Phobias are one of the most common and disabling anxiety disorders, and for many people, the only treatment available is medication. But a new study suggests that virtual reality exposure therapy can be used to help those with phobias to overcome their fear of what they are exposed to.
This article will examine how VR therapy works, how it compares to other types of treatments, and what statistics and data we have on its efficacy. We will also explore the limitations of this new technology to make educated decisions about integrating it into our work with clients facing phobias.
What Is Virtual Reality Therapy For Phobias
Virtual reality therapy is a type of exposure therapy that uses virtual reality technology to expose a person with a phobia to the thing that they fear. A therapist will work with the client in developing a scenario that most closely resembles their actual fear and then guide them as they experience it in the virtual reality world.
Acrophobia, or the dread of heights, affects about one-third of people, along with visual height intolerance.
It differs from other types of exposure in that it does not utilize any real stimuli. A person undergoing VR therapy for arachnophobia would be exposed to three-dimensional spiders, but the spider would not be real, and there would be no danger of being stung or bitten by it.
Importance Of Virtual Reality Therapy For Phobias
Traditional exposure therapy involves confronting and working through a phobia using various methods such as decision making exercises and exposure to the phobia. The therapist guides the client through these exercises until they can reduce or eliminate the fear of the situation without experiencing any negative side effects.
According to research, exposure therapy is the most effective method of treating a particular phobia.
Virtual reality exposure therapy has not been used much to treat phobias and has not been thoroughly researched. It has many of the same theoretical advantages of traditional exposure therapy, but it does not have all of them due to current limitations with progress on this technique as a whole.
Benefits Of Virtual Reality Therapy For Phobias
When therapy is conducted outside of the therapy room, confidentiality issues may occur, and it may be challenging to access the dreaded stimuli.
Virtual reality treatment is becoming increasingly popular as a way to help people with post traumatic stress disorder and anxiety disorders. The reason why virtual reality is so effective for these conditions is because it allows the person to confront their fears in a safe environment.
For example, someone with a fear of flying can experience what it feels like to be on a plane without actually having to be on one. This can help them to overcome their fear and eventually be able to fly without any anxiety.
1. Increased Exposure Time
A person with a phobia experiencing VR exposure therapy will be able to spend more time getting used to what they are afraid of than they would in other types of exposure therapy, where the client is typically given feedback after a very brief exposure as part of graduated desensitization.
2. Personalization And Continuity
In many cases, people with phobias need for their treatment plan to be personal, especially when it comes to exposures. They may want to go back and revisit scenarios that they have already done, or perhaps do them again in a different order.
With VR technology, all of that becomes possible, giving the therapist an almost infinite number of possibilities in terms of scene creation and layout.
3. Unlimited Scenarios
As part of the virtual reality experience, a client is not only encountering their feared stimulus, but also entering an entire virtual world that they would not otherwise be able to. In these worlds, the client can encounter other challenges and situations that they could not in real life. The limitless possibilities allow for an almost infinite number of possible scenarios to use in treatment.
4. Less Cognitive Load On The Client
Despite the fact that exposure therapy has a proven track record of success, many patients go untreated or go unrecognised.
It is much easier to focus on one thing at a time when doing virtual reality therapy than it is when doing traditional exposure therapy. Because VR approaches tend to be personalized, clients are not exposed to as many stimuli at once as they are in other types of exposure therapy protocols.
5. Lower Cost
One of the major benefits of virtual reality therapy is that it is much cheaper than other types of therapy for phobias. This is because there is no need for office visits, travel costs, etc.
It all takes place in the therapist’s office using a computer and a virtual reality headset. The only costs are for the equipment, which can be recouped over time with insurance billing and a bit of careful planning.
6. Pre-Configured VR Environments
The most tedious part of creating exposure scenarios in traditional exposure therapy is the set up. Staging requires time and money to create the props necessary to complete an exposure. With VR therapy, pre-configured scenes are already available, allowing the therapist to create a customized scenario with less effort.
7. Clients Are Better Able To Identify Their Phobias
During traditional exposure therapy, clients may develop a fear of something that they did not fully understand before treatment. During this process, they will learn more about their fear and what causes them anxiety in order to work on overcoming it. In virtual reality therapy, they can understand the nature of their phobia better while focusing on facing and overcoming it.
8. Target The Root Cause Of Phobias
In traditional exposure therapy, the therapist can only focus on a specific scenario, like a spider or a snake. This limits what they accomplish during treatment. For VR therapy, the client’s fears can be as vague as “I’m afraid of things getting lost in my house” or as specific as “I dislike snakes because they bite me when I get too close to them.”
The therapist can then focus their efforts on working through the root cause of that phobia instead of just the immediate stimulus that triggers it.
Risks Of Virtual Reality Therapy For Phobias
In a study conducted in 2013 by Hipol and Deacon, they found that only 19–33% of individuals receiving treatment for anxiety disorders had in vivo exposure.
Obsessive compulsive disorder (OCD) is a mental disorder that affects people of all ages. Symptoms of OCD include unwanted and intrusive thoughts (obsessions) and repetitive behaviors (compulsions).
OCD can be treated with cognitive behavioral therapy, which includes exposure sessions and panic disorder treatment. Clinical psychologists can help people with OCD manage their symptoms and live a normal life.
1. Difficulty In Immersion
The main challenge of being immersed in a virtual reality world that closely replicates something one fears is that it is not necessarily real. Because of this, some clients may be afraid to go through the therapy and try to push through the fear that they are experiencing.
2. Lack Of Concrete Data And Evidence On Efficacy Of VR Therapy For Phobias
Since VR exposure therapy has only recently been introduced into clinical practice, there has been little research done on it. We do not know much about the long-term effects of VR therapy, or whether it is as effective as traditional exposure therapy techniques.
3. Inclusion Of Other People In The Scenario
The therapist can decide who else appears in a client’s virtual reality scenario to interact with them and create an atmosphere that feels more real, but they may be creating more anxiety for the client.
For example, one person with agoraphobia creating a scenario that includes a family member taking her out of the house could actually increase her anxiety rather than help it, because she is not used to having other people around when she leaves home.
4. Presence Of Scary But Unavoidable Stimuli
In most virtual reality scenarios, there will be parts of them that are designed to trigger anxiety. For example, the client might see a spider that does not do anything to them or try to interact with them. This is usually done for the purposes of desensitization, but some therapists may go too far with it and end up creating a negative experience for their clients.
5. Virtual Reality Headset Can Cause Anxiety By Itself
Additionally, a meta-analysis suggested that the VRET degradation rate is low (4%), equivalent to face-to-face therapy, and effective.
The headset itself can be a source of anxiety because it is new technology that people have not experienced before, limiting the amount of time they can comfortably spend using it at first before exposure therapy begins.
6. Inability To Reverse Exposure Therapy From VR
In VR exposure therapy, the client has no way to exit or reset their scenario if they are upset or in a panic during it. This is usually not a problem in traditional exposure therapy, where the therapist will work with them through their anxiety until they feel comfortable facing the stimulus again.
7. Difficulty With Adjusting To Reality After VR Exposure Therapy
After virtual reality exposure therapy ends, it can take some time for clients to adjust back into reality after being so immersed in a virtual world even for only 30 minutes at a time.
8. Difficulty With Returning To Reality After VR Exposure Therapy
Some clients may be so comfortable in their virtual reality scenario that they do not want to return to the real world. This could be due to mental health concerns such as depression or anxiety, or simply because they enjoyed spending so much time in a safe environment where they were able to face their fears. For these clients, returning to everyday life can be a little uncomfortable and may take some time before it no longer causes them grief or anxiety.
Virtual reality exposure therapy is not something that has been introduced into clinical practice and is not as widely used as traditional exposure therapy techniques. It can be used to work with specific phobias such as social anxiety, while traditional exposure therapy can be used to work with the whole spectrum of phobias from a collector to a snake.
The lack of efficacy data for these techniques makes moving forward with virtual reality exposure therapy for phobias difficult and should be explored further in research studies on the topic.