The trial used a headset and a smartphone app treatment program to study phobia patients, combining Virtual Reality (VR) 360-degree video exposure therapy and cognitive behavioral therapy (CBT). The findings of a University of Otago, Christchurch trial offer new hope to the estimated one-in-twelve people worldwide who are afraid of flying, needles, heights, spiders, and dogs.
The trial, led by Associate Professor Cameron Lacey of the Department of Psychological Medicine, looked at phobia patients using a headset and a smartphone app treatment program – a mix of Virtual Reality (VR) 360-degree video exposure therapy and cognitive behavioral therapy (CBT).
Participants downloaded “oVRcome,” a fully self-guided smartphone app developed by Christchurch tech entrepreneur Adam Hutchinson to treat patients suffering from phobias and anxiety.
The app was used in conjunction with a headset to immerse participants in virtual environments in order to treat their phobia. The trial’s findings, which were recently published in the Australian and New Zealand Journal of Psychiatry, revealed a 75% reduction in phobia symptoms after six weeks of treatment.
“The improvements they reported suggests there’s great potential for the use of VR and mobile phone apps as a means of self-guided treatment for people struggling with often-crippling phobias,” Associate Professor Lacey says.
“Participants demonstrated a strong acceptability of the app, highlighting its potential for delivering easily accessible, cost-effective treatment at scale, of particular use for those unable to access in-person exposure therapy to treat their phobias.”
The improvements they reported suggests there’s great potential for the use of VR and mobile phone apps as a means of self-guided treatment for people struggling with often-crippling phobias.Associate Professor Lacey
A total of 129 people took part in the six-week randomised, controlled trial, between May 2021 and December 2021, with a 12-week follow-up. Participants needed to be aged between 18-64 years, have a fear of either flying, heights, needles, spiders and dogs. They were emailed weekly questionnaires to record their progress. Those experiencing adverse events could request contact from a clinical psychologist at any stage.
“Participants experiencing all five types of phobia showed comparable improvements in the Severity Measures for Specific Phobia scale over the course of the trial. The average severity score decreased from 28/40 (moderate to severe symptoms) to 7/40 (minimal symptoms) after six weeks. There were no participant withdrawals due to intervention-related adverse events.
“The oVRcome app uses what’s known as “exposure therapy,” a type of CBT that involves exposing participants to their specific phobias in short bursts in order to build tolerance to the phobia in a clinically-approved and controlled manner,” Associate Professor Lacey explains.
“After the trial period, some participants reported significant progress in overcoming their phobias, with one feeling confident enough to book an overseas family vacation, another lining up for a Covid vaccine, and another reporting they now felt confident not only knowing there was a spider in the house, but that they could possibly remove it themselves.”
The app programme consisted of standard CBT components including psychoeducation, relaxation, mindfulness, cognitive techniques, exposure through VR, and a relapse prevention model. Participants were able to select their own exposure levels to their particular phobia from a large library of VR videos.
“This means the levels of exposure therapy could be tailored to an individual’s needs which is a particular strength. The more traditional in-person exposure treatment for specific phobias have a notoriously high dropout rate due to discomfort, inconvenience, and a lack of motivation in people seeking out fears to expose themselves to. With this VR app treatment, triallists had increased control in exposure to their fears, as well as control over when and where exposure occurs,” says Associate Professor Lacey.
The researchers describe this trial as novel because of the low cost of the app and headsets, as well as the fact that multiple phobias were tested at the same time. According to them, most comparative VR studies to date have focused on high-end VR devices that are only available in research and limited clinical settings. One Dutch study looked at a low-cost VR Dutch-language program that used animated imagery and showed improvement in fear-of-height symptoms, but this study only looked at one type of specific phobia.
According to Associate Professor Lacey, public demand to participate in the trial was unprecedented, demonstrating the community’s growing need and desire for phobia treatment.
“Because of needle phobia, an estimated 10% of New Zealanders have been hesitant to participate in the government’s COVID-19 vaccination program. A significant shortage of psychologists hasn’t helped. According to a petition submitted to Parliament last year, New Zealand is 1,000 psychologists short, resulting in nationwide wait times that make it difficult for people to seek help if needed. To provide people with the treatment and support they require, we need to conduct additional research and investigate the use of more cost-effective, easily accessible, home-based solutions, such as this oVRcome app.”