“Face-to-face” with your fears
Virtual reality in the psychotherapy of specific phobias
by Marius Rubo, Andrea Wyssen, Felicitas Forrer & Simone Munsch
This project is conducted in collaboration between the Clinical Psychology and Psychotherapy workgroup at Fribourg University (head: Prof. Simone Munsch) and the HumanTech Institute (head: Prof. Elena Mugellini). Its purpose is to make virtual reality treatments for specific phobias easily available to therapists and patients.
Specific Phobias: Frequent and debilitating, but often respond well to treatment
How do you feel right at the top of a tower with the view on the abyss? For many people, the mere imagination of such a situation, let alone the real experience, provokes intensive anxiety. With a point prevalence of around 3% height phobia is one of the most frequent specific phobias. Less severe manifestations of this mental disorder are even much more frequent and affect up to one quarter of individuals in community samples.
Specific phobias tend to generalize, which means that people who suffer from intense anxiety while standing on a high tower may later also experience anxiety when driving over a bridge for example. If such situations are avoided, phobias may therefore strongly affect people’s daily lives (for instance if someone drives a longer route to work every day in order to avoid a bridge).
Fortunately, phobias can be treated effectively within a few therapy sessions, where individuals, after a preparation phase, learn to expose themselves to their phobic anxieties in real situations, but it is well known that treatment in virtual reality (VR) is actually similarly effective. After exposure training, therapists offer support to transfer behavior change from the laboratory to daily life in order to decrease the individual’s safety behaviors and avoidance.
Novel approaches to therapy strive for easier dissemination
In recent years, the traditional face-to-face psychotherapy is more and more often combined with other techniques such as internet-based or technique-supported interventions (so-called “blended treatments”). In treating specific phobias, exposure in VR are especially advantageous. Exposure trainings in VR can be conducted repeatedly, independent of time and location, in varying intensity and difficulties. In addition, they allow the exposure to situations which are difficult to plan (e.g., height exposure on a mountain peak). Moreover, the therapist can fully control the situation. Once therapists are familiar with the application of the VR setting, these interventions are less time consuming. Nevertheless, dissemination of such VR tools in clinical practice is still unsatisfactory. Therefore, the present project aims at developing and distributing an easily applicable VR intervention to treat fear of height.
In the initial phase of the project, we develop software and test its feasibility, acceptance, and efficacy in a sample of patients at the outpatient psychotherapy unit at the University of Fribourg (Psychotherapeutische Praxisstelle). Later, we will provide the novel therapeutic tool to interested members (psychotherapists) of the Swiss Society for Cognitive-Behavioral Therapy. The complete treatment program includes four standardized face-to-face, email- or internet-based sessions with a guideline for preparation, performance and postprocessing of the exposure sessions. It contains the software for the VR exposure intervention addressing height phobia (with different levels of intensity and difficulty) and a tutorial for its application. The outcome of the VR-supported treatment will be evaluated.
We thank the Swiss Society for Cognitive-Behavioral Therapy for the financial support of our project and Marco Mattei for his work on the project.
