An internet-based self-applied rat phobia treatment using a Virtual Therapy Assistant: Study protocol for a randomized controlled trial

Abstract

Specific phobias are a common anxiety disorder that deteriorates the lives of people who suffer from them. To reduce the symptoms produced by this mental disorder exposure therapies have been used. However, low- and middle-income countries, including Mexico, have the lowest rate of treatment due to multiple barriers that prevent addressing mental health problems. Self-applied treatments have been explored in previous studies, nevertheless, high dropout rates are a common problem in this kind of treatment. An alternative is using immersive self-applied treatments that could help increase adherence to the treatment. This article aims to present a study protocol to explore the feasibility of an Internet self-applied exposure treatment for rat phobias, using four types of immersive multimedia elements: images, videos, video games, and 360° videos. Also, the satisfaction and perception of a Virtual Therapy Assistant (VTA) that provides information and support to the user are described. The study protocol will compare two groups of participants, one on the waiting list, and the other will receive the self-applied treatment for rat phobia supported by the VTA. For this study, 45 participants will be recruited and the evaluation measures will be taken at four different times: baseline, post-treatment, and follow-ups at 3 and 6 months. The levels of anxiety and avoidance of the user manifested during the exposure to the multimedia elements, the improvement of the user’s clinical symptoms, the level of satisfaction, the perception of effectiveness, and ease of use of the self-applied system will be evaluated. This study is expected to support the viability of self-applied treatment for rat phobias and the use of a VTA, showing the impact on treatment adherence. To the best of our knowledge, this is the first study to explore an exposure treatment for rats using different multimedia elements with the support of a VTA. The work will serve as a basis for the development of new virtual assistants that help in the treatment of other types of specific phobias. This research has been registered in Clinical Trials NCT (NCT05081323).

Ludic and Narrative Immersion in Virtual Reality Exposure Therapy to Animal Phobias: A Systematic Literature Review

“…Both studies which were found to have a VRE lacking ludic immersion potential involve non-interactive 360 • videos. In one of the studies, the feasibility of a multimodal internet-based exposure approach is evaluated, incorporating images, videos, games, and 360 • videos [64]. While the entire intervention holds potential for ludic immersion, particularly during the digital game phase, the only VR component is present when the user watches 360 • videos, which were not described as possessing the characteristics associated with ludic immersion.…”

“…Many studies with low potential for spatial immersion shared a similar type of navigation freedom, limited to three degrees of movement where users could only rotate their heads in the virtual environment but not move within it [59,60,[64][65][66][67]71,75,81]. Although Farrell et al [67] and Minns et al [65] had high realism due to high-definition video captures of real environments and animals, they lacked sufficient navigational freedom as they were non-interactive videos that didn't allow users to explore the presented environment spatially.…”

“…Studies classified as having no potential for temporal immersion are those where virtual animals either have no movement or their movement is not dynamic [59,60,64,66,67,74,75]. In some cases [67,75], the animals move, which can create some tension.…”