VR in CBT: New Solutions Make Virtual Exposure More Accessible
'VRET' has become a cheaper and accessible option for CBT therapists and their clients.
When working with phobias, you've likely faced this challenge: how do you create realistic exposure scenarios when a feared situation can't be easily replicated? Now, emerging virtual reality solutions are not just offering an answer - they're more accessible than you might think.
The Exposure Challenge
Traditional exposure therapy often relies on pictures, videos, or imaginal exposure, if we can’t replicate the real thing. But showing a client photos of airplanes or festival crowds can fall short of creating the immersive experience needed for effective treatment.
While VR has proven effective for exposure therapy1 the high cost of VR headsets has kept this tool out of reach for many practitioners, and the NHS.
A New Approach
Enter Ovrcome, a company that's developed a solution using technology most clients already own - their smartphones. By combining a phone-based VR app with an affordable cardboard-style headset, they're making virtual reality exposure therapy (VRET) more accessible than ever.
What Does It Look Like in Practice?
We checked out the platform to see how it performs. The library includes a comprehensive range of exposure scenarios:
Aircraft experiences, including turbulence
Crowd situations like festivals
Needle exposures
Heights and confined spaces
And more.
While the phone-based quality doesn't match high-end VR headsets, it was sufficiently immersive to trigger anxiety responses. The needle exposure scenarios were particularly impressive, offering a safe alternative to in-person exposure.
An example of the flying situation we tried out which had our toes curled:
The Clinical Implications
This development raises interesting questions for the field:
Could more accessible VR tools accelerate treatment outcomes?
Might the NHS find this a cost-effective addition to treatment?
How does phone-based VRET compare to full headset solutions like PsytechVR?
In addition, patients' have been studied to prefer VRET over in vivo exposure (1), which could enhance treatment adherence.
However, VR studies have mainly focused on single phobias or mild-moderate social anxiety presentations. Van Loenen et al (2022) tested the effectiveness of VR on other disorders, including severe anxiety, OCD and PTSD in meta-analysis2.
They conclude that VR was found to be as effective as CBT in the treatment of more severe anxiety disorders. But, higher-quality randomised controlled trials are needed to verify the robustness of these findings.
Beyond the Technology
While the platform offers promising features - including treatment program customisation and real-time progress monitoring - the real innovation might be its accessibility. By removing the need for expensive hardware, it could make VRET a realistic option for more practitioners and clients.
What do you think? Is VR something you’ve tried out, where could it be helpful?
[Note: This article is based is not sponsored by any VR company.]
Seuling, P.D., Czernin, N.S. and Schiele, M.A. (2024) ‘VIRTUAL REALITY EXPOSURE THERAPY IN THE TREATMENT OF PUBLIC SPEAKING ANXIETY AND SOCIAL ANXIETY DISORDER’, Neuroscience applied, pp. 104074–104074. Available at: https://doi.org/10.1016/j.nsa.2024.104074.
van Loenen, I. et al. (2022) ‘The Effectiveness of Virtual Reality Exposure–Based Cognitive Behavioral Therapy for Severe Anxiety Disorders, Obsessive-Compulsive Disorder, and Posttraumatic Stress Disorder: Meta-analysis’, Journal of Medical Internet Research, 24(2), p. e26736. Available at: https://doi.org/10.2196/26736.