Virtual Reality Therapy for Anxiety Disorders
Virtual reality therapy is an innovative solution to anxiety treatment that can eliminate many of the common obstacles to traditional exposure therapy. Most notably, patients cannot control their experience during exposure which could result in increased dropout rates (13). Therapists’ concerns about administering exposure are another potential hindrance; VR resolves these concerns and makes exposure much more tolerable for patients.
VRET can provide patients with better patient outcomes compared to traditional therapy approaches for many anxiety disorders, such as social anxiety, agoraphobia and panic disorder. Studies have demonstrated that VRET helped alleviate phobia symptoms such as fear of heights or public speaking; it also decreased nausea and improved coping skills (29, 32, 41).
The therapist can choose what the patient sees in a VR environment, which addresses several limitations of imaginal exposure: not every patient visualizes well; patient imagery may be too scary or triggering for the therapist; and lack of insight into what is being imagined. Furthermore, they have control over intensity and duration of exposure – providing gradual yet repeatable exposures to anxious stimuli (34, 40).
A study published in March by Lancet Psychiatry detailed how Edwin, a middle-aged man with paranoia, used virtual reality (VR) to practice navigating a busy coffee shop. Through special goggles and computer technology plus biofeedback monitoring devices, Edwin was guided through various scenarios he found uncomfortable in real life such as visiting his local store or taking the bus.
In addition, therapists can guide and direct a patient’s attention towards specific elements of the virtual environment, helping them forget about their fear of either the scene or other people in it. Studies reported that patients who completed VR exposure therapy for acrophobia and public speaking experienced lower heart rates, decreased skin conductivity, and higher alpha waves than those who didn’t participate in the intervention.
There remains an unmet need for VR-based treatments of anxiety disorders. To meet this demand, research must focus on clinical applications of virtual reality in therapy and training for therapists must be expanded to enable these applications.
Barbara Rothbaum, a psychologist at Emory University in Atlanta, conducted one of the earliest studies to explore using VR for treating anxiety disorders. In the early 1990s she collaborated with computer scientists to create an environment that would give her patients the chance to confront their fears head-on – taking them into bridges, balconies and elevators while adding turbulence into the virtual environment to replicate real-life fears of flying.
According to Dr. Li, the results were almost too good to be true. Patients responded so positively to their exposure that the team decided to test the concept with a group of schizophrenia patients. Participants rated how frightening they found VR therapy on a scale from 0 to 10, and their scores significantly decreased at the end of treatment.
Rothbaum’s research proved so successful that she adapted it for other patients, such as those suffering from post-traumatic stress disorder and social anxiety. Utilizing similar principles, Dumais’ team has tested an avatar-based system to reduce fear of spiders using animated arachnids – starting with a cartoonish slipper-wearing version and eventually evolving into an incredibly realistic tarantula. Results showed that using this program (which lasted about three hours and could be used alone or alongside a therapist) led to both decreases in distress and decreased hallucinations.