- Phobias are a type of anxiety disorder that can be challenging to treat.
- A new study trialed the use of a virtual reality-based app to treat 126 people with specific phobias.
- Using the app reduced average symptoms from moderate to severe to minimal after 6 weeks.
A phobia is a form of anxiety disorder defined by the American Psychological Association as “a persistent and irrational fear of a specific situation, object or activity.”
Common phobias includeacrophobia (a fear of heights), aviophobia (a fear of flying), and arachnophobia (a fear of spiders).
While phobias are relatively common — according to the National Institute of Mental Health,
Exposure therapy, a form of cognitive behavioral therapy (CBT) that aims to expose the person to their fear in a safe environment, is often the first line of treatment for specific phobias. However, exposure therapy can be difficult to access, may cause discomfort, and is associated with high dropout rates.
In a new study from the University of Otago in New Zealand, researchers trialed an app-based virtual reality (VR) system to treat specific phobias.
Published in the Australian and New Zealand Journal of Psychiatry, the results show that the self-guided VR system reduced the severity of symptoms for five different phobias.
The study, a 6-week randomized controlled trial, involved 126 adults living in New Zealand with one of five phobias:
- fear of flying
- fear of heights
- fear of spiders
- fear of dogs
- fear of needles.
A further group of people was on a waitlist for treatment.
Participants needed to have access to a smartphone and the internet in order to use the VR app, called oVRcome. The app was paired with a VR headset to allow participants to experience 360-degree virtual environments.
This type of therapy can have important benefits compared to real-life exposure therapy, Dr. John Francis Leader, a psychologist developing a mixed reality therapy room at University College Dublin, told Medical News Today.
“Traditionally, therapeutic work with phobias via exposure therapy required recreating the scene physically. Physically going to a location or having access to a given phobic stimuli can prove challenging from a resource perspective and it can be harder to control the variables,” he said.
The app has six different modules — psychoeducation, relaxation, mindfulness, cognitive techniques, exposure through VR, and relapse prevention — which participants worked through over 6 weeks. Participants could also choose the degree of exposure to their phobia using a library of different VR videos.
To assess changes in symptoms, the researchers used the Severity Measure for Specific Phobia-Adult from the American Psychiatric Association (APA). This is a 10-item scale that assesses the severity of specific phobia in adults. Measures include frequency of experiencing moments of sudden terror, feeling anxious, worried or nervous, as well as physical symptoms such as racing heart and tense muscles.
Of the 126 people who started the trial, 109 completed the study at week 6.
The researchers say this suggests the app has high acceptability and could be used to help people who cannot or are reluctant to access in-person exposure therapy. The app is also cost-effective, which means it could be more accessible than other, more expensive forms of treatment.
Study author Dr. Cameron Lacey explains that the “[l]evels of exposure therapy could be tailored to an individual’s needs, which is a particular strength.”
“The more traditional in-person exposure treatment for specific phobias have a notoriously high dropout rate due to discomfort, inconvenience and a lack of motivation in people seeking out fears to expose themselves to,” he notes. “With this VR app treatment, triallists had increased control in exposure to their fears, as well as control over when and where exposure occurs.”
The researchers also found a significant improvement in symptoms in the people who used the app compared to those on the waitlist.
The average severity score decreased from 28/40 (moderate to severe symptoms) to 7/40 (minimal symptoms) by the end of the trial.
“The improvements they reported suggest there’s great potential for the use of VR and mobile phone apps as a means of self-guided treatment for people struggling with often-crippling phobias,” says Dr. Lacey.
Some people left comments about changes to their behavior as a result of using the app, including one person with a fear of needles who said the app had helped them to book their COVID-19 vaccination. Another participant said they had been able to book flights to see their family and were spending less time worrying about flying.
oVRcome is now available for use for 10 specific phobias, as well as for social anxiety.
Dr. Leader told MNT that this approach has a lot of potential, but reminded us that it will be important to ensure that suitable safeguards and processes are in place to support users.
“The unique feature of this study is that the approach focuses on self-guided supports for the treatment of phobias, rather than the use of experiential technology administered by a practitioner. This offers great advantages in terms of reach; however, further research will need to be carried out to understand the limitations of conducting psychological interventions for phobias in the absence of professional supervision.”
– Dr. John Francis Leader
Finally, it is also important to note that oVRcome is a commercial, for-profit initiative, and people who wish to use the app to address their phobias are required to pay a monthly subscription fee.