Beyond Cues and Cravings: Exploring the Design of Assistive Systems for Craving Perception in Drug Psychotherapy with VR and Biofeedback

Psychotherapy is crucial for managing cue-induced cravings. However, most research has focused on explicit drug cues that elicit intense cravings, and recreating such high-risk scenarios in practice can inadvertently heighten cravings afterward, making these approaches impractical or ethically problematic in real-world settings. To address this, we developed a cue-exposure technology probe system, VirtualCravingProbe, which integrates VR simulations with real-time biofeedback to enhance self-awareness in clinical drug psychotherapy. We conducted an exploratory study with twelve patients recovering from methamphetamine addiction using the VirtualCravingProbe system, generating design guidelines for future iterations of an integrated VR and biofeedback-assisted therapy tool. Results revealed qualitative evidence that real-time heart-rate monitoring in VR heightened patients’ awareness of triggers and their craving responses. These findings align with the CBT cognitive-triangle framework, which emphasizes the interplay of thoughts, emotions, and behaviors. Moreover, the system demonstrated potential to enrich patient–therapist dialogue and support the adoption of effective coping strategies.