VR as an effective tool for exposure therapy & phobia treatment

VR may still be considered a new technology but its practical applications beyond entertainment is evident through innovative, therapeutic VR applications that have been around for years. What is the current climate of VR in phobia treatment, and how does VR treatment work?

During VRDC Fall 2017 in San Francisco today, executive director of Checkpoints Organisation and Doctor Jennifer Hazel answered these questions and more during a discussion that covered what makes a VR experience effective for phobia treatment from a psychological, physiological, and technical point of view.  

Before starting, Hazel looked around the room and gestured to the attendees. "Is anyone in here terrified of clowns, spiders, or dogs?" she asked. Upon being met with silence, she resumed and we were greeted with a slide that featured a looping gif of Pennywise the clown. Nervous laughter fills the room as we all revel in the shared experience of not having clowns ruined for us during childhood.

But people do have very real phobias of clowns. Some may view certain phobias as "irrational" (and it's true, Hazel mentioned encountering someone with a phobia of knees), but the majority of them are justified. The fear of spiders or snakes is an evolutionary response. Hazel went on to describe that phobias are classified as anxiety disorders, capable of being treated in many different ways- VR being one of them. 

Therapeutic VR treatment has a history starting in the '90s. "This has been going on for a long time and has gone through various iterations.” Said Hazel. "The first VR work in terms of therapy was specifically for PTSD. This is because it was expensive and could only be explored through funding, which came through the military."

Even though the technology has been around for awhile and utilized by therapists, Hazel encouraged the developers in the room to take research studies that discuss therapy and VR with a grain of salt. "Not all of us are tech-saavy, so take that in mind when looking at evidence."

What are the advantages of virtual reality exposure therapy? Hazel was prepared with a list of benefits. Say that a patient had a phobia of spiders. Placing them in a situation where they're wearing a headset and controlling a virtual arm to pick up a virtual spider could be just as effective as going through ten sessions of working up to being able to see a spider in real life.

VR can provide a controlled environment, where variables can change depending on the needs of the patient and direction of the therapist. Exposure therapy in VR works because VR also elicits the same psychological response as a patient going through it physically. "The evidence is strong. It works."

More benefits of VRET include flexibility and being able to go through therapy in private environment. Perhaps more importantly though, is that it's flexible. Going back to spiders, a patient can be exposed to different types of spiders. They can be made bigger, smaller, mobile or stationary. VRET can provide multiple different experiences in one application."That's what really cemented it for me." Hazel said. 

Hazel encouraged developers to take her design considerations into account when going off to create therapeutic VR applications. "There are no right or wrong answers. I can’t tell you how to do this stuff. I can give you a checklist of things to think about before you start engaging in a project." There are a lot of factors to consider when designing for VRET. If you're developing a simulation for patients with a fear of flying, what conditions are you going to have? Are you going to have that 1 plane with different conditions, or are you going to have the entire process leading up to boarding? What’s the weather like? Are you going to vary those different environments? It's a lot to factor.

Before wrapping up, Hazel looked to the future. “We need more research, understanding, and collaboration between someone who knows the psychology and the tech.” She said. “I’m a doctor, you’re the experts in this field, not me.”