Medical VR

Madison Bartolucci 

ENGL 202

3/19/24 

Medical Breakthrough: VR Transforming the world of Anxiety Treatment 

1. Introduction

With anxiety being such a broad topic, the most common being treated by VR are generalized anxiety disorder, post-traumatic stress disorder, and panic disorder. Anxiety disorders have been treated for decades, so how is the addition of VR therapy really innovative? Anxiety disorders like most mental health conditions are typically treated through a combination of medicine as well as therapy. However, VR therapy is different in the way that people’s fears and anxieties can be magnified in a real world experience unlike what you get with traditional treatments. Also with the fastly emerging world of online therapy and healthcare, VR being accessible from your home and remotely makes it just that much approachable. This kind of therapy is still relatively new, so there are definitely some weaknesses, and not all the studies have shown significant differences, however this is still an exciting breakthrough for the future of psychological treatments in the medical world. 

2. VR’s Role in Therapy and Anxiety

VR in relation to anxiety disorders is used predominantly to give patients real world exposure to their fears and anxieties, in a more immersive experience to better help overcome these issues. “The bulk of VR treatment research has been conducted for anxiety disorders, and broadly, results suggest the VRE is related to large declines in anxiety symptoms, demonstrates similar efficacy compared to traditional exposure interventions, has a powerful real-life impact, and demonstrates good stability of results over time”(Rizzo, 2008). VR treatment differs from traditional exposure therapy, even though these both rely on exposing patients to real world fear scenarios, exposure therapy requires therapists to take their patients somewhere in real time to be exposed to these scenarios. VR therapy allows these scenarios to be easily available through a headset either in a therapist office, or even at home in a comfortable environment. This allows for a more diverse array of options when it comes to what patients can be exposed to, it also allows for stability overtime compared to real world exposure therapy, because it allows the same scenario, or different fears in different contexts to be shown repeatedly and in close repetition so there’s a greater chance the fear won’t come back as quickly following treatment. VR also can help patients who struggle with exposure therapy due to not  being able to imagine themselves in these different possible scenarios assigned by their therapists. Using VR instead eliminates this mental block and allows for patients to have whatever reality they desire be magnified into a real world experience.  

3. Patient Relationship with VR Therapy 

Not only is VR used to help patients overcome these fears, but in a more positive light, it can also be used to calm patients with distractions, such as their favorite places being shown through the VR headset, thus allowing VR to have diverse uses some being to overcome fears, and others being to escape or distract from fears. In a 2023 article published by the University of Pennsylvania Medicine, a trial was run on this VR therapy with a group of over 100 anxiety patients. Then following their treatments, they were asked to give this treatment a rating, as well as the percentage they felt their anxiety decreased following their appointments. “On average, participants report a 35 percent reduction in anxiety after the sessions and give the program a 4.75 out of 5 rating for its helpfulness”,(Mialetti, 2023). There were also some personal statements given by participants on their experiences with the VR program, “Nothing else can bring me to a calm, soothing place,” one participant wrote on the survey, noting they have an active mind, making it difficult to relax. “VR helps this active mind”, (Mialetti, 2023). This refers to the calming and distracting approach that can be used with VR. Now this is just one experiment testing this fairly new concept, however this idea came about in the 90’s when Dr. Rothbaum, one of the first psychologists to explore this idea of VR in therapeutic treatments, did a study on VR’s effectiveness in treating acrophobia, which is an anxiety causing a fear of heights. She compared 8 patients with no VR treatment being used to cure their acrophobia, with 12 patients who were receiving VR treatment for their acrophobia. This study was done over a span of 8 weeks, and the results were significant, resulting in 10 out of the 12 students experiencing less anxiety towards their acrophobia. “ The Outcome was assessed by using measures of anxiety, avoidance, attitudes, and distress associated with exposure to heights before and after treatment.”(Rothbaum, 1995). Rothbaum’s study was only a microcosm of what VR could mean for the field of psychology and mental healthcare, but this idea is what helped spark interest and the evolution of VR in therapy.   

4. VR Versus Exposure Therapy 

VR is also an attractive treatment to therapists considering its diverse ability to be used not only singularly, but along with other more traditional treatments. A senior clinical therapist at Princeton stated that, “Virtual reality integrates with other therapies very well,”(Sever, 2023). A study done on arachnophobia patients also resulted in this notion, the study was done to test whether VR opposed to real world exposure therapy would have the same return fear rate when shown in multiple different contexts. This study was done on a group of 30 patients 15 patients with arachnophobia shown spiders in one context, vs. the other half shown spiders in four differing contexts outside of exposure therapy. These were done using VR technology. The study concluded that, “As reflected in the ratings, skin conductance level, and behavioral measures, the fear of spiders decreased significantly in both groups within and between the exposure trials and from pre to post exposure. Importantly, extinction in multiple contexts was able to significantly reduce renewal compared to extinction in a single context.”(Shiban, 2013). These results indicate that in the sub category of anxiety treatment known as exposure therapy, VR was most successful in allowing patients to experience their fears and phobias in a diverse array of settings compared to the exposure of these fears in real time. It also shows the benefits of VR versus regular exposure therapy because it had a higher success rate in patients experiencing relapses in phobias post exposure therapy. 

5. Conclusion 

The most important thing about this new kind of therapy is that it can integrate well with patients and make an impact over other more traditional methods, considering the patient’s needs come first as they are the ones consuming this treatment.. A study was done in 2010 to compare how patients reacted to in vivo therapy, meaning exposure to their fears in real time, versus getting exposure through VR therapy. The results showed, “Seventy-six percent chose VR over in vivo exposure, and the refusal rate for in vivo exposure (27%) was higher than the refusal rate for VR exposure (3%)”(Wiederhold, 2010). These results indicate that VR can increase the number of patients who go through with VR therapy related to phobias, compared to those willing to do in vivo. 

What can be the take away from these studies exploring the possible success of the new VR form of therapy? Considering the first paper done on this form of therapy was over 25 years ago, and there are more studies done as recently as 2023 revisiting this concept, I’d say this renewed interest and attempts at improving it mean it’s making its way to being a successful fully-implemented form of therapy. Although research shows success among anxiety patients, it seems there should be more research done relating from more specific forms of anxiety, to eventually other mental disorders that aren’t as common among patients like anxiety has been, to know the effect of this therapy in the world of mental disorder treatment. With the results found from the research done in this subcategory of VR therapy, one can conclude that this therapy is a groundbreaking psychological advancement. This is because VR usage in therapy, especially when related to anxiety disorders, is extremely innovative by improving the concept of exposure therapy in real life scenarios. This is because VR allows patients to use this form of therapy at their own disposal, whether that’s at home or in a therapist’s office, and allows repetition of repeated anxieties to be shown easily from this new technology compared to the effort needed to expose patients to various fears in real time. Not only does it improve other forms of therapy, but it also introduces new concepts to the world of psychological treatments by adding ways to distract patients in uncomfortable situations by allowing them to immerse in their desired environment using brand new technology.  

References: 

Author links open overlay panelYoussef Shiban, et al. “Effect of Multiple Context Exposure on Renewal in Spider Phobia.” Behaviour Research and Therapy, Pergamon, 11 Nov. 2012, www.sciencedirect.com/science/article/abs/pii/S0005796712001611.

Bell, Imogen H, et al. “Virtual Reality as a Clinical Tool in Mental Health Research and Practice
.” Dialogues in Clinical Neuroscience, U.S. National Library of Medicine, June 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7366939/.

Carl E;Stein AT;Levihn-Coon A;Pogue JR;Rothbaum B;Emmelkamp P;Asmundson GJG;Carlbring P;Powers MB; “Virtual Reality Exposure Therapy for Anxiety and Related Disorders: A Meta-Analysis of Randomized Controlled Trials.” Journal of Anxiety Disorders, U.S. National Library of Medicine, 10 Aug. 2019, pubmed.ncbi.nlm.nih.gov/30287083/.

“Expanding Mental Health Uses for Virtual Reality.” Psychiatry.Org – Expanding Mental Health Uses for Virtual Reality, 21 June 2021, www.psychiatry.org/news-room/apa-blogs/expanding-mental-health-uses-for-virtual-reality.

J;, Oing T;Prescott. “Implementations of Virtual Reality for Anxiety-Related Disorders: Systematic Review.” JMIR Serious Games, U.S. National Library of Medicine, 7 Nov. 2019, pubmed.ncbi.nlm.nih.gov/30404770/.

Maples-Keller, Jessica L, et al. “The Use of Virtual Reality Technology in the Treatment of Anxiety and Other Psychiatric Disorders.” Harvard Review of Psychiatry, U.S. National Library of Medicine, 25 May 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5421394/. 

Parsons T, Rizzo AA. Affective outcomes of virtual reality exposure therapy for anxiety and specific phobias: a meta-analysis. J Behav Ther Exp Psychiatry. 2008;39:250–261

Rothbaum BO;Hodges LF;Kooper R;Opdyke D;Williford JS;North M; “Effectiveness of Computer-Generated (Virtual Reality) Graded Exposure in the Treatment of Acrophobia.” The American Journal of Psychiatry, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/7694917/. Accessed 22 Mar. 2024.

“VR Therapy for Phobias, Depression, PTSD, and More.” Medical News Today, MediLexicon International, 13 Oct. 2023, www.medicalnewstoday.com/articles/vr-therapy. 

Image Credits:
Archer, Amye. “How VR Therapy Can Help You Face Your Fears.” Therapist.Com, 15 Aug. 2023, therapist.com/technology/virtual-reality-therapy/.

Kelly, Heather. “Afraid of Spiders? Try Virtual Reality.” CNNMoney, Cable News Network, 19 Apr. 2015, money.cnn.com/2015/04/29/technology/virtual-reality-therapy-phobias/.

Yetman, Daniel. “Exposure Therapy: Types, How It’s Done, and More.” Healthline, Healthline Media, 21 June 2021, www.healthline.com/health/exposure-therapy.