Spain for just over 10 years. The Spanish Ministry of Education and Science, the Government of Catalonia, along with other regional and national agencies currently fund projects for research teams towards the application of new ICTs in clinical psychology and rehabilitation. Many award-winning projects and innovative research have risen out of Spanish laboratories and universities, placing Spain in an impressive position in the world of cybertherapy.

International Collaborations

Many Spanish universities and clinics have begun using cybertherapy to treat mental disorders, joining an international community of researchers and clinicians. Specifically, over the past few years, the connections between Spain and the rest of the world has improved dramatically. Nonetheless, Spain lacks the same budget for research and development to comparatively remain at the same level as its surrounding countries. Many researchers use international journals to disseminate their findings in an effort to globalize their studies.

The European Framework Programmes have decisively contributed to the connection of the research groups in Spain with the rest of Europe. Currently, Spanish teams are participating in some of the most important European projects in mental health, allowing Spanish laboratories to connect and collaborate with other European institutions. Select labs have ongoing collaborations with universities and research centers in Italy, the United States, the United Kingdom, Germany, The Netherlands, Portugal, Sweden, Ireland, Canada, Mexico, Colombia, Argentina, and South Africa, among others. It is not uncommon for Spanish clinics and universities to solicit foreign researchers as well as visit laboratories in other countries.

Research Facilities in Spain

The ability to raise funds for research has grown dramatically in Spain in recent years. Both the central government and many of the regional administrations are now aware that the investment in research and development is vital to ensure the welfare of the population. Private companies of a certain size, as well, are investing in basic and applied research. Spain is in a relatively good position in Europe, with the possibility of FEDER funds, which have been a notable help towards the development and update in many domains, including research. National agencies normally fund equipment and personnel for furthering research. Nonetheless, constant funds are needed due to the high-speed evolution of the cutting edge systems and platforms as well as other essential equipment such as HMDs, projectors, sound systems, informatics, head position trackers, and eye tracking displays.

Universities work hand-in-hand with clinicians, realizing the support needed for ICT projects. Cooperation and mutual enrichment make Spanish laboratories’ research improve and become more enjoyable. In general there is a very good relationship between the universities and the research labs that operate within them. Collaboration between well-connected Spanish colleagues has also been beneficial for most Spanish universities with projects such as CONSOLIDER, which includes seven participating universities as well as CENIT, which links Spanish universities and enterprises.

EU Funded Projects

EU funded projects and funding is one of the best ways to obtain adequate resources that will enable Spain to reach levels of scientific output of high quality. The possibility of collaborating with first line researchers and to participate in the joint effort of developing scientific knowledge is key for Spanish laboratories. Extending and disseminating knowledge and research is of the highest priority. However, some groups hesitate to take advantage of EU funded projects because of the complexity and time needed to set up a consortium, a proposal, and finally manage the administrative tasks associated with the projects, preparation of reports, etc.

Research Areas

Many distinguished studies are being explored in Spain, promising future exemplified results. Areas of current study include:

• Theoretical and methodological topics including:
  • Reality judgment and sense of presence in virtual environments
  • Learning in virtual environments and learning transfer
  • Design and development of psychological assessment tools based on ICT
  • Development of mood induction and mood change experimental procedures
  • Experimental procedures for subliminal perception in virtual environments.
• Advances in the utility of technological developments in clinical psychology including:
  • Environmental Intelligence
  • Augmented reality without traces
  • Autonomous agents
  • D systems in real time on ICT mobiles
  • RFID sensors
• Psychological disorders and other psychological problems including:
  • Development and consolidation of technological applications for the assessment and treatment of anxiety, eating disorders, child mental disorders, adjustment disorders and grief, and problems related to violence and aggressiveness
• Physical and health problems including:
  • Development consolidations of technological applications for the assessment and treatment of pain management
  • Palliative treatment for restricted mobility people
  • Palliative treatment of cancer
  • Cognitive rehabilitation in cognitive disorders
• Quality of life and wellbeing in the elderly enhancing e-inclusion solutions
• Advances in psychopathology and psychological treatment of several mental disorders including:
  • Anxiety disorders
  • Mood disorders
  • Somatoform disorders
  • Adjustment disorders
  • Substance-related disorders
  • Impulse control disorders
• Kansei engineering and product evaluation
• Basic perceptual processes

Spanish Projects in the Spotlight

Some significant projects to come out from Spain are: “Development and Application of Technologically Advanced Methods Ba – sed on Virtual Reality for Attention-Diversion, Visualization and Body Image Modification, and Adjunct Analgesic Techniques Against Chronic Pain”, and the EU funded EMMA Project (Engaging Media for Mental Health Applications).

The first project consists of 19 researchers, deriving from the University of Barcelona, the University Jaume I, the Hospital Provincial de Castellón, the University of Valencia, the Polytechnical University of Catalonia, and the University Miguel Hernández of Alicante for a three-year collaboration. The gathering of these groups to carry out this project has given birth to one of the most efficient teams in the field of virtual reality applied to health disorders and disease.

The latter of the two projects, EMMA, developed a mood induction procedure that effectively changes the users’ mood and has been proven to be useful in basic and clinical research. An adaptive display was developed during this project for the delivery of psychological treatments in complex mental disorders. This display has been effective in the treatment of posttraumatic stress disorder, complicated grief, and adjustment disorders.

The Future of ICT Research in Spain

It is agreed that the future is limitless in Spain due to its efficiency and future collaboration possibilities. Physical and mental health, health in the workplace, leisure, and general wellbeing are among several possibilities for the future. CyberTherapy in Spain has left its mark on the world and the world looks back with interest as future research emerges. With future collaborations with European and international partners, advances in cybertherapy will continue to flourish in la España soleada.

Sources:
World Health Organization, European Commission, Medical News Today, personal communication with Dr. Cristina Botella and Dr. José Gutiérrez Maldonado