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Last updated: Dec 15, 2021

VR for exposure therapy

Author: Maria Tsarouva
Last updated: Dec 15, 2021
What's inside

Virtual Reality (VR) has had a major impact on the healthcare sector, with broad applications in both training and patient education and care.

With regards to the psychology field in particular, multiple studies have found that VR exposure therapy can have many benefits for patients.

But what exactly is VR exposure therapy, and how does it work?


What is VR Exposure Therapy?

In order to understand what Virtual Reality Exposure Therapy (VRET) is, we first need to dissect this term into its two components: VR and exposure therapy.

Virtual Reality (VR)

VR is computer-generated technology that helps to create a simulated environment. With the help of VR headsets, a user is placed inside a particular 3D world that they can interact with.

While in this environment, many senses can be stimulated (sight, sound, touch, and sometimes smell), which helps to immerse the user completely into the artificial world.

Exposure therapy

The American Psychological Association describes exposure therapy as a psychological treatment that was developed to help people confront their fears.

This is because when people have any fear (e.g., the fear of heights, flying, spiders, etc.), they tend to avoid situations or activities that expose them to these fears. While this might work to reduce the anxiety for a little while, the problem is, over time, the fear might become worse.

In exposure therapy, a psychologist will create a safe environment that includes those fears in order to expose the patient to them and help reduce the avoidance and ultimate anxiety.


Now that we understand what VR and exposure therapy individually mean, it's easier to understand that VRET is a type of exposure therapy that simply uses VR technology to help expose patients to a safe environment where they can face and overcome their fears (or reduce their intensity).


How do patients get started with VRET?

Patients usually begin VRET by getting to know their therapist and discussing in detail what caused their trauma. Their therapist will then create a unique VRET environment, tailored to that specific patient.

To begin the therapy, patients will use a VR headset with a simulated environment that mimics their trauma. There might be sounds, sights, vibrations, or smells to help recreate the experience and evoke an emotional response.

This exposes patients to what they may be "running away" from. Through this treatment, they are able to confront the situations they fear most.

After the session, patients get to discuss the experience with their therapist, who will better understand their trigger points, and how best to help them recover, moving forward.

Does it work?

VRET is still a relatively new form of therapy, so research is still ongoing about the full benefits of this approach. However, multiple studies already indicate how helpful it can be.

For example, Jimmy Castellanos, a Veteran Marine corps, experienced post-traumatic stress disorder for many years after serving in Iraq. His psychiatrist recommended this approach, which virtually took him back to the memory of his trauma over and over again until his triggers no longer produced anxiety.

Castellanos had the following to say about the experience:

It was a completely different experience. I don't remember having the physiological reaction...In 13 weeks I'd completely changed who I had been for the previous ten years. Before the treatment, 80-90 percent of my dreams were Iraq related. Now I can't remember the last time I had one. I live in a completely different way now.

It is common knowledge that soldiers who come from war zones often suffer from PTSD. Breakthroughs in VR technology over the past few years are now allowing these veterans (and many patients who suffer from PTSD, anxiety, etc.) to finally get the help they need and deserve.


Why does it work?

VRET has shown incredible benefits in treating a few disorders, particularly PTSD, anxiety, and phobias.

Unfortunately, these are the same disorders that are currently on the rise — The CDC has found that there's a significant increase in symptoms of anxiety disorders. Many health care workers in the US have also reported increased rates of PTSD during the ongoing COVID-19 pandemic.

The reason why VRET is so effective is that people tend to develop anxiety and avoid any circumstance that may remind them of a traumatic experience, but VRET makes them stop avoiding it.

For example, a war veteran with PTSD due to military combat might get triggered by the sound of fireworks. But VRET will allow them to face these triggers in a safe environment. And with prolonged exposure, they learn how to cope with the anxiety and change how they think and feel about a particular event.

Eventually, the patient will get used to the triggers, accept the experience, and their anxiety or stress response will be less intense.

The same can be said about using VRET for other types of PTSD, anxiety, and phobias.

VRET v. in Vivo Therapy

In the past, most psychologists have relied on "in vivo" therapy, which relies on guiding patients through exposure-focused activities in person. For example, someone who suffers from agoraphobia might be guided to a public setting where they can begin to overcome their fears, or someone who is afraid of flying on a plane might go to the airport with their therapist to simulate the experience of getting on a plane.

This form of therapy can be effective, but relies on the patient's mobility and access to situations that will help them overcome their fears without overwhelming them, so it can be difficult to find the right settings. With VRET, the therapist can customize the exposure level based on the patient's situation, helping them to work through their fears gradually over time. Additionally, the therapy can be conducted virtually from any location, providing access to many more patients than those who might benefit from in vivo therapy.

VRET serves as a promising new treatment for many mental health conditions, and this innovative technology will likely have a positive impact on countless patients' lives.

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