What is Virtual Reality Exposure Therapy?
Exposure therapy is a psychotherapy type allowing clients to confront their triggers in a safe and controlled environment and gradually release or reduce their fears and anxieties. Psychotherapists rely on exposure therapy to decrease stress levels that skyrocket in clients who usually experience anxiety or some form of post-traumatic stress disorder (PTSD).
Whether it be memories, situations, sounds, or any connection with past trauma, these triggers provoke anxiety and fear, affecting people in various ways. When exposed to stimuli, people can experience a range of negative emotions. Psychotherapists use exposure therapy to help people manage these reactions and regain control over their lives.
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Exposure therapy is segregated into several types, the most common being in vivo and imaginal. The former motivates clients to handle their fears in person. If you fear tarantulas, your psychotherapist might ask you to eventually handle one in a controlled environment. With imaginal exposure therapy, a psychotherapist would do the opposite and, for example, ask you to remember the scenarios that increased your fear of spiders.
Simlarly to traditional exposure therapy, virtual reality exposure therapy (VRET) is an exposure therapy type that relies on technology to treat client symptoms or conditions. As it’s sometimes challenging to recreate experiences that can be attributed to a client’s trauma, VR could be the next breakthrough in psychotherapy. Not only would this approach help people tackle their fears, but it would also help us better understand the human mind.
How Does Virtual Reality Exposure Therapy Work?
When experts use VRET in their sessions, they rely on VR technology to mimic a client’s stressor or fear. And, as the name says, they’re essentially exposing clients to the versions of traumatic events through a VR headset. The triggering stimuli could be anything from a vibration to sound, which is why it isn’t always easy to mimic these triggers and help clients release trauma with “traditional” exposure therapy. VRET, on the other hand, offers more flexibility and control.
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For example, hearing fireworks could trigger a soldier with a PTSD developed in combat. As the sound reminds of past traumatic events, the body’s stress levels skyrocket every time around New Year’s Eve or Christmas. With VRET, a client will deliberately expose themselves to such triggers, which gradually decrease or disappear after prolonged exposure.
Another example could be a client with severe aerophobia (fear of flying), who may seek professional help to alleviate their concerns and finally book a vacation. In this scenario, VRET would expose the client to aircraft takeoffs and landing simulations, allowing them to face their fears gradually and fully control the situation.
Like the standard prolonged exposure therapy, VRAT allows people to challenge their anxiety and fears and learn how to cope with them. It could also aid in readjusting their thinking tied to a specific traumatic event. As a result, a client may realize their traumatic memories aren’t as frightening and threatening as they many feel when they’re exposed to stimuli.
Who Might Benefit from Virtual Reality Exposure Therapy?
Statista survey conducted between April 2020 and January 2023 on 60,461 respondents show that between January 4 and January 16, 2023, almost 28% of surveyed American adults reported having an anxiety disorder symptom in the previous two weeks. And that’s just the US.
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Millions of people deal with anxiety disorder, and most of them don’t seek professional help, which, in most cases, worsens the anxiety and fear over time. Engaging in virtual reality exposure therapy would allow clients to realistically reexperience past stressors and prevent other symptoms or conditions from developing.
Additionally, VRET could be an excellent alternative to those who rejected traditional exposure therapy due to discomfort and high stress levels. Standard exposure therapy could be too stressful for some clients. When subjected to this treatment, clients repeatedly expose themselves to their trauma. And since psychotherapists can’t “see” or predict client’s reactions during the session, VR exposure therapy could be revolutionary, as professionals would be able to see and control which triggers the clients are exposed to. This would allow them to understand patients’ triggers and perhaps, measure client’s stress levels when exposed to particular stimuli.
That said, VR exposure therapy could help people with social and general anxiety disorder, PTSD, OCD, panic disorder phobias such as fears of a certain creature (spiders), objects (balloons), or situations (fear of flying). Although some experts are already using VR exposure therapy to help clients alleviate mental discomfort and worries, this approach to psychotherapy is not widespread.
It could take years before a majority of psychotherapists have a VR headset in their medical office, and even more to motivate people to try it.
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Some people are afraid of going to therapy for various reasons, while a mentionable percentage still believes that therapy is ineffective. Stigma around mental health and therapy prevents many from seeking help, and until changes, the VR therapy might be a revolutionary aid only for the selected few.
Challenges of Virtual Reality Exposure Therapy
Despite being an effective method that could alleviate anxiety, VRET has its challenges. Some of them include the following:
- Slow adoption: Significant advancements in the VR department allow us to use the technology for the betterment of society. But after years of a “traditional” approach to work, finding ways to include new and less familiar techniques is challenging. Additionally, VR headsets can be costly, and the virtual reality environment must be adapted to each client. Incorporating VR would be expensive and would require additional support in terms of software maintenance and adjustment.
- Training and regulatory issues: VRET experience could be intense and shouldn’t be taken lightly. To start reaping the benefits of VR exposure therapy, practitioners must undergo training and ensure they’re skilled to navigate the client through an unfamiliar environment. Presuming that technical support wouldn’t always be available, psychotherapists must learn the ins and outs of the software and equipment they’re using. Moreover, the use of VRET could lead to regulatory challenges, as this approach to therapy isn’t widely adopted. That said, practitioners might have to acquire additional licenses before including VR exposure therapy in their service.
- Research: VRET could be widely accepted by private and state practitioners alike. Of course, professionals have already proven through research the positive effect of VR exposure therapy. However, additional research is needed to back up these claims and ensure that the method in question is indeed safe to use.
- Patient tracking: The technical challenges in the use of Virtual Reality Exposure Therapy report states that “a challenge that was discussed a lot … was the use of eye tracking to study how the focus of the patient is oriented during VRET sessions. It is expected that this may give better insight in what triggers the emotions during the sessions. This information may be used to adjust the session procedure or the characteristics of the virtual world online.” The report furthermore explains that “the most futuristic challenge is to implement a mechanism to allow the use of MRI or CT scans of the brain during a VRET session. Early steps in this direction have been taken by devising a fiberoptic magnet-friendly high-resolution wide-field-of-view image delivery system. Initial tests with functional MRI (fMRI) offer promising results, showing that the display does not interfere with the brain scans, and that the users can feel the sense of presence in the virtual environment while being inside the scanner.”
VRET research is needed to solve these challenges and ensure that both practitioners and their clients are comfortable including VR in therapy sessions. Although VR exposure therapy draws attention from psychotherapists and patients alike, VRET will likely remain an “exotic” approach to psychotherapy until the researchers manage to provide more substantial proof of its effects.