Acceptability of VR and in vivo exposure for specific phobia

Before a therapy can work, patients need to be willing to engage with it. This study examined how acceptable patients find virtual reality exposure and traditional in vivo exposure as treatment options for specific phobia. Understanding patient preferences is crucial for clinicians considering whether to offer VR as an alternative or complement to standard exposure approaches.

Abstract

Phobic individuals are often reluctant to engage in exposure in vivo (IVE). We examined whether providing exposure in virtual reality (VRE) can increase the acceptability.

In Study 1, we provided 186 fearful participants with (hypothetical) VRE and IVE treatment offers and examined their willingness to engage in treatment, estimated success, negative beliefs, acceptance/refusal and their preference. Almost 70 % preferred VRE over IVE and acceptance rates were higher for the VRE offer (58 %) than for IVE (35 %). Although participants held fewer negative beliefs about VRE, they did rate IVE as slightly more successful.

In Study 2, we examined whether VRE can serve as a stepping stone to IVE in a sample of 102 spider fearful individuals. Willingness to engage, estimated success and negative beliefs about IVE were assessed before and after VRE. After VRE, participants rated IVE as more successful, but were not more willing to engage in IVE, nor were they more inclined to accept an IVE offer. No decreases in negative beliefs were observed.

In conclusion, VRE is deemed more acceptable than IVE and could lower refusal rates, hereby resulting in more phobic individuals receiving treatment. Future research should shed light on underlying motivations and associations.

Keywords: specific phobia, virtual reality, exposure therapy, in vivo exposure, acceptability, treatment preferences

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Reference

Scheveneels, S., De Witte, N. A. J., & Van Daele, T. (2023). The first steps in facing your fears. The acceptability of virtual reality and in vivo exposure treatment for specific phobia. Journal of Anxiety Disorders, 95, 102695. https://doi.org/10.1016/j.janxdis.2023.102695