Virtual Reality (VR) therapy is a huge leap forward in the treatment of anxieties and phobias. To fully appreciate the transformational impact of VR therapy, let’s first discuss the foundational concept behind VR therapy, that is, exposure therapy.
Exposure therapy is a psychological treatment that helps people confront their fears. People who are fearful tend to avoid the feared objects, activities or situations. In the short term, avoidance may help reduce feelings of fear, but can make the fear worse over the long term. Exposing individuals to the things they fear and avoid, in a controlled manner, should help break the pattern of avoidance and fear.
The challenge is in creating a ‘safe’ version of the fear-inducing or stressful environment. In the most common type of exposure therapy, in vivo exposure, individuals directly face a feared object, situation or activity in real life. Obviously, it is very difficult for a therapist to control a real life situation that involves anyone other than their patient. Another type of exposure therapy, imaginal exposure, asks the individual to vividly imagine the feared object, situation or activity. Similarly, it is difficult for the therapist to control the parameters of that environment as it is constructed within the individual’s imagination.
Clearly some other technique is needed where the therapist has control the fear-inducing or stress-inducing environment, as well as it’s intensity, duration, and other characteristics.
Virtual Reality Exposure Therapy
VR therapy is an innovation that expands the clinical efficacy of exposure therapy. By using digitally created virtual environments, the therapist can provide an immersive environment where the patient is truly safe; safe from physical danger, safe from exposure to ridicule, and safe from the impact of unforeseen variables in the fear-inducing environment.
Virtual scenarios can be defined for each type of anxiety or phobia that can be treated through VR exposure therapy. The scenarios can be programmed so that the therapist can control each stress factor and variable. Importantly, the therapist can completely control the intensity and duration of the fear-inducing experience, which provides opportunities to guide the patient through relaxation exercises and other therapeutic methods, while inside the stress-inducing environment.
VR therapy is an innovation in exposure therapy that brings many benefits to the therapeutic experience and has many advantages over in vivo exposure and imaginal exposure:
Safest Possible Exposure Environment
A real life environment can be unpredictable, difficult to locate and manage, and is subject to unforeseen and random occurrences that may put the patient at risk of physical or emotional harm. With VR therapy, the virtual environment is always available, always consistent, and is completely within the control of the therapist. There is nothing left to chance, and no risk of physical harm.
Maximum Control of Stress or Fear Factors
With VR therapy, the therapist has complete control over the intensity as well as the duration of the immersive experience. Different individuals with various disorders may benefit from different approaches to exposure therapy, and using VR therapy the therapist can utilize each technique as warranted:
Graded exposure: begin with mildly difficult exposures, then progress to harder ones.
Flooding: begin exposure with the most difficult tasks.
Systematic desensitization: combine exposure with mindfulness skills and relaxation exercises to make fear stimuli more manageable.
More Efficient Treatment
Standard real life exposure therapy can be inefficient from a therapeutic perspective as it requires extensive coordination of schedules, availability of a suitable exposure environment, travel, and extended sessions; which results in extending the duration of the treatment process. Virtual reality exposure therapy can accomplish the same exposure within the standard therapy session, within the confines of the therapist’s office, and without any impact from uncontrollable environmental factors. Multiple sessions can even be scheduled in the same week.
No Risk to Patient
Since VR therapy is conducted in the therapist’s office, there is no risk of physical harm resulting from random factors in a real life environment; for example, VR therapy for fear of driving will never expose a patient to the physical harm that could result from a real life exposure to driving. Similarly, there is no risk to patient confidentiality, as there is no possibility of “bumping into” friends or co-workers as there would be during a real life exposure.
Unlimited Repetitions of Feared Situations
VR therapy allows the therapist ultimate control over stimuli for the perfect exposure. Standard exposure therapy is bound by real world limitations, for example, only one take-off and landing per flight. VR exposure allows the therapist to repeatedly land the virtual airplane.
Immediate Psychological Intervention
Because the therapist is in complete control of the VR exposure therapy environment, there is opportunity for immediate psychological intervention, which may consist of prompting, coaching or teaching relaxation techniques, cognitive restructuring, mindfulness skills or training in social skills, as appropriate for the patient and the disorder.