Bianca D. McCall, M.A. LMFT (00:01.664)
Welcome to the NOCE Dose, brought to you by the Nevada Opioid Center of Excellence at NVOpioidcoe.org. I'm your host with the NOCE, Bianca D. McCall. Go ahead and hit that subscribe, that like, and that comment button right now to disrupt the algorithms and bring more attention and insights to these important conversations. Now the NOCE Dose launched with a mission to celebrate.

the Nevada strong and communities in this great silver state saying no to silence and fighting the good fight to prevent the tragedies experienced by our loved ones, our families, our friends, and communities impacted by the opioid epidemic. And today we are tackling the digital frontiers. In our recent listening session, we brought together four absolute titans to map out the intersection of high.

Tech innovation and the deeply personal landscape of recovery. And we talked about automated empathy, GPS geofencing, virtual reality tech, which we'll talk about today, and interventions and the ethical nuances of training algorithms on lived experience data. But we only scratched the surface of you all. Today we are going behind the scenes through the screens for an exclusive one-on-one recording session with each of our panelists to ask the tough, the unfiltered.

Follow-up questions that came out of that last that last session. so grab your coffee, Nevada, grab your tea and your matcha, and let's get into the deeper dive. Our special guest for today is Mark Lambert, co-founder of Lighthouse XR. So, Mark, thank you so much for for joining me today. How are you holding up since the last listening session and what's been going on in your world?

Mark Lambert (01:47.362)
Thanks. well it's great to be here. And you know, our our world has been been busy. you know, we're right in the middle of expanding our what we do, you know, our our retreat platform. we're doubling the amount of content. So we've been filming nonstop for about the last six months. And so now we're in sort of a post production stage to add in sixteen more lessons or sessions as we call them.

you know, mostly based on on responses that we get from clinicians. you know, so we we've got new things going in about grief, about more about community, you know, about d different things, finding your passion. we're we're doubling down on that particular topic. you know, so so it's it's more production right now and also conferences. We've been doing

I think we've done five conferences in the last two months. and and I I and I I go to another one I I s go to another one next week to to speak and demo that. so it's it's keeping us busy.

Bianca D. McCall, M.A. LMFT (02:58.223)
Gosh, the conference lifestyle, life on the road. and it's so exciting. I cannot wait to take a deeper dive into Lighthouse and into your processes, you know, when you talk about filming and and and what it takes to to build you know, the headset that that we're gonna see, you know, kind of representing today's session. But you know, Mark, in addition to the magic that is that is made with Lighthouse, you have such a a powerful story.

And quite possibly one of the most interesting man on earth awards should should go to you, right? And and and I want to give you some time and some space to to share parts of your story that we didn't get to during the listening session. Now you've experienced you know, Hollywood and and and then you've got relational lived experience with addiction. So so I'm wondering how is it that you went from hogworks and ended up in the recovery space with Lighthouse?

Mark Lambert (03:57.014)
Yeah, the you know, I I I've as I say, I've I've always been sort of at the at the bleeding edge of of technology and creative development. and you know, back in the early nineties developed software that everybody in Hollywood used and and then I've ended up going out to Hollywood and and getting the opportunity to to head up visual design teams you know, that were that were building all of these incredible movies. you know, the the Polar Express, the Harry Potters, the

Narnia, you know, figuring out what those worlds looked like. and in the early two thousands I left you know, the Hollywood vibe and and and started doing my own some other projects. and and VR was was one of the things that I came along and started doing in, I don't know, twenty fourteen. and we we went all over the world you know.

Creating this VR for for Toyota for PBS documentaries. you know, I got to go and climb mountains in Uganda and film mountain gorillas and you know, do endangered species projects. And you know, that was that's been amazing and still occasionally it will do a VR production, you know, a a standard documentary or something. But along that same time I you know, my son was going through

opioid addiction. you know, he had the the classic you know sort of beginning of of an operation and he was giving given opioids. you know, he had brain surgery in fact. and and that gave him epilepsy and that gave him partial blindness. you know, very very hard things for him to deal with at eighteen. but at the same time, you know, the oxycontin and you know, led him into into

you know, an eight year journey and and multiple recovery sessions. And I think that that's when, you know, that's when I was really seeing we learned a lot during that time. You know, we we had our own education as a family. and I would see what the the twenty eight day recoveries, you know, that that sort of early crisis recovery was and then and then the the next steps in there.

Mark Lambert (06:22.663)
luckily he's he's now in long-term recovery, but when we started this, he was not. And and we wanted to really create something that was that would support you know, the people that are that are doing amazing work. but you know, they're what can we do? What what with all this background with you know creating these amazing worlds, what can storytelling, what can gamification, what can virtual reality do, and will that help?

And so we started that in twenty eighteen and and you know, our studies are telling us that it does help. you know, and and it's it you know, the the things that we hear back from people are are pretty amazing.

Bianca D. McCall, M.A. LMFT (07:06.199)
Yeah. Gosh. thank you so much for for being vulnerable and and sharing that story. I mean, just it's not uncommon, you know, for folks when we when we think about opioid use disorder and and the experience thereof, you know, th it's not just about adults or it's not just about people that are that are making poor decisions in life, but rather kind of, you know, in

they're engaged in in a healthcare system where protocols large largely are are are designed to to introduce these medications, right? you know, you talk about post stop and and things like that and and and families, there's no you know, for the person, for the individual, for the families, for the community, there's no warning you know, that that this may happen to you, that you may be a a part of of of this other statistic, right? that

that doesn't talk about recovery from from the surgery itself, but recovery from you know, the the system, right? The protocols that are part of of you know our our system. So gosh, thank you so much for for sharing that and and I'd love to

Mark Lambert (08:20.235)
Yeah, I I I actually worked on a one of the things that that I I did get the the opportunity to do, you know, I I left Hollywood and I was I was doing this and and they they called me up that they were f gonna film a a T V series in in Virginia and and I said, Well, I don't do that anymore. I'm I'm doing this other stuff and they said, Well it's for this T V series called Dope Sick. and if you've seen that T V series, if if if people in the

Bianca D. McCall, M.A. LMFT (08:42.949)
Yeah.

Mark Lambert (08:46.999)
that are listening now, if if you haven't seen that, I I thought it was a a brilliant you know, T V series. I don't know about, you know, if you can promote a T V series on here, but but I would promote that one because it does sort of give an idea of of what was going on in in in the industries. you know, back then we see it a lot in, you know, starting in Appalachia, and the and the coal miners and and and the workers and stuff as far as that particular

storyline goes. you know, so yes, I I I do believe hopefully that people are becoming more educated now, than than we were then. But I I think that also you know if if if you attend a Naranon meeting or any of the family meetings and and you s you you hear someone that's coming in for the first time with a loved one you know that has you know that is in a

possibly a crisis situation. you know, you see this sort of I don't know if it's during the headlights, but, you know, people are not educated a you know, as as this is introduced. And so that's that's one of the areas that that eventually I I hope to go to is is helping more with that family and community education. right now we're focused on on the the you know the person the that

it is in crisis, but I think that that's an area that that I really hope to to move into is is helping people understand more you know, so that they can support people that are around.

Bianca D. McCall, M.A. LMFT (10:24.217)
Yeah, and I I I love that. I'm a huge fan of of systems, by by trade, you know, the work that I do, but also just inherently you know, being a retired athlete, I I'm I'm a team player, you know, through and through. and and I understand I've seen so much you know, where we we can't we can no longer operate on the belief that

These things happen in a vacuum or that they're isolated incidents of of just one person's experience. that when we talk about sp specifically opioid use disorder and and addiction and things, it impacts systems, right? There's a ripple effect that has an impact on on the family system, on the community system, and and and outward and and and I love the passion and the desire to

address that and to also confront some of our complex and conflicting feelings and thoughts and things like that that that we have, right? These preconceived ideas that we have about you know, the dangers of relationships with with substances. you know, I tell people all the time, you know, again, it's it's not about, you know, making poor decisions. It's not about making you know, or

having the agency to to make a choice, do I want to be dependent on or or you know have having such a dangerous relationship with this substance. but again it's it's kind of wrapped and masked in in our safe spaces and the spaces that we're supposed to go to to heal. so I, you know, I I I love I want to get into the conversation of of how does technology

Empower that specific mission and vision to support systems. Mark, during the the listening session, you made it clear that we can't let technology turn our behavioral health workforce into these tech support agents, right? That it's less about the technology and and the real magic happens with the the genuine reflection work and and and specifically after a VR experience. So I'd love for you to talk to us about the retreat.

Bianca D. McCall, M.A. LMFT (12:40.293)
And and can you take us behind the the scenes of what development looks like and and through to the the clinical session, you know, like what exactly does a a peer or clinician say to to bridge the gap between what a client just experiences, you know, with the retreat, you know, in and inside their headset and then apply that to to real world recovery.

Mark Lambert (13:06.325)
Yeah, yeah. you know, it's it's it's been a a a slow journey to create what what we've created and and we we start around we base it around human centered design. so you know we started with one module and then four and and we're about to be up to to thirty six different mod thirty six different sessions. and and then we're we organize those into a module. So let's i if we want to talk about

cognitive behavioral therapy, CBT, there'll be five sessions on that. So that's the, that's a, that's a quick order organizational thing. So, you know, for for instance, we we talk about your your core values you know is is an area that we're expanding a lot and and how you know you sh you can examine your core values and then understanding your core values can help you better navigate decisions that you make

Does this align with my core values? you know, and the difference between core values and core beliefs. So there's a lot of these these different topics that we you know undertake to to try to educate people and then give them a chance to explore that topic. and we divide them into very small chunks so that you're not you're not looking at this, you know, massive forest of of topics. you know, there's there's modules and there's sessions.

When you go into a session, you know, you get an introduction, you get a you get a brief educational you know about a four minute educational experience. And and and by saying going into the session, what happens is you put on the headset and you're at this cabin on a lake. You're you're in this world and it is more like a video game than a than a movie or anything. You know, you you you sort of wake up and so to speak, you you know, you

you you open your eyes into this cabin and you you may have somebody talking to you we don't have avatars in there. We don't have other game people you know in this. So it's not like a game, some game, battle game or something like that where you'll have other people speaking at to you as an actual character. And that's on purpose for a couple of reasons. so typically you'll wander around in this world

Mark Lambert (15:32.918)
And you'll go to a location and then at that location you'll go to what's called 360 video and you'll you'll you'll see a pre-recorded lesson from somebody. Or if you go to the fire pit, you may hear the a session that we did with somebody with lived experience. you know, that's that's an opportunity to hear from people on whatever that day's topic is with lived experience.

So those are the lessons and the pre-recorded sessions. The rest of the time though that you're in there, you have the opportunity to go to different zones, different areas. So think about like walking out into a backyard, and you know, over there is what's called the grove. And so you walk up this path and you go to the grove, and there'll be exercises up there. if you're learning about values, you're gonna pick your core values that are big rune-covered blocks, these three foot by three foot.

blocks that come up out of the dirt and you're going to go wander through and pick those values. you know, you're going to go up to Meditation Rock, you'll go up to the to the mountain. we're we're about to add, you know, you may play with a a slingshot like in in Angry Birds. But all all those, you know, they sound like games and and some of them are games. You know, there's a hoop shot game. But at the same time, all the games have recover whatever that topic of the day is, they have those

recovery content weaved into them. So we're giving you that chance to interact with the content in sort of a different way. So that becomes diversionary. As you go through, you're building success and and you if you're picking mantras, those mantras will show up in your cabin, which is the center of all this world. And so you start gaining trophies and achievements inside the cabin.

So by the time you're done with with thirty-six you know sessions, you've sort of mapped out, hey, I I went through this module, I went through that module, and I learned this, or you know, I picked when when I'm angry, I'm gonna do these four things, and this is the mantra thought or the challenge thought that I'm gonna use. you know, it's it's it's a different way of doing notes, almost. You know, I mean, i if you were to go and and

Mark Lambert (17:54.164)
and sit in a regular classroom, you might maybe taking notes, but those notes get, you know, the they show up in a in a book and you may forget the book or, you know, you're not going to go back to it. But if you go into that cabin and you look around, the idea is that you are seeing sort of those notes up on the walls and around you as symbols and and we think that you remember that better.

because it becomes something that has a visual spatial reference. And that's that's, you know, it sounds very you know either science based or or you know it it's it's a hard thing to understand or to prove yet and and we're looking at how do we do that. But we really think that it's it's allowing people to sort of

Become engaged and and remember these topics and the what they've been through better in the long run.

Bianca D. McCall, M.A. LMFT (18:57.529)
Yeah. And I'm so this is just it's it's mind blowing. So when you say that it's it's more of it's more like a video game rather than a movie, I'm I'm envisioning kind of like these digitally constructed backgrounds and things like that that more so look like gamification as opposed to real landscape or or am I am I off on that? Okay.

Mark Lambert (19:22.401)
Yep. No, yeah, right. It it's it's and we haven't leaned too far into into making this hyper realistic. We we may, you know, go down that road eventually. but no, it it it looks more like a I mean it is a video game. And also with the the headsets where they are now, we can only sort of put so much you know graphics power at it. These are these are it's not like an Xbox or some of the the games that are getting super realistic.

so it is a little more stylized you know in in the look, but actually people seem to enjoy that. It's at the same time, even with it being simplified, it you know, it's getting back out to nature. And and there's been you know quite a few studies that say, you know, getting into nature you know is is a powerful way to to sort of calm yourself down. And

Most people when they drop into it, they s they go, Yeah, that was that was really nice. I I just liked sort of being, you know, being there and and at the lake and we we've got occasionally a bird will fly over and you know, little nuances like that that that we add in, so that it becomes just sort of a calming place to go.

Bianca D. McCall, M.A. LMFT (20:41.207)
Mm-hmm. Mm-hmm. Gosh, I don't and so you're saying that people like this, right? But but I've I've read that your clinical trials actually show a massive forty-three percent increase in treatment completion for veterans using the virtual reality, right? And so so skeptics, I mean, they they love to claim that this is just like a novelty effect, right? That that patients, clients, consumers are just excited to play around with the headset. but but Mark, can you talk to us about like what

scientific and neurobiological indicators or behavioral markers prove that the retreat is actually restructuring those core values and and reactivities, right? Rather than just offering kind of this temporary digital escape.

Mark Lambert (21:27.253)
Yeah, that's you know, and and and we could design something that is just diversionary and and and there would be value to that. but but we're we're trying to lean into a combination of increasing engagement, you know, and you know, value through through the the the training that we're giving, you know, and and and the the self introspection.

and the diversionary aspects. There's nothing wrong with somebody coming in and and saying, Hey, I just need to meditate. you know, I mean, if if that's what that headset can do for for for someone, that's a value, that's a high value. but yeah, what what we have found is that it it does indeed you know a lot of people come into recovery, I think, and many of them, you know,

it's not their first time you know, in recovery and particularly those with social anxiety, you know, they have a they have a hard time in in in a group setting. And so that's where we're we're finding a high value in in what what we do. And I think that that's what one of the things that's driving engagement is that people aren't leaving or tuning out because they're like, hey, I I really like

doing this VR. and when I'm doing the VR, I'm gonna hang out and and and complete, you know, the program. part but you know, but I mean I I always I always get a little bit, you know, the the the 28 day program or the 30 day program, you know, that's that's great. But I I know that, you know, the the real journey is is is the long middle. you know, is that is that time afterwards. And so

What we hope to do is is set somebody up for for that the long middle, which is you know, that six months or eight months, you know, and maybe recovery housing or, you know, other things. And then that, you know, by eighteen months you're you're at at this stage. you know, so we're we're moving towards a program you know, I think our our our next one, the the version that we're doing now is is as much for that early recovery.

Mark Lambert (23:50.528)
And keeping people engaged for that that 30 day program where you can say, the you know, we completed, to helping people in in that post you know, initial crisis mode to have a support you know for them. So you know, we we're we're continuing, we're doing an RCT right now, randomly controlled trial, for that, you know, the the the scientific things are just take forever to to stand up.

you know, but I just I just heard I and I wish I had the exact quote. It was a new one for me. I I still like the the qualitative responses that we get back. you know, and and I think that just last Wednesday somebody said, Yeah, yeah, that that he had a the this one clinician had a a client that said, I slept for the first time last night. And and I was like, Wow. you know, we're not we're not trying to

Bianca D. McCall, M.A. LMFT (24:45.251)
Wow.

Mark Lambert (24:49.857)
work with insomnia, but it's like those you know, those comments they that that come back. and and and I I'm gonna loop back to social anxiety, because I think that that, you know, that's the one that we hear you know, qualitatively the most, I think, is is that I never got this until I did it in the headset because I have social anxiety and I, you know, and I couldn't

focus when people were trying to tell me a concept or have me think about something. And this just gave me the space and the time to sort of either engage with the the education or just sit and think with, you know, what what the topics are, and and come up with my own views on it.

Bianca D. McCall, M.A. LMFT (25:37.519)
Yeah, no, and and there's so much buzz going on right now in behavioral health, with people talking about kind of the the nervous system and and reactivity and and cues and activations, triggers is the language in in some spaces, but we're we're talking a lot about just what that nervous system in in high reactivity, what that looks like.

Mark Lambert (25:40.598)
Yes.

Bianca D. McCall, M.A. LMFT (26:02.059)
over a period of time when it's unaddressed and how that turns into that toxic stress that causes some of these these other symptoms, right? For to our physical health, our our psychological health and and and so forth. You also, you know, hit on the the point that you know you're seeing more positive outcomes in cohorts. You noted in the listening session that early data from Stanford from UCSF shows that specific cohort you know

that matters, you know, establishing kind of those groups. And so I'm just trying to think about the retreat and its use cases. it doesn't sound like it's meant to be used in isolation, right? Somebody's not just purchasing a headset or or licensing, renting a a headset and and they're alone in their home and and they're out, you know, kind of isolated in the retreat, alone in the cabin at a lake, but rather it's it's more so integrated into the group therapies.

in in a true retreat type environment. Am I right on that?

Mark Lambert (27:05.931)
Yeah, well th yes and and we do have versions that that that go home you know with with the veteran that that were you know and they can but they're they're in regular, you know, they're they're still in regular weekly sessions, you know, outpatient that you know, that that's our so we've got typically residential, intensive outpatient, outpatient, you know, those models that that have

that have arisen you know in in this world and and so within the residential is where we started and and so that's where you know the the the the person will get the the headset and they just take it back to their room and the and you know they can use it whenever whenever they want. but it's still and then there'll be one or two group sessions with you know in in headset during the week. We're we're spinning up a few

locations outside the VA now where we're hoping to to do this and we're looking for more you know places to to work with where we put the headsets in a location in a community clinic or up in in one location we're in a a a diversionary court system and and in a in a location in that community

where the headsets are there and people come in once or twice a week and use the headset. But the idea is that you're not just going there to to use the headset and then leave. You will do a half an hour in headset and then a half an hour work with whoever you can work with. And and what we're really excited about doing and and we're we're encouraging trying to find locations to work with in this is is working with peers.

you know, working with CPRS. and and I think that that has a a great opportunity because I I think half of our locations right now work with peers. you know, it's a lot of it's being driven by by peers. And I think that that's a wonderful you know, model. We've we've seen great results from. So the idea is that after you come out of if you've come out of the anger session, if you've come out of the the core values session,

Mark Lambert (29:30.515)
you know, you can refer to the notebook and say, hey, here's five discussion topics. That's the tr truest values that at the end we reinforce this with a human connection and build that bond, but by giving them guidance and setting it up that conversation with a topic so that it's not just like, hey, how you doing today? it's like, hey, you you just talked about core values. Have you ever thought even about core values before? And

And what do you think yours are? you know, or hey, when was the last time you were angry and and what did you do? So, you know, that's what that's that's what we have sort of arrived at is the magic formula, I think. and even when people use it at home, there's some there's some cool things that that's that's happening now, but that when they can use it at home.

then they but they we still want them seeing an outpate, you know, maybe it's individual, maybe it's group, but they're coming back to that group with things that they've learned from the headset as conversation starters.

Bianca D. McCall, M.A. LMFT (30:42.883)
Yeah. And and I'm so glad that you said that, you know, just paying particular attention to you know, reinforcing that human connection, right? and and that kind of leads into the discussion of of clinical safety because I I do believe that in our healthcare, in our behavioral healthcare systems, we are on high alert with the advances in technology and and digital tools. we are very open to

you know, technology writing our notes and doing kind of the work that that none of us like doing. I don't I don't know if anybody's saying it. I'm gonna say it for all of us. nobody likes doing documentation, right? And so it's fine for technology to come and do that. but when it comes to really you know providing kind of the psychoeducation and and responding, especially to to certain trauma profiles, right? And psychiatric presentations, you know, clinicians are are very protective.

over our over our populations, over our communities, you know, right now when it comes to to technology. And so I'm wondering kind of going back to that cohort matters, what specific trauma profiles or presentations do does this immersive therapy perhaps pose a risk of re-traumatization for? And and what what should clinicians, protective clinicians like myself, what should we be screening for?

before our clients, patients, consumers put on that headset.

Mark Lambert (32:13.793)
Right. The the we've designed it like in particular when when you talk about the you know and and calling them the triggers or or whatever the you know, however you're gonna to to term those those moments, we're very conscious about not trying to drive cravings.

you know, so we're not doing exposure therapy. We're not doing, you know, and and when we talk about cravings and and and triggers and and things like that, we we're we're very careful about that. We do have sessions where we where we talk about it, but we talk about it in a very sort of separated way. and and it's not like we're gonna encourage urge surfing or or something like that. but you know, i as as far as as as profiles to be concerned about.

you know, I mean, our our initial things are basically there's always a screening beforehand. you know, there's always a screening because it it's it's that, you know, is there a problem with the digital aspects of it? You know, I mean you know, y just starting as simple as that. Some some people, you know, and it's it's remarkable that, you know, because I mean our our median age is fifty two.

and and most of the our patients right now in in in in the VA are are not necessarily digitally literate, but we you know, we we d we were very careful about making sure that we are not only targeting this towards you know, a a young person that has come up through the gaming world. so we've done pretty well on that, but there are still some people that, you know, it it's it's not going to

to work but we we we really haven't found profiles there was there was one profile th there's one profile where we're doing adjustments on and actually I I I can't talk about you know exactly why that's been requested but you know we are making some changes because some people are

Mark Lambert (34:38.207)
a little uncomfortable. There's a scene where you're sitting next to a person that's been filmed about six feet away from you, but some people may not be comfortable with that close of an of of a a position with with another person. so that's actually being modified right now. you know, but that's that's w one of the the few areas where where we've seen it to be problematic.

Bianca D. McCall, M.A. LMFT (35:07.022)
Mm-hmm.

Mark Lambert (35:07.417)
so yeah, so I I I wish I could say that we, you know, we have clearly defined profiles that you know, that we say, hey, this is not you know, there's there's the medical things. you know, the the the the biggest thing would be people that that are motion sick. you know, it may not be appropriate. We've designed around that, but then we still have, I would say six percent, maybe eight percent of people that

Bianca D. McCall, M.A. LMFT (35:25.765)
Mm-hmm.

Mark Lambert (35:34.432)
It's just it th their ears, the way their ears and their eyes are working together, it's not going to work you know, for them. you know, but but I haven't seen other you know, other than this one that I'm talking about, and and hedging around, I know. you know, but th this one thing where we're we're we're making it now so that there won't be in this one particular situation a person sitting next to you, but you'll get the same same content.

portrayed over the lake. you know, for for that. you know the most of the things in there, there's there's a climbing exercise, you know, and if you if you have agoraphobia, I mean agoraphobia, if you have fear of heights, you know, the the you know you you may not want to do the climbing exercise and we have emergency buttons and you know there's a button on your thing or you can just decide not to do it and we're

You know, we we we don't add any stigma. We we make sure that we're you know, hey, if if you want to do this, if not, go ahead and head back to the retreat and we'll go on to the next thing. you know, when we're but we're we're trying to teach you about anxiety, you know, in that in that session. So you know, I'm trying to think of of other things that, you know, we've people that have that are hyper vigilant.

you know, we've actually adjusted for that so that some of the timing of when we talk about things, we make sure that people have enough time to scan their environment before we discuss topics. you know, so we're trying to address those and then also trying to to listen for any indicators that, you know, where this is a problem, and and and then see how we can adjust and when we can adjust for it.

Bianca D. McCall, M.A. LMFT (37:28.549)
Yeah. Gosh, you know, and during the listening session, no different than today, you just speak so beautifully about, you know, using these these this resource as as play and immersive storytelling, right? so it's not exposure, which a lot of a lot of VR resources are really into the cue exposure therapy side, but but the immersive storytelling and and and I would go so far to to to presume

that this is, you know, this is born from from you being a creative and a storyteller, you know, throughout your entire careers, right? but but but I love I love that approach to to this particular you know VR resource. especially because traditional talk therapy it often struggles to to break through those deep seated you know issues and challenges with with shame and with stigma in in the households that that need it, right? And so

So Mark, how how does entering into a shared virtual space kind of bypass those cognitive defense mechanisms and and give families the language for healing that they couldn't find sitting in a circle or or sitting in in a therapy office?

Mark Lambert (38:48.139)
Well that's so so we're not doing the the the shared virtual space. You know, in other words, like someone doesn't come in there with you. the there's there's Noah is d there's somebody out of Vanderbilt and and I'm blanking on that the the name of the the the product, Everworld or Overworld. But you know, someone is is doing that where a a group can come up

Together in a virtual space. you know, and that's something we had envisioned about eight, ten years ago. And and somebody else is doing it now, and and I'm and I'm glad that they're they're allowing multiple people to come together. you know, I do that regularly actually with with other people. I will jump into a shared virtual space. You know, ours is is is much more designed for that that personal reflection time. you know, and and and even the the the narrative, you know, when when you talk about a

story and we we we had discussions you know ev even just recently but over the years, you know, it's like we have some story being built, but really I think the story that's being built is the person's stor. You know, what we're trying to lean into is it's the person's story. It's it's that, you know, their discovery and then that becomes part of the the cabin as it as it builds of you know, things that they're learning and and and choices that they're making.

you know, that's that's really part of this the story is is going along that path and the things that you discover along that path. you know, but we're still we're you know, our choice has been leaning into that to the personal, not sort of trying to, you know, and I I believe in in exposure therapy and I know that it it that it is successful for people, but it it has its limitations.

you know, and and one of the limitations is that, you know, that clinician just has to be in the room, you know, really should be in the room with you. you know, we're we're offering a different journey, and and it is very much a journey of of a path that you can walk and discover things along the way. And so that's that's sort of our our technique, our our approach is that this has value in a different way than than other techniques where you're working with other people, even you know

Mark Lambert (41:13.485)
I mean the big thing now, AI chat bots and you know, or if you're in individual therapy and you're working back and forth with a therapist, there's value to that, but you know, sometimes the a a person just needs to do their own work too. You know, and this is giving them that space to to sort of do some personal exploration without somebody talking, you know, and responding.

you know, constantly. So it's it's just a different form, it's a different tool in the toolkit. It's one of many that that we're trying to create that complements you know, it can complement the other ones, but it's it's its own sort of unique it has its own unique position, I think.

Bianca D. McCall, M.A. LMFT (41:56.453)
Yeah, and and and I'm really starting to kind of see the bigger picture there and and it's kind of creating collaborating with the individual to to create this safe space, even just with this personal safe space, right? and and I see it working so well with special populations like veterans groups and things, because there's a lot of pro internal processing, right? When you especially when you talk about trauma.

and and moral injury, you know, a lot of that is processed internally, how we internalize the the lived experience. And so first being able to to create safety and within the space within ourselves, I think is is so important. So it it makes me think of you know, more use cases where you see some of those you know, you see a similar pathology, right? With with struggling internally and then and then encouraging

the connectedness, you know, with community, with group, or or or with that processing with the clinician. And I'm wondering for clinicians, would this would this even be great, right? Because you're talking about digital liter literacy and in the VA space, and it makes me consider those veterans working with drones, right? Having higher rates of PTSD, post-traumatic stress disorder than than combat veterans.

Right. And so so I'm thinking, how can a well-designed VR program actually not only reduce provider burnout, but but also address, you know, the vicarious and the secondary trauma in these special populations?

Mark Lambert (43:32.908)
Yeah, they a s you know, w we we cover a lot of different topics. and and and so not every topic is is appropriate for every, you know, situation you know, person coming in. But when we're talking about dealing with anxiety or deal dealing with anger and stress you w we we've got all these these skills lessons. you know, those apply to to to generally

you know, a a lot of different people, a lot of different you know, you you're calling profiles and I think and and, you know, when when we talk about you know the the the values, the moral compass and things that may apply to a different person at a different point in time. you know, we we talk a lot about w we we have a four pillars it we're we're still working on exactly what

how that how that's gonna be termed, but it's it's you know the health community purpose, you know. in that section we're talking about, you know, the the importance of identifying your passion or your passions and your purpose. but purpose is is a different thing. but passions and community you know and and and health you know all of these different topics

i it's it's it's it's really a big world and you can go over here and and learn about this you know this particular topic so if you're coming to it w what we hope is that there's something there for you it if you're coming from a a P A T S D or you know a a a different you know direction, whatever that direction is, there'll be something in there that is supportive to you.

but and and then earlier I I'm gonna branch a little bit because you did say community, you know, you we were talking about community and and again this is gets back to that human connection. When we are doing this in you know, and a large number of people at a location are doing the VR, it I think is building community. We've seen that in a couple of places. because the people that are doing it then share their experiences.

Mark Lambert (45:55.15)
you know, and and particularly you know, with with with with one one group we we hear, you know, people arguing outside about who had the better score in the slingshot game. you know, but that's that's just giving them something, you know, to talk about that they can both relate to. you know, and so that's that's I I think that that building a little community around this this game that's about recovery.

Bianca D. McCall, M.A. LMFT (46:07.225)
Ha ha ha.

Mark Lambert (46:23.555)
you know, a and and about mental health, you know, supports that community building in in the real world, you know, in in real life.

Bianca D. McCall, M.A. LMFT (46:33.539)
Yeah. No, I love that. In real life, Mark, please let us know. Let all all that are listening know. how can we learn more about Lighthouse? How can we get connected and and and perhaps bring the lighthouse or the retreat to our agencies? How can we get a hold of you and keep this conversation going?

Mark Lambert (46:54.497)
Yeah, but I yeah, we're definitely looking, like I said, we're we're we're looking in particular for you know that the the the community clinic. We're we're we're designing something that's that's gonna be really cool now in in the community clinic environment and we're hoping to base it around you know peer support. It could be around a licensed professional as well. you know, but that's just happens to be where we're looking right now. There's you know, because

there's also an opportunity of workforce development, which is, you know, when when we can help support a a peer do workforce development and then and then arrange it around, you know, a virtual reality program as being one of the the key things that that that can be used in there. But you know, to to reach us, Mark at lighthouse XR dot com. you know, we we have I wish I could say I spent as much time on my website as I do on everything else, but

It's it's a little neglected, but there is a lighthouse XR dot com you know, website that that gives you some p pictures, you know, and and and some images. but reach out to me at at at my website and you know we're we're looking right now at like rural health transformation projects. you know, I think that this is a a a tremendous opportunity for the you know

the the rural community clinic, you know, to to but but you know, and and also we're standing up the same thing in a in a very urban you know community clinic type of thing. you know, and then you know the the VA can you know the the the VA centers are are getting to us directly through through that that pipeline. But we are looking for more partners to explore this idea and and we are standing up, you know, it's

it's it's part learn it's it's that first phase of seeing how it works outside of the the VA. So you know it's it is we're looking for those people that that can can that can say, hey, we're gonna work with you, but it's not just ordering a bunch of headsets or anything like that. No, it's it's really coming with we want to be talking to you weekly or or maybe ever once a month, you know, whatever's appropriate in your

Mark Lambert (49:20.317)
you every time everybody's time is busy. But have regular calls and get that feedback so that we can refine how to make this better.

Bianca D. McCall, M.A. LMFT (49:28.293)
Yeah.

Mark Lambert (49:29.399)
So so that's you know, that's the that's the the ask and and the and the where to find me type of thing because we would we would love to bring this to to more locations.

Bianca D. McCall, M.A. LMFT (49:41.325)
I love it. Well, thank you so much, Mark, for sharing your light, no pun intended, with the world and with us. And thank you for your vulnerability and and putting up with me today. my I'm a little bit starstruck every time I get on the line with Mark. such a phenomenal guest. Thank you so much, Mark, for being here.

Mark Lambert (50:02.541)
Yeah, it's a true point.

Bianca D. McCall, M.A. LMFT (50:04.589)
Yeah, likewise, likewise. And and and I can't wait to I can't wait to continue the conversation with you offline. And and really a major takeaway for me is, especially given what lighthouse you know the the road ahead for you all there is is Nevada, we're we're in such a unique position and have such a unique opportunity to to lead this entire conversation nationally, not because we have the flashiest tech, but because we have a workforce that's brave enough to have these conversations.

and and to demand human-centered designs and development. so I love that. The immersive storytelling really resonates with me. And and and I just like to say to our incredible listeners who have stayed with us in this space, who have challenged us, who have supported the Nostos through all three seasons, thank you. You're the reason why we say no to silence. You are the reason why we are Nevada strong. So make sure to visit NVOpioidcoe.org to access

all of the program references, the data resources, the toolkits from today's sessions and beyond, keep supporting each other, keep closing the gap, Nevada, and as always, keep fighting that good fight. I'm your host, Bianca D. McCall. Thank you for listening. Take great care, Nevada, and be well.