{"id":48745,"date":"2026-02-03T09:39:27","date_gmt":"2026-02-03T08:39:27","guid":{"rendered":"https:\/\/www.vr-coach.at\/la-therapie-dexposition-par-la-realite-virtuelle\/"},"modified":"2026-03-23T16:35:56","modified_gmt":"2026-03-23T15:35:56","slug":"la-therapie-dexposition-par-la-realite-virtuelle","status":"publish","type":"post","link":"https:\/\/www.vr-coach.at\/fr\/la-therapie-dexposition-par-la-realite-virtuelle\/","title":{"rendered":"La th\u00e9rapie d\u2019exposition par la r\u00e9alit\u00e9 virtuelle"},"content":{"rendered":"\t\t
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\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t<\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\tAper\u00e7u du blog.<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t
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\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"Beitragsbild:\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t
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T\u00e9moignage de l'h\u00f4pital r\u00e9gional d'Augsbourg<\/h3>\t\t\t\t<\/div>\n\t\t\t\t
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La th\u00e9rapie d\u2019exposition par la r\u00e9alit\u00e9 virtuelle<\/h2>\t\t\t\t<\/div>\n\t\t\t\t
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De nouveaux espaces d\u2019exp\u00e9rience en psychoth\u00e9rapie<\/h2>\t\t\t\t<\/div>\n\t\t\t\t
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L\u2019exposition dans la pratique clinique<\/h2>\t\t\t\t<\/div>\n\t\t\t\t
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Les m\u00e9thodes bas\u00e9es sur l\u2019exposition comptent parmi les interventions psychoth\u00e9rapeutiques les plus efficaces. En m\u00eame temps, la pratique clinique montre que les expositions in sensu ou in vivo ne sont pas utilis\u00e9es assez fr\u00e9quemment. Selon la complexit\u00e9 des stimuli cibles, leur mise en \u0153uvre implique un effort organisationnel consid\u00e9rable. Certaines situations ne peuvent pas \u00eatre reproduites in vivo, ou seulement au prix d\u2019un investissement important en temps et, finalement, en co\u00fbts. C\u2019est pr\u00e9cis\u00e9ment \u00e0 ce niveau que, dans notre cadre psychiatrique stationnaire, nous avons commenc\u00e9 \u00e0 int\u00e9grer syst\u00e9matiquement l\u2019exposition par la r\u00e9alit\u00e9 virtuelle (Virtual Reality Exposure Therapy, VRET) dans notre offre psychoth\u00e9rapeutique. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t

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La r\u00e9alit\u00e9 virtuelle comme espace exp\u00e9rientiel th\u00e9rapeutique<\/h2>\t\t\t\t<\/div>\n\t\t\t\t
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La r\u00e9alit\u00e9 virtuelle ouvre un espace d\u2019exp\u00e9rience th\u00e9rapeutique suppl\u00e9mentaire qui permet de vivre des stimuli \u00e9motionnellement pertinents de mani\u00e8re r\u00e9aliste, contr\u00f4lable et accompagn\u00e9e sur le plan th\u00e9rapeutique. En pratique, nous utilisons ce syst\u00e8me de mani\u00e8re transdiagnostique chaque fois que l\u2019\u00e9quipe th\u00e9rapeutique estime que l\u2019exposition est cliniquement pertinente \u2013 en particulier lorsque les formats classiques (exercices d\u2019imagination, jeux de r\u00f4le, etc.) ne sont pas suffisamment efficaces ou sont difficiles \u00e0 mettre en \u0153uvre. Gr\u00e2ce \u00e0 cette modalit\u00e9 d\u2019exposition suppl\u00e9mentaire, nous avons \u00e9galement pu d\u00e9passer certaines limitations li\u00e9es aux conditions m\u00eames du traitement, par exemple lorsque les patient\u00b7e\u00b7s sont hospitalis\u00e9\u00b7e\u00b7s ou qu\u2019il n\u2019est (temporairement) pas possible de quitter l\u2019unit\u00e9. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t

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Exposition assist\u00e9e par la RV dans les troubles anxieux et l\u2019anxi\u00e9t\u00e9 sociale<\/h2>\t\t\t\t<\/div>\n\t\t\t\t
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Le VRET a d\u2019abord \u00e9t\u00e9 mis en place dans notre clinique afin de pouvoir r\u00e9aliser des expositions pour les troubles anxieux de mani\u00e8re plus cibl\u00e9e et plus fr\u00e9quente. La diversit\u00e9 des sc\u00e9narios virtuels permet une large gamme de stimuli d\u2019exposition (par exemple la hauteur, l\u2019enfermement, les espaces publics, les foules, l\u2019interaction et l\u2019\u00e9valuation), qui peuvent \u00eatre finement gradu\u00e9s en termes d\u2019intensit\u00e9, de dur\u00e9e et de complexit\u00e9. Cela permet d\u2019adapter tr\u00e8s pr\u00e9cis\u00e9ment l\u2019exposition au niveau de charge actuel, y compris chez des patient\u00b7e\u00b7s souffrant d\u2019anxi\u00e9t\u00e9s s\u00e9v\u00e8rement chronifi\u00e9es. D\u2019apr\u00e8s notre exp\u00e9rience, le VRET sert souvent de tremplin vers l\u2019exposition in vivo : les patient\u00b7e\u00b7s peuvent d\u2019abord faire des exp\u00e9riences correctrices dans un cadre hautement contr\u00f4lable, puis g\u00e9rer progressivement le transfert vers des situations r\u00e9elles. <\/p>

Le syst\u00e8me s\u2019est r\u00e9v\u00e9l\u00e9 particuli\u00e8rement efficace, au-del\u00e0 des phobies sp\u00e9cifiques, \u00e9galement pour les troubles anxieux sociaux et les situations interactionnelles. Par exemple, les situations d\u2019\u00e9valuation, les conversations en groupe ou les exp\u00e9riences cibl\u00e9es de rejet peuvent \u00eatre rendues beaucoup plus concr\u00e8tes dans la r\u00e9alit\u00e9 virtuelle que dans des jeux de r\u00f4le classiques. La qualit\u00e9 immersive entra\u00eene une activation corporelle, des pens\u00e9es automatiques et des impulsions d\u2019action qui apparaissent imm\u00e9diatement et peuvent ainsi \u00eatre travaill\u00e9es th\u00e9rapeutiquement en temps r\u00e9el. En particulier chez les patient\u00b7e\u00b7s qui \u00ab restent dans leur t\u00eate \u00bb lors des jeux de r\u00f4le traditionnels, le VRET peut aider \u00e0 passer de la simple discussion \u00e0 une exp\u00e9rience r\u00e9ellement v\u00e9cue. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t

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Th\u00e9rapie par RV dans les troubles li\u00e9s \u00e0 l\u2019usage de substances et le craving<\/h2>\t\t\t\t<\/div>\n\t\t\t\t
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Avec l\u2019\u00e9tablissement de l\u2019exposition par la r\u00e9alit\u00e9 virtuelle dans le traitement des troubles anxieux, nous avons \u00e9tendu son application aux troubles li\u00e9s \u00e0 l\u2019usage de substances comme autre champ d\u2019application central. Dans le traitement des addictions, on constate souvent que les th\u00e9rapeutes ne sont pas pr\u00e9sent\u00b7e\u00b7s aux moments d\u00e9cisifs \u2013 c\u2019est-\u00e0-dire lorsque le craving appara\u00eet et que l\u2019orientation vers la rechute ou l\u2019abstinence se joue. La r\u00e9alit\u00e9 virtuelle permet de d\u00e9clencher le craving de mani\u00e8re cibl\u00e9e tout en restant pr\u00e9sent sur le plan th\u00e9rapeutique. Dans des sc\u00e9narios virtuels tels qu\u2019un bar, un salon ou une f\u00eate, les patient\u00b7e\u00b7s vivent le craving avec une intensit\u00e9 proche de l\u2019exp\u00e9rience r\u00e9elle, mais sans risque r\u00e9el de rechute imm\u00e9diate. <\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t

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Travail th\u00e9rapeutique sur la r\u00e9gulation \u00e9motionnelle et des impulsions<\/h3>\t\t\t\t<\/div>\n\t\t\t\t
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Au sein de ces situations d\u2019exposition, des strat\u00e9gies de r\u00e9gulation \u00e9motionnelle et impulsive peuvent \u00eatre \u00e9labor\u00e9es ensemble et directement mises \u00e0 l\u2019\u00e9preuve : par exemple le fait de nommer et de \u00ab surfer \u00bb sur le craving, la redirection de l\u2019attention, la focalisation sur la respiration et le corps, les auto-instructions, la gestion des pens\u00e9es permissives ainsi que la simulation de plans d\u2019action alternatifs. \u00c0 ce moment-l\u00e0, le patient n\u2019est pas seul face au craving, mais accompagn\u00e9. Cela rend observable ici et maintenant ce qui, dans l\u2019entretien th\u00e9rapeutique, n\u2019est souvent rapport\u00e9 que r\u00e9trospectivement : quelles pens\u00e9es \u00e9mergent ? Quelles r\u00e9actions corporelles augmentent ? Quels d\u00e9clencheurs sont particuli\u00e8rement actifs ? Et qu\u2019est-ce qui aide r\u00e9ellement \u00e0 interrompre l\u2019impulsion ?<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t

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Anxi\u00e9t\u00e9s comorbides et entra\u00eenement \u00e0 l\u2019acceptation du rejet en r\u00e9alit\u00e9 virtuelle<\/h3>\t\t\t\t<\/div>\n\t\t\t\t
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Dans les troubles li\u00e9s \u00e0 l\u2019usage de substances, il existe souvent des troubles anxieux comorbides ou des ins\u00e9curit\u00e9s sociales qui peuvent maintenir ou renforcer le craving. La r\u00e9alit\u00e9 virtuelle permet de traiter sp\u00e9cifiquement ces peurs dans le cadre de l\u2019exposition, par exemple des situations sociales dans lesquelles le rejet est redout\u00e9, ou des contextes dans lesquels la honte et l\u2019auto-d\u00e9valorisation rendent la consommation attractive comme strat\u00e9gie de soulagement \u00e0 court terme. C\u2019est pr\u00e9cis\u00e9ment ici qu\u2019un entra\u00eenement au rejet peut devenir beaucoup plus concret : les patient\u00b7e\u00b7s peuvent exp\u00e9rimenter que des \u00e9motions sociales d\u00e9sagr\u00e9ables augmentent puis diminuent \u00e0 nouveau sans que la consommation soit \u00ab n\u00e9cessaire \u00bb, et que de nouvelles mani\u00e8res de r\u00e9agir, plus s\u00fbres d\u2019elles, sont possibles. <\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t

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L\u2019exposition en r\u00e9alit\u00e9 virtuelle en milieu psychiatrique hospitalier<\/h2>\t\t\t\t<\/div>\n\t\t\t\t
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Une autre exp\u00e9rience importante issue de notre pratique stationnaire est que le VRET ne s\u2019est pas seulement av\u00e9r\u00e9 utile pour des troubles \u00ab plus l\u00e9gers \u00bb, mais qu\u2019il se montre particuli\u00e8rement b\u00e9n\u00e9fique dans un contexte psychiatrique stationnaire avec des patient\u00b7e\u00b7s s\u00e9v\u00e8rement atteint\u00b7e\u00b7s. Nous traitons fr\u00e9quemment des patient\u00b7e\u00b7s pr\u00e9sentant des comorbidit\u00e9s marqu\u00e9es, des \u00e9volutions longues de la maladie, plusieurs traitements ant\u00e9rieurs et des hospitalisations r\u00e9p\u00e9t\u00e9es. Il n\u2019est pas rare que plusieurs syndromes psychopathologiques coexistent, associ\u00e9s \u00e0 une vuln\u00e9rabilit\u00e9 accrue aux crises, pouvant aller jusqu\u2019\u00e0 la suicidalit\u00e9. Notre exp\u00e9rience est que le VRET peut \u00e9galement \u00eatre utilis\u00e9 efficacement dans ces configurations complexes \u2013 pr\u00e9cis\u00e9ment parce que les expositions peuvent \u00eatre soigneusement dos\u00e9es, \u00e9troitement accompagn\u00e9es et pr\u00e9par\u00e9es et retravaill\u00e9es imm\u00e9diatement dans le cadre stationnaire. Pour certain\u00b7e\u00b7s patient\u00b7e\u00b7s, c\u2019est un avantage d\u00e9cisif que l\u2019exposition devienne r\u00e9alistement faisable malgr\u00e9 une lourde charge symptomatique et ne doive pas \u00eatre report\u00e9e \u00e0 un \u00ab moment ult\u00e9rieur \u00bb. <\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t

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Conclusion : la RV comme composante de la psychoth\u00e9rapie moderne<\/h2>\t\t\t\t<\/div>\n\t\t\t\t
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Apr\u00e8s plus de deux ans, nous consid\u00e9rons l\u2019exposition par la r\u00e9alit\u00e9 virtuelle comme un outil th\u00e9rapeutique pr\u00e9cieux au sein de notre concept th\u00e9rapeutique global, qui suscite curiosit\u00e9 et int\u00e9r\u00eat tant chez les patient\u00b7e\u00b7s que chez les th\u00e9rapeutes et conduit souvent \u00e0 des exp\u00e9riences de r\u00e9ussite imm\u00e9diates. M\u00eame si l\u2019exposition virtuelle repose fondamentalement sur l\u2019approche classique bas\u00e9e sur l\u2019exposition, mise en \u0153uvre \u00e0 travers un autre m\u00e9dium, des exigences th\u00e9rapeutiques sp\u00e9cifiques apparaissent dans la pratique. La qualit\u00e9 immersive de la r\u00e9alit\u00e9 virtuelle, l\u2019intensit\u00e9 de l\u2019exp\u00e9rience ainsi que la conception flexible de diff\u00e9rents sc\u00e9narios exigent une formation cibl\u00e9e des th\u00e9rapeutes. <\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t

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Isabella Mehling<\/strong> est psychoth\u00e9rapeute psychologue sp\u00e9cialis\u00e9e dans les approches cognitivo-comportementales. Elle dispose de nombreuses ann\u00e9es d\u2019exp\u00e9rience dans les soins psychiatriques stationnaires et travaille de mani\u00e8re transdiagnostique dans diff\u00e9rents domaines cliniques. Elle exerce \u00e9galement en lib\u00e9ral et combine la prise en charge clinique avec un travail psychoth\u00e9rapeutique ambulatoire. Son activit\u00e9 comprend le traitement de troubles complexes, notamment dans les domaines des troubles anxieux, des addictions et des troubles psychotiques. Un accent particulier est mis sur l\u2019int\u00e9gration de formes de th\u00e9rapie innovantes et fond\u00e9es sur les preuves dans des concepts de traitement clinique existants. En plus de son activit\u00e9 th\u00e9rapeutique, elle est impliqu\u00e9e dans le d\u00e9veloppement conceptuel de dispositifs psychoth\u00e9rapeutiques ainsi que dans la formation initiale et continue. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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L\u2019autrice<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Reportage t\u00e9l\u00e9vis\u00e9 de l\u2019H\u00f4pital psychiatrique de district d\u2019Augsbourg<\/h3>\t\t\t\t<\/div>\n\t\t\t\t
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\n\t\t\t\t\t\t\t\t\t\t\t\"Video-Overlay\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Vous souhaitez int\u00e9grer la th\u00e9rapie VR dans votre \u00e9tablissement ?<\/h3>\t\t\t\t<\/div>\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t<\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\tCommander la fiche d\u00e8s maintenant<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t
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\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"VR\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Cela pourrait \u00e9galement vous int\u00e9resser.<\/h4>\t\t\t\t<\/div>\n\t\t\t\t
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\"Nahaufnahme<\/figure><\/a><\/div>

Traiter l’anh\u00e9donie dans la d\u00e9pression : pourquoi le syst\u00e8me de r\u00e9compense est le point d’ancrage d\u00e9cisif \u2014 et ce que le VR Reward Training peut apporter<\/a><\/h3><\/div>\t\t\t<\/div>\n\t\t<\/article>\n\t\t\n\t\t
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\"Mise<\/figure><\/a><\/div>

Mise \u00e0 jour du smartsystem (Version 29): Nouveaux sc\u00e9narios d’exposition, dialogues d’avatars plus flexibles et nouveau module pour le TSPT<\/a><\/h3><\/div>\t\t\t<\/div>\n\t\t<\/article>\n\t\t\n\t\t
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\"Beitragsbild:<\/figure><\/a><\/div>

Traiter la peur de l’avion gr\u00e2ce \u00e0 une th\u00e9rapie moderne en r\u00e9alit\u00e9 virtuelle<\/a><\/h3><\/div>\t\t\t<\/div>\n\t\t<\/article>\n\t\t\n\t\t
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\"PTSD<\/figure><\/a><\/div>

TSPT apr\u00e8s des exp\u00e9riences de guerre<\/a><\/h3><\/div>\t\t\t<\/div>\n\t\t<\/article>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t
<\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"

Aper\u00e7u du blog. T\u00e9moignage de l’h\u00f4pital r\u00e9gional d’Augsbourg La th\u00e9rapie d\u2019exposition par la r\u00e9alit\u00e9 virtuelle De nouveaux espaces d\u2019exp\u00e9rience en psychoth\u00e9rapie L\u2019exposition dans la pratique clinique Les m\u00e9thodes bas\u00e9es sur l\u2019exposition comptent parmi les interventions psychoth\u00e9rapeutiques les plus efficaces. En m\u00eame temps, la pratique clinique montre que les expositions in sensu ou in vivo ne […]<\/p>\n","protected":false},"author":20,"featured_media":47421,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"elementor_header_footer","format":"standard","meta":{"_acf_changed":false,"_seopress_titles_title":"Expositionstherapie mit VR | Virtuelle Realit\u00e4t in der Psychotherapie","_seopress_titles_desc":"Wie Virtual Reality Exposure Therapy neue Erfahrungsr\u00e4ume in der Psychotherapie schafft und Exposition bei Angst und Sucht wirksam 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Les m\\u00e9thodes bas\\u00e9es sur l\\u2019exposition comptent parmi les interventions psychoth\\u00e9rapeutiques les plus efficaces. En m\\u00eame temps, la pratique clinique montre que les expositions in sensu ou in vivo ne sont pas utilis\\u00e9es assez fr\\u00e9quemment. Selon la complexit\\u00e9 des stimuli cibles, leur mise en \\u0153uvre implique un effort organisationnel consid\\u00e9rable. Certaines situations ne peuvent pas \\u00eatre reproduites in vivo, ou seulement au prix d\\u2019un investissement important en temps et, finalement, en co\\u00fbts. C\\u2019est pr\\u00e9cis\\u00e9ment \\u00e0 ce niveau que, dans notre cadre psychiatrique stationnaire, nous avons commenc\\u00e9 \\u00e0 int\\u00e9grer syst\\u00e9matiquement l\\u2019exposition par la r\\u00e9alit\\u00e9 virtuelle (Virtual Reality Exposure Therapy, VRET) dans notre offre psychoth\\u00e9rapeutique. <\\\/p>\",\"wcm_element_visibility_content_restricted_message\":\"You are not authorized to view this content.\",\"dce_tooltip_content\":\"I'm a tooltip\",\"transforms_transform-origin\":[],\"transforms_perspective-origin\":[],\"dce_visibility_mode\":\"quick\",\"dce_visibility_triggers\":[\"post\",\"user\",\"archive\",\"dynamic_tag\",\"device\",\"datetime\",\"context\",\"woocommerce\",\"random\",\"custom\",\"events\"],\"dce_visibility_debug\":\"\",\"dce_visibility_dynamic_tag\":{\"url\":\"\",\"id\":\"\",\"size\":\"\"},\"_mask_notice\":\"\",\"dce_visibility_favorites_key\":\"my_favorites\"},\"elements\":[],\"widgetType\":\"text-editor\"},{\"id\":\"2ba7e11\",\"elType\":\"widget\",\"settings\":{\"title\":\"La r\\u00e9alit\\u00e9 virtuelle comme espace exp\\u00e9rientiel th\\u00e9rapeutique\",\"align\":\"left\",\"_margin\":{\"unit\":\"px\",\"top\":\"0\",\"right\":\"0\",\"bottom\":\"-8\",\"left\":\"0\",\"isLinked\":false},\"_flex_align_self\":\"flex-start\",\"wcm_element_visibility_content_restricted_message\":\"You are not authorized to view this content.\",\"dce_tooltip_content\":\"I'm a tooltip\",\"__globals__\":{\"typography_typography\":\"globals\\\/typography?id=accent\"},\"transforms_transform-origin\":[],\"transforms_perspective-origin\":[],\"dce_visibility_mode\":\"quick\",\"dce_visibility_triggers\":[\"post\",\"user\",\"archive\",\"dynamic_tag\",\"device\",\"datetime\",\"context\",\"woocommerce\",\"random\",\"custom\",\"events\"],\"dce_visibility_debug\":\"\",\"dce_visibility_dynamic_tag\":{\"url\":\"\",\"id\":\"\",\"size\":\"\"},\"_mask_notice\":\"\",\"dce_visibility_favorites_key\":\"my_favorites\"},\"elements\":[],\"widgetType\":\"heading\"},{\"id\":\"fe07fcf\",\"elType\":\"widget\",\"settings\":{\"editor\":\"

La r\\u00e9alit\\u00e9 virtuelle ouvre un espace d\\u2019exp\\u00e9rience th\\u00e9rapeutique suppl\\u00e9mentaire qui permet de vivre des stimuli \\u00e9motionnellement pertinents de mani\\u00e8re r\\u00e9aliste, contr\\u00f4lable et accompagn\\u00e9e sur le plan th\\u00e9rapeutique. En pratique, nous utilisons ce syst\\u00e8me de mani\\u00e8re transdiagnostique chaque fois que l\\u2019\\u00e9quipe th\\u00e9rapeutique estime que l\\u2019exposition est cliniquement pertinente \\u2013 en particulier lorsque les formats classiques (exercices d\\u2019imagination, jeux de r\\u00f4le, etc.) ne sont pas suffisamment efficaces ou sont difficiles \\u00e0 mettre en \\u0153uvre. Gr\\u00e2ce \\u00e0 cette modalit\\u00e9 d\\u2019exposition suppl\\u00e9mentaire, nous avons \\u00e9galement pu d\\u00e9passer certaines limitations li\\u00e9es aux conditions m\\u00eames du traitement, par exemple lorsque les patient\\u00b7e\\u00b7s sont hospitalis\\u00e9\\u00b7e\\u00b7s ou qu\\u2019il n\\u2019est (temporairement) pas possible de quitter l\\u2019unit\\u00e9. <\\\/p>\",\"wcm_element_visibility_content_restricted_message\":\"You are not authorized to view this content.\",\"dce_tooltip_content\":\"I'm a tooltip\",\"transforms_transform-origin\":[],\"transforms_perspective-origin\":[],\"dce_visibility_mode\":\"quick\",\"dce_visibility_triggers\":[\"post\",\"user\",\"archive\",\"dynamic_tag\",\"device\",\"datetime\",\"context\",\"woocommerce\",\"random\",\"custom\",\"events\"],\"dce_visibility_debug\":\"\",\"dce_visibility_dynamic_tag\":{\"url\":\"\",\"id\":\"\",\"size\":\"\"},\"_mask_notice\":\"\",\"dce_visibility_favorites_key\":\"my_favorites\"},\"elements\":[],\"widgetType\":\"text-editor\"},{\"id\":\"29073b5\",\"elType\":\"widget\",\"settings\":{\"title\":\"Exposition assist\\u00e9e par la RV dans les troubles anxieux et l\\u2019anxi\\u00e9t\\u00e9 sociale\",\"align\":\"left\",\"_margin\":{\"unit\":\"px\",\"top\":\"0\",\"right\":\"0\",\"bottom\":\"-8\",\"left\":\"0\",\"isLinked\":false},\"_flex_align_self\":\"flex-start\",\"wcm_element_visibility_content_restricted_message\":\"You are not authorized to view this content.\",\"dce_tooltip_content\":\"I'm a tooltip\",\"__globals__\":{\"typography_typography\":\"globals\\\/typography?id=accent\"},\"transforms_transform-origin\":[],\"transforms_perspective-origin\":[],\"dce_visibility_mode\":\"quick\",\"dce_visibility_triggers\":[\"post\",\"user\",\"archive\",\"dynamic_tag\",\"device\",\"datetime\",\"context\",\"woocommerce\",\"random\",\"custom\",\"events\"],\"dce_visibility_debug\":\"\",\"dce_visibility_dynamic_tag\":{\"url\":\"\",\"id\":\"\",\"size\":\"\"},\"_mask_notice\":\"\",\"dce_visibility_favorites_key\":\"my_favorites\"},\"elements\":[],\"widgetType\":\"heading\"},{\"id\":\"9dadb77\",\"elType\":\"widget\",\"settings\":{\"editor\":\"

Le VRET a d\\u2019abord \\u00e9t\\u00e9 mis en place dans notre clinique afin de pouvoir r\\u00e9aliser des expositions pour les troubles anxieux de mani\\u00e8re plus cibl\\u00e9e et plus fr\\u00e9quente. La diversit\\u00e9 des sc\\u00e9narios virtuels permet une large gamme de stimuli d\\u2019exposition (par exemple la hauteur, l\\u2019enfermement, les espaces publics, les foules, l\\u2019interaction et l\\u2019\\u00e9valuation), qui peuvent \\u00eatre finement gradu\\u00e9s en termes d\\u2019intensit\\u00e9, de dur\\u00e9e et de complexit\\u00e9. Cela permet d\\u2019adapter tr\\u00e8s pr\\u00e9cis\\u00e9ment l\\u2019exposition au niveau de charge actuel, y compris chez des patient\\u00b7e\\u00b7s souffrant d\\u2019anxi\\u00e9t\\u00e9s s\\u00e9v\\u00e8rement chronifi\\u00e9es. D\\u2019apr\\u00e8s notre exp\\u00e9rience, le VRET sert souvent de tremplin vers l\\u2019exposition in vivo : les patient\\u00b7e\\u00b7s peuvent d\\u2019abord faire des exp\\u00e9riences correctrices dans un cadre hautement contr\\u00f4lable, puis g\\u00e9rer progressivement le transfert vers des situations r\\u00e9elles. <\\\/p>

Le syst\\u00e8me s\\u2019est r\\u00e9v\\u00e9l\\u00e9 particuli\\u00e8rement efficace, au-del\\u00e0 des phobies sp\\u00e9cifiques, \\u00e9galement pour les troubles anxieux sociaux et les situations interactionnelles. Par exemple, les situations d\\u2019\\u00e9valuation, les conversations en groupe ou les exp\\u00e9riences cibl\\u00e9es de rejet peuvent \\u00eatre rendues beaucoup plus concr\\u00e8tes dans la r\\u00e9alit\\u00e9 virtuelle que dans des jeux de r\\u00f4le classiques. La qualit\\u00e9 immersive entra\\u00eene une activation corporelle, des pens\\u00e9es automatiques et des impulsions d\\u2019action qui apparaissent imm\\u00e9diatement et peuvent ainsi \\u00eatre travaill\\u00e9es th\\u00e9rapeutiquement en temps r\\u00e9el. En particulier chez les patient\\u00b7e\\u00b7s qui \\u00ab restent dans leur t\\u00eate \\u00bb lors des jeux de r\\u00f4le traditionnels, le VRET peut aider \\u00e0 passer de la simple discussion \\u00e0 une exp\\u00e9rience r\\u00e9ellement v\\u00e9cue. <\\\/p>\",\"wcm_element_visibility_content_restricted_message\":\"You are not authorized to view this content.\",\"dce_tooltip_content\":\"I'm a tooltip\",\"transforms_transform-origin\":[],\"transforms_perspective-origin\":[],\"dce_visibility_mode\":\"quick\",\"dce_visibility_triggers\":[\"post\",\"user\",\"archive\",\"dynamic_tag\",\"device\",\"datetime\",\"context\",\"woocommerce\",\"random\",\"custom\",\"events\"],\"dce_visibility_debug\":\"\",\"dce_visibility_dynamic_tag\":{\"url\":\"\",\"id\":\"\",\"size\":\"\"},\"_mask_notice\":\"\",\"dce_visibility_favorites_key\":\"my_favorites\"},\"elements\":[],\"widgetType\":\"text-editor\"},{\"id\":\"cd0824d\",\"elType\":\"widget\",\"settings\":{\"title\":\"Th\\u00e9rapie par RV dans les troubles li\\u00e9s \\u00e0 l\\u2019usage de substances et le craving\",\"align\":\"left\",\"_margin\":{\"unit\":\"px\",\"top\":\"0\",\"right\":\"0\",\"bottom\":\"-8\",\"left\":\"0\",\"isLinked\":false},\"_flex_align_self\":\"flex-start\",\"wcm_element_visibility_content_restricted_message\":\"You are not authorized to view this content.\",\"dce_tooltip_content\":\"I'm a tooltip\",\"__globals__\":{\"typography_typography\":\"globals\\\/typography?id=accent\"},\"transforms_transform-origin\":[],\"transforms_perspective-origin\":[],\"dce_visibility_mode\":\"quick\",\"dce_visibility_triggers\":[\"post\",\"user\",\"archive\",\"dynamic_tag\",\"device\",\"datetime\",\"context\",\"woocommerce\",\"random\",\"custom\",\"events\"],\"dce_visibility_debug\":\"\",\"dce_visibility_dynamic_tag\":{\"url\":\"\",\"id\":\"\",\"size\":\"\"},\"_mask_notice\":\"\",\"dce_visibility_favorites_key\":\"my_favorites\"},\"elements\":[],\"widgetType\":\"heading\"},{\"id\":\"719bfe7\",\"elType\":\"widget\",\"settings\":{\"editor\":\"

Avec l\\u2019\\u00e9tablissement de l\\u2019exposition par la r\\u00e9alit\\u00e9 virtuelle dans le traitement des troubles anxieux, nous avons \\u00e9tendu son application aux troubles li\\u00e9s \\u00e0 l\\u2019usage de substances comme autre champ d\\u2019application central. Dans le traitement des addictions, on constate souvent que les th\\u00e9rapeutes ne sont pas pr\\u00e9sent\\u00b7e\\u00b7s aux moments d\\u00e9cisifs \\u2013 c\\u2019est-\\u00e0-dire lorsque le craving appara\\u00eet et que l\\u2019orientation vers la rechute ou l\\u2019abstinence se joue. La r\\u00e9alit\\u00e9 virtuelle permet de d\\u00e9clencher le craving de mani\\u00e8re cibl\\u00e9e tout en restant pr\\u00e9sent sur le plan th\\u00e9rapeutique. Dans des sc\\u00e9narios virtuels tels qu\\u2019un bar, un salon ou une f\\u00eate, les patient\\u00b7e\\u00b7s vivent le craving avec une intensit\\u00e9 proche de l\\u2019exp\\u00e9rience r\\u00e9elle, mais sans risque r\\u00e9el de rechute imm\\u00e9diate. <\\\/span><\\\/p>\",\"wcm_element_visibility_content_restricted_message\":\"You are not authorized to view this content.\",\"dce_tooltip_content\":\"I'm a tooltip\",\"transforms_transform-origin\":[],\"transforms_perspective-origin\":[],\"dce_visibility_mode\":\"quick\",\"dce_visibility_triggers\":[\"post\",\"user\",\"archive\",\"dynamic_tag\",\"device\",\"datetime\",\"context\",\"woocommerce\",\"random\",\"custom\",\"events\"],\"dce_visibility_debug\":\"\",\"dce_visibility_dynamic_tag\":{\"url\":\"\",\"id\":\"\",\"size\":\"\"},\"_mask_notice\":\"\",\"dce_visibility_favorites_key\":\"my_favorites\"},\"elements\":[],\"widgetType\":\"text-editor\"},{\"id\":\"3084792\",\"elType\":\"widget\",\"settings\":{\"title\":\"Travail th\\u00e9rapeutique sur la r\\u00e9gulation \\u00e9motionnelle et des impulsions\",\"align\":\"left\",\"_margin\":{\"unit\":\"px\",\"top\":\"0\",\"right\":\"0\",\"bottom\":\"-8\",\"left\":\"0\",\"isLinked\":false},\"_flex_align_self\":\"flex-start\",\"wcm_element_visibility_content_restricted_message\":\"You are not authorized to view this content.\",\"dce_tooltip_content\":\"I'm a tooltip\",\"__globals__\":{\"typography_typography\":\"\"},\"header_size\":\"h3\",\"typography_typography\":\"custom\",\"typography_font_size\":{\"unit\":\"em\",\"size\":1,\"sizes\":[]},\"typography_font_weight\":\"500\",\"typography_line_height\":{\"unit\":\"em\",\"size\":1.4,\"sizes\":[]},\"transforms_transform-origin\":[],\"transforms_perspective-origin\":[],\"dce_visibility_mode\":\"quick\",\"dce_visibility_triggers\":[\"post\",\"user\",\"archive\",\"dynamic_tag\",\"device\",\"datetime\",\"context\",\"woocommerce\",\"random\",\"custom\",\"events\"],\"dce_visibility_debug\":\"\",\"dce_visibility_dynamic_tag\":{\"url\":\"\",\"id\":\"\",\"size\":\"\"},\"_mask_notice\":\"\",\"dce_visibility_favorites_key\":\"my_favorites\"},\"elements\":[],\"widgetType\":\"heading\"},{\"id\":\"68887f7\",\"elType\":\"widget\",\"settings\":{\"editor\":\"

Au sein de ces situations d\\u2019exposition, des strat\\u00e9gies de r\\u00e9gulation \\u00e9motionnelle et impulsive peuvent \\u00eatre \\u00e9labor\\u00e9es ensemble et directement mises \\u00e0 l\\u2019\\u00e9preuve : par exemple le fait de nommer et de \\u00ab surfer \\u00bb sur le craving, la redirection de l\\u2019attention, la focalisation sur la respiration et le corps, les auto-instructions, la gestion des pens\\u00e9es permissives ainsi que la simulation de plans d\\u2019action alternatifs. \\u00c0 ce moment-l\\u00e0, le patient n\\u2019est pas seul face au craving, mais accompagn\\u00e9. Cela rend observable ici et maintenant ce qui, dans l\\u2019entretien th\\u00e9rapeutique, n\\u2019est souvent rapport\\u00e9 que r\\u00e9trospectivement : quelles pens\\u00e9es \\u00e9mergent ? Quelles r\\u00e9actions corporelles augmentent ? Quels d\\u00e9clencheurs sont particuli\\u00e8rement actifs ? Et qu\\u2019est-ce qui aide r\\u00e9ellement \\u00e0 interrompre l\\u2019impulsion ?<\\\/p>\",\"wcm_element_visibility_content_restricted_message\":\"You are not authorized to view this content.\",\"dce_tooltip_content\":\"I'm a tooltip\",\"transforms_transform-origin\":[],\"transforms_perspective-origin\":[],\"dce_visibility_mode\":\"quick\",\"dce_visibility_triggers\":[\"post\",\"user\",\"archive\",\"dynamic_tag\",\"device\",\"datetime\",\"context\",\"woocommerce\",\"random\",\"custom\",\"events\"],\"dce_visibility_debug\":\"\",\"dce_visibility_dynamic_tag\":{\"url\":\"\",\"id\":\"\",\"size\":\"\"},\"_mask_notice\":\"\",\"dce_visibility_favorites_key\":\"my_favorites\"},\"elements\":[],\"widgetType\":\"text-editor\"},{\"id\":\"3785480\",\"elType\":\"widget\",\"settings\":{\"title\":\"Anxi\\u00e9t\\u00e9s comorbides et entra\\u00eenement \\u00e0 l\\u2019acceptation du rejet en r\\u00e9alit\\u00e9 virtuelle\",\"align\":\"left\",\"_margin\":{\"unit\":\"px\",\"top\":\"0\",\"right\":\"0\",\"bottom\":\"-8\",\"left\":\"0\",\"isLinked\":false},\"_flex_align_self\":\"flex-start\",\"wcm_element_visibility_content_restricted_message\":\"You are not authorized to view this content.\",\"dce_tooltip_content\":\"I'm a tooltip\",\"__globals__\":{\"typography_typography\":\"\"},\"header_size\":\"h3\",\"typography_typography\":\"custom\",\"typography_font_size\":{\"unit\":\"em\",\"size\":1,\"sizes\":[]},\"typography_font_weight\":\"500\",\"typography_line_height\":{\"unit\":\"em\",\"size\":1.4,\"sizes\":[]},\"transforms_transform-origin\":[],\"transforms_perspective-origin\":[],\"dce_visibility_mode\":\"quick\",\"dce_visibility_triggers\":[\"post\",\"user\",\"archive\",\"dynamic_tag\",\"device\",\"datetime\",\"context\",\"woocommerce\",\"random\",\"custom\",\"events\"],\"dce_visibility_debug\":\"\",\"dce_visibility_dynamic_tag\":{\"url\":\"\",\"id\":\"\",\"size\":\"\"},\"_mask_notice\":\"\",\"dce_visibility_favorites_key\":\"my_favorites\"},\"elements\":[],\"widgetType\":\"heading\"},{\"id\":\"5c3d8ce\",\"elType\":\"widget\",\"settings\":{\"editor\":\"

Dans les troubles li\\u00e9s \\u00e0 l\\u2019usage de substances, il existe souvent des troubles anxieux comorbides ou des ins\\u00e9curit\\u00e9s sociales qui peuvent maintenir ou renforcer le craving. La r\\u00e9alit\\u00e9 virtuelle permet de traiter sp\\u00e9cifiquement ces peurs dans le cadre de l\\u2019exposition, par exemple des situations sociales dans lesquelles le rejet est redout\\u00e9, ou des contextes dans lesquels la honte et l\\u2019auto-d\\u00e9valorisation rendent la consommation attractive comme strat\\u00e9gie de soulagement \\u00e0 court terme. C\\u2019est pr\\u00e9cis\\u00e9ment ici qu\\u2019un entra\\u00eenement au rejet peut devenir beaucoup plus concret : les patient\\u00b7e\\u00b7s peuvent exp\\u00e9rimenter que des \\u00e9motions sociales d\\u00e9sagr\\u00e9ables augmentent puis diminuent \\u00e0 nouveau sans que la consommation soit \\u00ab n\\u00e9cessaire \\u00bb, et que de nouvelles mani\\u00e8res de r\\u00e9agir, plus s\\u00fbres d\\u2019elles, sont possibles. <\\\/span><\\\/p>\",\"wcm_element_visibility_content_restricted_message\":\"You are not authorized to view this content.\",\"dce_tooltip_content\":\"I'm a tooltip\",\"transforms_transform-origin\":[],\"transforms_perspective-origin\":[],\"dce_visibility_mode\":\"quick\",\"dce_visibility_triggers\":[\"post\",\"user\",\"archive\",\"dynamic_tag\",\"device\",\"datetime\",\"context\",\"woocommerce\",\"random\",\"custom\",\"events\"],\"dce_visibility_debug\":\"\",\"dce_visibility_dynamic_tag\":{\"url\":\"\",\"id\":\"\",\"size\":\"\"},\"_mask_notice\":\"\",\"dce_visibility_favorites_key\":\"my_favorites\"},\"elements\":[],\"widgetType\":\"text-editor\"},{\"id\":\"382f7fe\",\"elType\":\"widget\",\"settings\":{\"title\":\"L\\u2019exposition en r\\u00e9alit\\u00e9 virtuelle en milieu psychiatrique hospitalier\",\"align\":\"left\",\"_margin\":{\"unit\":\"px\",\"top\":\"0\",\"right\":\"0\",\"bottom\":\"-8\",\"left\":\"0\",\"isLinked\":false},\"_flex_align_self\":\"flex-start\",\"wcm_element_visibility_content_restricted_message\":\"You are not authorized to view this content.\",\"dce_tooltip_content\":\"I'm a tooltip\",\"__globals__\":{\"typography_typography\":\"globals\\\/typography?id=accent\"},\"transforms_transform-origin\":[],\"transforms_perspective-origin\":[],\"dce_visibility_mode\":\"quick\",\"dce_visibility_triggers\":[\"post\",\"user\",\"archive\",\"dynamic_tag\",\"device\",\"datetime\",\"context\",\"woocommerce\",\"random\",\"custom\",\"events\"],\"dce_visibility_debug\":\"\",\"dce_visibility_dynamic_tag\":{\"url\":\"\",\"id\":\"\",\"size\":\"\"},\"_mask_notice\":\"\",\"dce_visibility_favorites_key\":\"my_favorites\"},\"elements\":[],\"widgetType\":\"heading\"},{\"id\":\"b2b939b\",\"elType\":\"widget\",\"settings\":{\"editor\":\"

Une autre exp\\u00e9rience importante issue de notre pratique stationnaire est que le VRET ne s\\u2019est pas seulement av\\u00e9r\\u00e9 utile pour des troubles \\u00ab plus l\\u00e9gers \\u00bb, mais qu\\u2019il se montre particuli\\u00e8rement b\\u00e9n\\u00e9fique dans un contexte psychiatrique stationnaire avec des patient\\u00b7e\\u00b7s s\\u00e9v\\u00e8rement atteint\\u00b7e\\u00b7s. Nous traitons fr\\u00e9quemment des patient\\u00b7e\\u00b7s pr\\u00e9sentant des comorbidit\\u00e9s marqu\\u00e9es, des \\u00e9volutions longues de la maladie, plusieurs traitements ant\\u00e9rieurs et des hospitalisations r\\u00e9p\\u00e9t\\u00e9es. Il n\\u2019est pas rare que plusieurs syndromes psychopathologiques coexistent, associ\\u00e9s \\u00e0 une vuln\\u00e9rabilit\\u00e9 accrue aux crises, pouvant aller jusqu\\u2019\\u00e0 la suicidalit\\u00e9. Notre exp\\u00e9rience est que le VRET peut \\u00e9galement \\u00eatre utilis\\u00e9 efficacement dans ces configurations complexes \\u2013 pr\\u00e9cis\\u00e9ment parce que les expositions peuvent \\u00eatre soigneusement dos\\u00e9es, \\u00e9troitement accompagn\\u00e9es et pr\\u00e9par\\u00e9es et retravaill\\u00e9es imm\\u00e9diatement dans le cadre stationnaire. Pour certain\\u00b7e\\u00b7s patient\\u00b7e\\u00b7s, c\\u2019est un avantage d\\u00e9cisif que l\\u2019exposition devienne r\\u00e9alistement faisable malgr\\u00e9 une lourde charge symptomatique et ne doive pas \\u00eatre report\\u00e9e \\u00e0 un \\u00ab moment ult\\u00e9rieur \\u00bb. <\\\/span><\\\/p>\",\"wcm_element_visibility_content_restricted_message\":\"You are not authorized to view this content.\",\"dce_tooltip_content\":\"I'm a tooltip\",\"transforms_transform-origin\":[],\"transforms_perspective-origin\":[],\"dce_visibility_mode\":\"quick\",\"dce_visibility_triggers\":[\"post\",\"user\",\"archive\",\"dynamic_tag\",\"device\",\"datetime\",\"context\",\"woocommerce\",\"random\",\"custom\",\"events\"],\"dce_visibility_debug\":\"\",\"dce_visibility_dynamic_tag\":{\"url\":\"\",\"id\":\"\",\"size\":\"\"},\"_mask_notice\":\"\",\"dce_visibility_favorites_key\":\"my_favorites\"},\"elements\":[],\"widgetType\":\"text-editor\"},{\"id\":\"85070df\",\"elType\":\"widget\",\"settings\":{\"title\":\"Conclusion : la RV comme composante de la psychoth\\u00e9rapie moderne\",\"align\":\"left\",\"_margin\":{\"unit\":\"px\",\"top\":\"0\",\"right\":\"0\",\"bottom\":\"-8\",\"left\":\"0\",\"isLinked\":false},\"_flex_align_self\":\"flex-start\",\"wcm_element_visibility_content_restricted_message\":\"You are not authorized to view this content.\",\"dce_tooltip_content\":\"I'm a tooltip\",\"__globals__\":{\"typography_typography\":\"globals\\\/typography?id=accent\"},\"transforms_transform-origin\":[],\"transforms_perspective-origin\":[],\"dce_visibility_mode\":\"quick\",\"dce_visibility_triggers\":[\"post\",\"user\",\"archive\",\"dynamic_tag\",\"device\",\"datetime\",\"context\",\"woocommerce\",\"random\",\"custom\",\"events\"],\"dce_visibility_debug\":\"\",\"dce_visibility_dynamic_tag\":{\"url\":\"\",\"id\":\"\",\"size\":\"\"},\"_mask_notice\":\"\",\"dce_visibility_favorites_key\":\"my_favorites\"},\"elements\":[],\"widgetType\":\"heading\"},{\"id\":\"453d672\",\"elType\":\"widget\",\"settings\":{\"editor\":\"

Apr\\u00e8s plus de deux ans, nous consid\\u00e9rons l\\u2019exposition par la r\\u00e9alit\\u00e9 virtuelle comme un outil th\\u00e9rapeutique pr\\u00e9cieux au sein de notre concept th\\u00e9rapeutique global, qui suscite curiosit\\u00e9 et int\\u00e9r\\u00eat tant chez les patient\\u00b7e\\u00b7s que chez les th\\u00e9rapeutes et conduit souvent \\u00e0 des exp\\u00e9riences de r\\u00e9ussite imm\\u00e9diates. M\\u00eame si l\\u2019exposition virtuelle repose fondamentalement sur l\\u2019approche classique bas\\u00e9e sur l\\u2019exposition, mise en \\u0153uvre \\u00e0 travers un autre m\\u00e9dium, des exigences th\\u00e9rapeutiques sp\\u00e9cifiques apparaissent dans la pratique. 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