Although the patient knows the virtual world is not real, the body and mind responds and reacts as if it was.
VR therapy gives equivalent results as traditional therapy and has even outperformed it in some aspects.
Patients may progress through the treatment hierarchy more rapidly in VR therapy due to the perception of increased control and safety in the treatment sessions.
More than 80% of subjects with specific phobias choose VR over real-life exposure, suggesting that VR therapy could increase the number of treatment seeking phobics.
VR therapy allows absolute control over the treatment session; exposure stimuli, environments, actions and design, even more so than in traditional in vivo therapy.
VR therapy can recreate complex scenarios or present inaccessible objects that could be impossible in real life, allowing the patient to work with specific traumatic memories or fears.
1. Kaussner Y, Kuraszkiewicz AM, Schoch S, Markel P, Hoffmann S, Baur-Streubel R, et al. (2020).
Treating patients with driving phobia by virtual reality exposure therapy – a pilot study. PLoS ONE 15(1): e0226937.
2. Lindner P, Miloff A, Bergman C, Andersson G, Hamilton W and Carlbring P (2020).
Gamified, Automated Virtual Reality Exposure Therapy for Fear of Spiders: A Single-Subject Trial Under Simulated Real-World Conditions. Front. Psychiatry 11:116. doi: 10.3389/fpsyt.2020.00116
3. Hinojo-Lucena, F. J., Aznar-Díaz, I., Cáceres-Reche, M. P., Trujillo-Torres, J. M., & Romero-Rodríguez, J. M. (2020).
Virtual Reality Treatment for Public Speaking Anxiety in Students. Advancements and Results in Personalized Medicine. Journal of personalized medicine, 10(1), 14.
4. Thng, C., Lim-Ashworth, N., Poh, B., & Lim, C. G. (2020).
Recent developments in the intervention of specific phobia among adults: a rapid review. F1000 Research, 9, F1000 Faculty Rev-195.
5. Freeman et al. (2017)
The aim of this article is to review previous research and describe the potential of the use of VR in mental health treatment. It mainly includes research of anxiety, schizophrenia, substance related and eating disorders. The most important finding is that VR exposure treatments can reduce anxiety disorders and that are several additional areas that show promise. It was also found that VR could enhance treatment outcomes as the technology enables creating new realities.
Freeman, D., Reeve, S., Robinson, A., Ehlers, A., Clark, D., Spanlang, B. & Slater, M. (2017). Virtual reality in the assessment, understanding, and treatment of mental health disorders. Psychological Medicine, 47, 2393-2400.
6. Carl et al. (2008)
This article is a meta-analysis, investigating the use of VR exposure therapy in the treatment of anxiety disorders (e.g. specific phobias, social anxiety disorder, post-traumatic stress disorder, panic disorder) in comparison with traditional exposure therapy. It was found that VR exposure therapy outperformed traditional therapy in several aspects, such as in effectiveness, control and cost. VR therapy is also advantageous as it can create complex environments and conditions without leaving the treatment room, such as in the treatment of fear of flying. In addition, it was found that patients could progress faster through the hierarchy of treatments through VR exposure therapy, as it increased the perception of control and safety.
Carl, E., T. Stein, A., Levihn-Coon, A., Pogue, J. R., Rothbaum, B., Emmelkamp, P., Asmundson, G. J. G., Carlbring, P., & Powers, M. (2018). Virtual reality exposure therapy for anxiety and related disorders: A meta-analysis of randomized controlled trials. Journal of Anxiety Disorders.
7. Lindner et al. (2017)
This literature review details the current state of VR technology and discusses important therapeutic considerations in design of VR exposure therapy. It also mentions several important findings from different studies of the use of VR in mental health treatment. For example, the article mentions the advantage of VR as it provides absolute control over the exposure stimuli, setting and design, solving many practical issues often found in traditional therapy.
Lindner, P., Miloff, A., Hamilton, W., Reuterskiöld, L., Andersson, G., Powers, M. & Carlbring, C. (2017). Creating state of the art, next-generation Virtual Reality exposure therapies for anxiety disorders using consumer hardware platforms: design considerations and future directions. Cognitive Behaviour Therapy, 46(5), 404-420.
8. Opris et al. (2012)
This meta-analysis article reviews previous literature on VR in exposure therapy of anxiety disorders and compares VR exposure therapy with traditional exposure therapy. Through the findings, it is concluded that VR exposure therapy does better than traditional exposure therapy in several aspects. In addition, VR can recreate complex scenarios or present inaccessible objects that could be impossible in real life, allowing the patient to work with specific traumatic memories or fears.
Opris, D., Pintea, S., García-Palacios, A., Botella, C., Szamosko, S. & David, D. (2012). Virtual Reality exposure therapy in anxiety disorders: a quantitative meta-analysis. Depression and Anxiety, 29, 85-93.
9. García-Palacious et al. (2001)
This article examines whether the use of VR exposure therapy in the treatment of phobias could increase the number of treatment seeking as oppose to traditional exposure therapy of phobias as less than 15-20% ever seek treatment. The authors conducted two studies; in Study 1 they examined whether the patients would prefer multisession in vivo exposure therapy or multisession VR exposure therapy and in Study 2 if they would prefer one-session in vivo exposure therapy or one-session VR exposure therapy. In Study 1, 81% favoured VR exposure therapy and in Study 2, 89% favoured VR exposure therapy, indicating that the number of treatment seeking persons with phobias would increase with VR exposure therapy.
García-Palacious, A., Hoffman, H. G., See, S. K., Tsai, A. & Botella, C. (2001). Redefining Therapeutic Success with Virtual Reality Exposure Therapy. Cyberpsychology & Behaviour, 4(3), 341-348.
10. Morina et al. (2015)
In this meta-analysis, the authors assess the extent to which VR exposure therapy results in specific phobia treatments can be observed in real-life situations. The findings revealed that patients who had been treated through VR exposure therapy did significantly better on behavioral assessments following the treatment than before treatment. It is concluded that VR exposure therapy can effectively enable change in real-life situations, i.e. that behaviour learnt in VR environments can be transferred into real-life.
Morina, N., Ijntema, H., Meyerbröker, K., Emmelkamp, P. (2015). Can virtual reality exposure therapy gains be generalized to real-life? A meta-analysis of studies applying behavioral assessments. Behaviour Research and Therapy, 74, 18-24.