Phobia Exposure Therapy Using Virtual and Augmented Reality: A Systematic Review

Abstract

A specific phobia is a common anxiety-related disorder that can be treated efficiently using different therapies including exposure therapy or cognitive therapy. One of the most famous methods to treat a specific phobia is exposure therapy. Exposure therapy involves exposing the target patient to the anxiety source or its context without the intention to cause any danger. One promising track of research lies in VR exposure therapy (VRET) and/or AR exposure therapy (ARET), where gradual exposure to a negative stimulus is used to reduce anxiety. In order to review existing works in this field, a systematic search was completed using the following databases: PubMed, ProQuest, Scopus, Web of Science, and Google Scholar. All studies that present VRET and/or ARET solutions were selected. By reviewing the article, each author then applied the inclusion and exclusion criteria, and 18 articles were selected. This systematic review aims to investigate the previous studies that used either VR and/or AR to treat any type of specific phobia in the last five years. The results demonstrated a positive outcome of virtual reality exposure treatment in the treatment of most phobias. In contrast, some of these treatments did not work for a few specific phobias in which the standard procedures were more effective. Besides, the study will also discuss the best of both technologies to treat a specific phobia. Furthermore, this review will present the limitations and future enhancements in this field.

Effectiveness of Augmented and Virtual Reality-Based Interventions in Improving Knowledge, Attitudes, Empathy and Stigma Regarding People with Mental Illnesses—A Scoping Review

“…Amongst healthcare students, virtual reality interventions have been observed to improve skill competencies, and better appreciation of symptom and illness [ 62 ]. Earlier studies have found that AR/VR interventions can be adopted to manage conditions such as specific phobias, autism spectrum disorder, psychotic conditions, substance related disorders, depression and eating disorders [ 23 , 24 , 63 , 64 ]. In our review, we observed that VR intervention could help to assess and enhance medication adherence amongst patients with schizophrenia (Baker et al, 2006).…”

“…Since then, the use of VR as a treatment modality has grown. Of note, there are recent studies examining the effectiveness of AR/VR-based therapeutic modalities in the management of patients with neurodevelopmental spectrum conditions (such as autism spectrum disorders, attention deficit hyperactivity disorders) [ 20 , 21 , 22 , 23 ], anxiety disorders (such as phobias) [ 24 , 25 , 26 , 27 ], obsessive compulsive disorder [ 28 , 29 , 30 ], post-traumatic stress disorder [ 31 ], and cognitive impairments in the elderly [ 32 , 33 ]. In comparison, there are fewer studies specifically elucidating the effectiveness of AR/VR based interventions as a psychoeducational tool such as in improving understanding of mental illnesses, engendering more positive attitudes regarding people with mental illnesses [ 34 , 35 ] and reduction of stigma [ 36 , 37 ].…”

Visual feedback-dependent modulation of arousal, postural control, and muscle stretch reflexes assessed in real and virtual environments

“…Beyond basic neural mechanisms of balance control, our findings further suggest that VR may be useful for therapeutic purposes. For example, VR exposure therapy has been presented as a promising concept for managing phobias and anxieties, such as towards heights or flying, by gradually exposing patients to a negative stimulus ( Rothbaum et al, 1997 ; Krijn et al, 2004 ; Bush, 2008 ; Albakri et al, 2022 ). There is already research in this area suggesting benefits in terms of fear of falling and fall risk in older adults ( Rendon et al, 2012 ; Levy et al, 2016 ), and clinically in people with acrophobia ( Coelho et al, 2009 ; Rimer et al, 2021 ), or anxiety disorders ( Meyerbröker and Emmelkamp, 2011 ).…”

Combined Fainting and Psychogenic Non-epileptic Seizures as Significant Therapy Hurdles in Blood-Injury-Injection Phobia: A Mini-Review and Case Report

“…Recently, virtual reality exposure has also proven promising (68)(69)(70). Efficacy was also demonstrated for augmented reality exposure, a similar tech-based approach, for many other specific phobias (71). Moreover, case reports have shown individuum-level success for approaches like selfexposure (67), individualization of therapy (72), cognitive restructuring (73), and applied tension (74).…”