Body of Evidence
Phobias are often considered relatively minor mental health issues, given their ability to be avoided, and the consequent lack of distress prospective clients endure. Nevertheless, they can prove incredibly debilitating, and significantly influence the quality of life experienced by the person in question. While the reasons for this vary as dependent on the nature of the phobia (consider for example, an employee required to travel for work, who has a fear of flying, or someone who is scared of storms, and has recently moved to Thailand), Cognitive Behavioural Therapy (CBT) is an adaptive model, that can appropriately treat such individual differences. While most people (up to 90%) do not seek help (Bennett-Levy et al., 2004(?)), those that do show significant improvement having undergone CBT (e.g. Koch et al., 2004; Ost et al., 2003; Straube et al., 2003). CBT is considered the gold standard for the treatment of specific phobias. The use of this treatment model in producing significant reductions in fear responses toward previously feared stimuli is well established in clinical practice (Choy, Fyer, & Lipsitz, 2007; Öst, 1996).
This treatment model focuses on the interactions between an individual's thoughts, feelings, and actions. It targets the cognitions surrounding the perpetuating cycle clients often find themselves stuck within (e.g. avoidance of feared object/situation). While the cognitive skills and restructuring taught and undertaken with clients typically facilitates a reduction in fear toward the feared stimulus (Koch et al., 2004), it is nevertheless a required part of treatment to confront the fear provoking situation. This is done in a controlled environment, and often under the guidance of a trained therapist.
Given the nature and severity of clients’ fears, it is often appropriate to build up to facing the fear itself. For example, someone scared of spiders may first be challenged with watching a spider on video, prior to confronting it in real life. The client will not be required to undertake a task they refuse to. Significant benefits are reported by those who do undertake treatment, as reported in experiments evaluating treatment of a variety of specific phobias (e.g. Koch et al., 2004; Ost et al., 2003; Straube et al., 2003).
Treating Phobias with Virtual Reality
A key component of the current gold standard in phobia treatment, Cognitive Behavioural therapy (CBT), is the clients confronting their fear. This has traditionally occurred in either real life situations, or through imaginal exposure. Unfortunately, both of these methods are subject to a number of constraints, which often make the exposures difficult, or less effective, than they otherwise could be. A new technological development, Virtual Reality (VR), has been validated as an effective alternative, which mitigates traditional concerns. This technology involves patients entering a 3 dimensional, artificially constructed “world”, within which they are tasked with confronting their fears.
While some virtual reality programs have been met with some skepticism, after all, isn’t it just a computer simulation? Technological advancements continue to bridge this gap. Currently, a number of aspects of the virtual world contribute to an immersive experience. The constructed world is rich in detail. Additionally, sensory perception of the “real world” is shut out, as the virtual context stimulates our sensory receptors. Additionally, a multitude of sensory experiences are evoked within the VR context (e.g. visual, auditory, and tactile).
A growing area of literature suggests this technology as a viable alternative to traditional treatment methods, particularly regarding the treatment of clients with specific phobias. For example, successful trials have been run for people scared of storms! Patients who have undergone virtual reality exposure, demonstrated significant reduction in fear responses having undergone treatment in virtual reality environments. Additionally, successful trials have been run for people scared of heights! In these studies, those assigned to the VR group demonstrate the same treatment improvements as those who undergo traditional CBT, with some studies reporting greater effect than traditional methods.
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