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VR Neuropsychological Therapy (VRNT) is a new experimental therapy being developed by CognifiSense It focuses on the brain's ability to change over time, known as neuroplasticity, to treat chronic pain long-term. As chronic pain has long-term effects on the brain, this therapy seeks to "undo" these maladaptive learning processes. It uses VR to create high cognitive load via VR video games which shift focuses away from the pain. This has short-term distraction benefits as well, but the idea here is that VR is immersive enough to be able to form long-term positive effects on the brain itself. Of note, VRNT is still in development and is not yet commercially available.
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In 2017-2018, the New Children's Hospital in Helsinki was opened. They received over a million euros for 14 artworks and installations made by 17 artists and artist groups.

Furthermore the entire hospital has been designed in Moomin style, with every floor having it's own theme. There is a jungle floor, a water floor, and a space floor, for example.

Quotes and images from the Moomin books can be found scattered over the hospital walls, with the goal of providing children (and their parents and extended family) with a familiar and reassuring environment.
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A compelling video where Dr. Robert Gupta explains many of the uses of music in medicine, ranging from psychological support to recovery from brain injuries.

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Robert Gupta: Between music and medicine

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When Robert Gupta was caught between a career as a doctor and as a violinist, he realized his place was in the middle, with a bow in his hand and a sense of social justice in his heart. He tells a moving story of society's marginalized and the power of music therapy, which can succeed where conventional medicine fails.

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Applied VR, a company dedicated to developing Virtual Reality content appropriate for healthcare, has defined 7 different types of content:

1. Coping skills for chronic pain patients

2. Coping skills for labor

3. Education

4. MRI preparation

5. Relaxing

6. Distractions

7. Escape

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Virtual Reality is an extraordinarily promising and quickly developing technology, of which we are only beginning to understand its potential. It is already being used succesfully to reduce costs, medication, and patient stay through pain management, exposure therapy, and a variety of other techniques.

It is wise for healthcare centers to be aware of this development, especially when considering patient well-being and cost efficiency.

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Blues and greens seem to be more effective at generating well-being through providing more pleasure but less arousal than colors such as red and yellows.
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The biophilia hypothesis is the idea that healthy, calming, and natural environments that would have been an evolutionary advantage to early humans, and so they still have a positive effect on our well-being.

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Visual art has the potential to reduce hospital stay, increase pain tolerance, and increase general well-being of patients.
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VR is also used by medical professionals for training purposes.

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Virtual Reality in Medicine: New Opportunities for Diagnostics and Surgical Planning

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George Khut creates interactive apps that help people connect to their bodies, foster mindfulness and help them relax. His works have already been used in medical settings, especially for children.

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Can Art Help Medicine?: George Khut at TEDxSydney

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Artworks in the Central Finland Central Hospital

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Art programs and artworks in general have been present in healthcare centers worldwide for many years, in one form or another, although the trend of including them is becoming more prevalent. This section presents a small selection of art in healthcare centers, bits of other examples can be found throughout this page.

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Overall, it is clear that art in healthcare has has been extensively researched, though there are still much that is left to research.

In terms of the findings, the importance of music and nature appear to be paramount in healthcare settings, though it is also important to remember that different mediums have different effects on patients, which can be beneficial in different circumstances. Both artists and healthcare centers ought to take this into account when making and placing art in medical centers.

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Exposure therapy for acrophobia (fear of heights)

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PTSD exposure therapy treatment for war veterans

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VR is very useful in reducing pain, and that can be explained by the Gate Control Theory. Pain nodes modulate the transmission and perception of pain, and sensory, cognitive and emotional factors (such as using VR) can force the brain to inhibit these nodes.
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VR worked on 80-90% of the patient who tried it. The fact that it does not work can still be useful, such as indicating that certain pain is not psychological in nature.
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Some patients prefer relaxing content while other prefer to play games or experience more dynamic environments. Some patients prefer real-life footage while some prefer CGI. There is a need for a “VR Pharmacy” of evidence-based, well-characterized visualizations that clinicians can pull of the shelf and “prescribe” to individual patients.
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After using VR goggles, patients reported a 24% drop in pain, compared to a 13.2% drop using regular 2D videos. This is suspected to be due to immersive distraction, which will require a larger variety of VR content to be effective long-term.
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Another important use for VR is for pain management. It appears that patients using VR can achieve significant reductions in pain, mostly through distraction. The immersive nature of VR gives it an enormous advantage over other, more simple distraction methods.

It might initally sound unimpressive, but ultimately this can reduce patient stay and reduce the use of medication (and the accompanying costs).

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''Virtual reality exposure therapy and virtual reality cognitive behavior therapy have become effective choices for patients with anxiety disorders and other phobias like fear of flying, claustrophobia, acrophobia or generalized social phobia. Instead of being exposed to the real world, patients can experience an anxiety-provoking scenario in the realistic virtual environment generated by VR technology. Patients and therapists can both benefit from this kind of treatment, especially in view of advanced VR technology that is becoming ever more available. Furthermore, VR technology can be used as self-treatment to some extent ''
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In the context of psychological therapy, VR is often used as a tool for exposure therapy for PTSD and various phobias. It is an extremely affordable way to recreate environments that may otherwise be difficult to convincingly imagine or actually visit. VR appears to be superior over other current methods of exposure therapy. VR has also been used to help children with Autism to practice emotional responses.

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There are many factors for a healthcare center to consider in the establishment of an art program and throughout its execution. Research have shown what works and what does not, and more art programs can provide evidence for more and better research, as much more is still needed.

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Research on VR technology and medicine already started in the 1990s, but has been seeing a dramatic increase in recent years, in large part thanks to improvements in technology.

In this section we will be presenting a breakdown of the evidence-based uses of VR for healthcare, its current practices, and its future potential.

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In practice installation of visual art is often the first step taken by a healthcare center. After such art programs become established in the center, it will often consult artists for future, specific designs for transforming existing spaces, and seek artistic input when considering renovations and designing new spaces.
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Artwork in the Royal Manchester Children`s Hospital, UK
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RESEARCH ON CONTEMPORARY ART AND MEDICINE

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RESEARCH ON CONTEMPORARY ART AND MEDICINE

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Over the years there has been a decent amount of research papers released on the subject. Most of it is based on theory and case studies, however. As of yet, there are not a lot of double-blind, placebo controlled studies, for example. This might not be too surprising, as this kind of high quality research might be difficult to conduct on this topic, given the highly subjective and variable nature of (visual) art.

Nonetheless, there does appear to be a general consensus and some interesting data (some of which was presented in the video above), which we will look into here. Our findings can be divided into the following categories: effects of music, effects of other forms of art, known preferences of patients, and effects on medical staff.

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Artwork in the Central Manchester University Hospital, UK
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1. Introductory video

2. Research on contemporary art and medicine

1. Introduction

2. Effects of music

3. Effects of visual art

4. Known preferences of patients

5. Effects on medical staff

6. Conclusion

3. Guidelines on art in healthcare

1. Introduction

2. Steps of an art program

3. Practical advice

4. Conclusion

4. Existing contemporary art projects in medicine

1. Espoo Hospital

2. Central Finland Central Hospital

3. Erasmus Medical Center Rotterdam

5. Virtual Reality

1. introduction

2. Exposure Therapy

3. Pain management

4. Other applications

5. Companies involved / Existing practices

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On this page you will find a summary of the current available research, theories and on-going projects that combine contemporary art, virtual reality, and medical healthcare. (Not social healthcare.)

Below you will find a table of contents. Keep scrolling down to check out all the information in a chronological order!

This page was compiled by Dor Koren and Rutger Blom, students of the TAMK Fine Arts programme.

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New artworks from Espoo Hospital

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Recently, 6 new commissioned works by Finnish artists were added to the hospital, which already has around 300 artworks on display (mostly from Espoo Museum of Modern Art).
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The hospital has been collecting artworks since 1984, and the collection includes over 1000 works (primarily paintings and statues), It now has a 3-year art program with a budget of 1 million € , divided as:

Integrated art – 500,000 €

New purchases – 300,000 €

Conservation of existing collection – 40,000 €

Active and performing arts (pilot) – 60,000 €

Program coordination (3 years) – 100,000 €

Future purchases will focus on active and performing arts, and most works will be displayed in areas where there are more people (lobbies, wards, waiting rooms, etc.), but the intention is to distribute the artworks based on these 4 categories, with decreasing need for art:

1. Comprehensive experience of space (where many people sped time)

2. Patient experience (consulting rooms, recovery rooms, etc.)

3. Functionality coming first (staff break rooms, intensive care rooms)

4.  Cost-efficient areas that don’t need art (staff rooms, storages, etc.)

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Art from London Children’s Hospital, UK
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Art from London Children’s Hospital, UK
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Source: What can the arts bring to medical training? (2006)
An article that essentially argues that viewing and making contemporary art can be a useful tool during medical training, as a way for medical personnel to develop more empathy and to see their work in a broader sense. Essentially contains no data and consists mainly of musings, but they are interesting nonetheless.

It delves into the historical connection between art and science and how they can benefit each other, and the writer claims that in their personal experience medical students have been very open to reflect on their profession from a more artistic perspective.

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Source: Aesthetic deprivation
A great short article on the importance of aesthetically pleasing surroundings in everyday life and more unique contemporary art experiences.

The writer argues that philosophically aesthetics have been considered as markers of human identity, pathways for exploration of the human condition, and key elements of personal self-expression and well-being.

Art is so important and ubiquitous that it's not an extra or a bonus, but that lack of access to (one's favorite) music and art can be considered aesthetic deprivation and will negatively effect one's well-being.

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This hospital in Rotterdam, the Netherlands was completely renovated and re-opened in 2018.

It was designed with the idea of a 'healing environment' in mind, based heavily on the ideas and research of evidence-based healthcare advocate Roger Ulrich.

Repetitive, grey and dull environments were avoided, and natural and calming environments were created wherever possible.

This resulted in, for example:
- A rooftop garden,
- Tropical plants throughout the hospital
- Wooden furniture
- Maximization of natural light
- Lots of custom, varying architecture for different areas throughout the hospital
- (Sky Factory?) ceilings in operation rooms with moving images of Cherry Blossom twigs and blue skies with clouds
- Private rooms for all patients with sleeping couches, to increase privacy and comfort, which results in faster healing and lower healthcare costs.
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The Nemours/Alfred I. duPont Hospital for Children in Wilmington, Del. now has an interactive “Discovery Zone” which uses 45 46-inch displays and Kinect2 technology. Up to 30 individuals can interact with it at once. Magical creatures and blooming plants appear on the digital canvas and are interactable via gesture technology.
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Sky factory is a US company that makes “ceilings” above healthcare environments, namely MRI and radiology suites, helping patients relax during the procedure.
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KwickScreen – a retractable, portable separator for clinical environments, developed in partnership with the (UK) National Health Service and Department of Health.
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Art placement should consider the people using or moving throughout the space. It should be placed in points of interest. For example, ceilings in CT and imaging environments where patients were often lying on their back.
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Children prefer representational nature art (specifically those with bright colors, water features and non-threatening wildlife) to abstract art. In addition, children between the ages of 7 to 17 prefer nature art over cartoon-like or fantasy images, while children between 5 and 7 prefer the latter.
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Nature art (and nature in general)is known to promote restoration if it contains the following features: calm or slowly moving water, verdant foliage, flowers, foreground spatial openness, park-like or Savannah-like properties (scattered trees, grassy undershot), and birds or other nonthreatening wildlife.
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Breast cancer patients reported reduced anxiety, fatigue, and distress chemotherapy when exposed to VR intervention displaying underwater scenes.
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Murals (as distraction) resulted in a significant decrease in reported pain intensity, pain quality, and anxiety by burn patients.
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Patients in a procedure room reported better pain control when exposed to a nature scene with nature sound in the ceiling.
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People prefer art that is calming, with naturalistic and domestic imagery over abstract or challenging art.
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Artworks present in hospital wards are perceived positively and as diminishing stress levels, improving mood and distracting from worries.
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Patients were also found to prefer natural lighting and a view from a window (related to the preference for nature).
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The notion that patients are often too ill to be aware of quality of the environment, is not supported by data.
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Art in hospitals has led to therapeutic benefits, enhanced experiences of care, reduced vandalism and aggression, greater privacy and dignity for patients, a promoted sense of identity and enhanced staff morale and motivation.
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Art installations can make patients view the medical environment more positively over time.
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Stress in patients undergoing stressful procedures (blood donation) was reduces when their environment contains nature images and sounds, as opposed to urban environments.
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Music and visual art reduce the length of hospital stay.
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Music is the most researched medium of art in the context of healing, primarily due to it being soothing and technologically accessible. It is known to decrease anxiety and reduce pain, calm neural activity in the brain and restores effective functioning in the immune system. Music affects the amygdala, which is an important part of processing emotions.
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Live music is more effective in reducing anxiety during chemotherapy than visual art, but visual art was more effecting in diminishing depression. Both are effective for women in and after pregnancy.
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Arts strengthens confidence and increases awareness in dealing with illness for nursing students.
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Visual arts help develop observational skills in medical staff, as well as 3D thinking in neurosurgeons.
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Using music in operating theatres creates a less stressful environment, but may also cause problems to the surgical team.
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Visual art and music (live or taped) reduce anxiety and depression during chemotherapy.
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Music in neonatal intensive cares improves clinical and behavioural states.
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Self-selected music (especially) and visual arts reduce stress and anxiety during post-surgery recovery, reduce requirements for sedative and help control vital signs.
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Some of the previously presented research involves both music and visual art. This is because art, and especially music, is beneficial for patients while and after undergoing medical procedures. Art and music are beneficial for the staff of medical facilities, as well as students of this field. Different mediums have different effects on health.
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Of course, for effective use of art in healthcare centers, the artists should also have relevant parameters to be aware of. Those may include:

An understanding of child-friendly art as opposed to child-like art

An inclusive style which is non-gender specific and which anyone from infants to teenagers could relate to.

A graphic language that was timeless to avoid staff or long-term patients tiring of it.

A style that had a relationship with the immediate of environment.

Art that showcased personality and featured characters that were recognisable and describable.

Colour has to align with the interiors master palette and texture had to work at a number of scales.

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As a result of this, when considering an art program, a healthcare center should keep in mind the following things about the patients:

What emotional state are they in when they are in the clinic?

What emotional state would the healthcare providers like their them to achieve?

What types of interventions are they already doing to create a healthy environment for patients

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Once art is placed in the healthcare space, important aspects of the art for the center to consider are:

Appropriate placement of the art within the center's space

Proper maintenance of the art once it is placed in the center.

Proper framing and glazing of the art.

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When an art program is a prospect, these are the steps for a healthcare center to follow when establishing it:

1. Setting up an arts committee.

2. Setting objectives and aims.

3. Considering the ethical implication of the project.

4. Consider health and safety issues.

5. Evaluating existing results.

6. Making a practical plan, taking into consideration factors such as time, space, communication, etc.

7. Making a budget, get a fund for the project and look for potential existing resources to use.

8. Finding and choosing artists.

9. Documenting the process of the project.

10. Avoiding potential problems via effective administration and communication.

11. Launching the project.

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Based on research, the content of the artworks in healthcare spaces are recommended to be:

Waterscapes

Landscapes

Flowers

Figurative art

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Lastly, as part of art programs being evidence-based, the healthcare center would want to know if the program is successful.The important outcomes relevant to arts and health research are the following health outcomes:

clinical indicators

patient / staff / family outcomes

economic outcomes

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Out of 2000 hospitals with art programs, 73% had permanent displays of visual art in the hospital and 32% had rotated exhibits (typically art by local or regional artists). 25% allow patients an opportunity to choose their own art.
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According to a guide published in 2008, nearly 50% of hospitals in the US have art programs, mainly for the purposes of creating a more uplifting environment, a welcoming atmosphere and build community relations.
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The existing research done on art in healthcare settings have led to the making of guides for art in healthcare. Organizations such as the Irish Arts Council, the Center for Health Design (California, USA) and Randall’s Children Hospital (Oregon, USA) have come up with such guides, though unofficial guides can be found in lay articles online as well. The common feature among them is a focus on evidence-base parameters and suggestions for art programs in medicine. In addition, more art programs can lead to more evidence, more research, and consequently - better guidelines.

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This video contains a well-informed and fun summary on why art and well-being are a useful combination.

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Why Beautiful Things Make us Happy – Beauty Explained