Tips for Effective Implementation of Virtual Reality Exposure Therapy in Phobias-A Systematic Review.

Marek Krzystanek,Mariusz Borkowski,Natalia Krzystanek,Małgorzata Stokrocka,Jacek Przybyło,Stanisław Surma,Monika Romańczyk

doi:10.3389/fpsyt.2021.737351

Abstract

Background: The high incidence of phobias and the limited accessibility of psychotherapy are the reasons for the search for alternative treatments that increase the availability of effective treatment. The use of virtual reality (VR) technology is an option with the potential to overcome the barriers in obtaining an effective treatment. VR exposure therapy (VRET) is based on a very similar rationale for in vivo exposure therapy. The study aimed to answer the question of how to perform exposure therapy in a virtual reality environment so that it is effective.Methods: A systematic review of the literature, using PRISMA guidelines, was performed. After analysis of 362 records, 11 research papers on agoraphobia, 28 papers on social phobia and 10 about specific phobias were selected for this review.Results: VRET in agoraphobia and social phobia is effective when performed from 8 to 12 sessions, on average once a week for at least 15 min. In turn, the treatment of specific phobias is effective even in the form of one longer session, lasting 45–180 min. Head mounted displays are an effective technology for VRET. Increasing the frequency of sessions and adding drug therapy may shorten the overall treatment duration. The effectiveness of VRET in phobias is greater without concomitant psychiatric comorbidity and on the condition of inducing and maintaining in the patient an experience of immersion in the VR environment. Long-term studies show a sustained effect of VRET in the treatment of phobias.Conclusion: A large number of studies on in VR exposure therapy in phobias allows for the formulation of some recommendations on how to perform VRET, enabling the effective treatment. The review also indicates the directions of further VRET research in the treatment of phobias.

Highlights

Phobic anxiety disorders are characterized by the occurrence of fear and anxiety in certain situations with little or no real threat, and a behavioral strategy to avoid those situations
Taking for granted the previously demonstrated effectiveness of VR exposure therapy (VRET) in the treatment of phobias, the current review focuses on parameters regarding the duration of therapy, session duration, session frequency, combining VRET with other types of therapy as well as technology used in exposure therapy
A large number of studies on in virtual reality (VR) exposure therapy in phobias allows for the formulation of some recommendations on how to perform VRET, enabling the effective treatment

Summary

Introduction

Phobic anxiety disorders are characterized by the occurrence of fear and anxiety in certain situations with little or no real threat, and a behavioral strategy to avoid those situations. Agoraphobia is an irrational fear of being out in the open space, in crowds, far from home, and of traveling alone. It is often accompanied or preceded by panic attacks. In turn, is an irrational fear of social situations and of avoiding them and specific phobias are fear and avoidance of specific objects or situations. All these phobias are common in the population. The use of virtual reality (VR) technology is an option with the potential to overcome the barriers in obtaining an effective treatment. The study aimed to answer the question of how to perform exposure therapy in a virtual reality environment so that it is effective

Methods

Results

Discussion

Conclusion