Using virtual reality in exposure therapy

The psychology field continuously aims to enhance the effectiveness of and accessibility to exposure therapy for clients with anxiety disorders. Clinicians and researchers have achieved this through the use of technology, including telehealth-delivered cognitive behavioural therapy (CBT), online self-help tools, and smart-phone interventions. These intervention formats are typically found to be equally effective as face-to-face therapy, which gives us hope that we can increase accessibility to effective treatments no matter a client’s geographical location.

Another technological advancement that has received recent attention is virtual reality exposure therapy (VRET). VRET involves the use of a headset that produces a fully immersive 3D environment that transports people to their feared situation to create new learning.  

VRET has been used in several research studies, demonstrating promising results for the treatment of social anxiety, specific phobia, OCD, PTSD and panic disorder in adults. At CCAO, we are investing in VR technologies to diversify treatment opportunities for our clients. 

VRET can be useful in therapy for anxiety disorders in the following ways:

Improves access to difficult-to-reach stimuli.

Being able to confront feared stimuli is an integral part of any successfully CBT intervention for anxiety. Many clients present with fears of objects or situations that are difficult to access in typical treatment settings e.g., fear of flying, spider phobia, needle phobia, and height phobia. VR technology can provide clients with an immersive experience for these stimuli that can’t easily be accessed for in vivo (real life) treatment.

Provides an important “step” in the exposure hierarchy.

For clients who are initially reluctant to participate in in vivo exposure, VRET provides an opportunity to face fears at a level of anxiety they can tolerate. While in vivo exposure is important, facing the feared object or situation using VR may be the step needed for clients to feel ready to face the ritual in real life. 

 Gives control to the client and the therapist.

 The real world is dynamic and unpredictable, which makes for highly effective exposure therapy at times. However, it is important for clients to feel in control of therapy. VRET is an alternative to in vivo that offers clients more predictability and control, which can be important in the early stages of exposure therapy before clients are ready to tolerate uncertainty and things “going wrong”. VRET can be individualised to the clients fears and the steps can also be more easily repeated than in vivo.

Offers an opportunity to build anxiety tolerance.

Because VRET is fully immersive, the client will experience anxiety just as they would in a real-life situation. This gives clients an opportunity to build their anxiety tolerance skills in order to develop bravery to face situations in the real world.

If you would like to explore VRET as a tool in your own exposure therapy, please get in touch with us today.

Authors: Cassie Lavell, Kirra Kirsch and Mindy Jordan, Psychologists at CCAO.

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