An investigation published yesterday in The Lancet Psychiatry found that automated cognitive intervention delivered via sessions with a consumer-grade virtual reality headset effectively reduced individuals’ fear of heights, and was generally well received by those participating in the study.
The results, researchers wrote, suggest that similar automated VR treatments could potentially be viable as a low-cost option for mental disorders outside of acrophobia.
“For many common mental health conditions, particularly anxiety disorders, evidence-based psychological treatments are both the best treatment option and the preference of patients. However, increasing the provision of psychological treatment is difficult. Therapists need to be trained and then adhere competently to evidence-based treatment protocols,” the researchers wrote. “Immersive [VR] has the potential to substantially increase access to the best psychological interventions.”
For their trial, the researchers enrolled 100 adult patients in the UK with a diagnosed fear of heights, as determined by a high score on the standardized Heights Interpretation Questionnaire. These participants were randomly stratified and assigned to receive the VR intervention during six roughly 30-minute sessions spaced over a two-week period (n = 49), or to continue receiving “usual care” (n = 51), which among the entire cohort was no treatment whatsoever.
The intervention itself took the form of a CE-marked VR software application specifically designed to treat acrophobia with or without a supporting therapist, and was delivered through an HTC Vive headset. The therapy is guided by a virtual coach, who was animated after and voiced by an actor, and allows patients to face their fear head on in an immersive environment.
Participants had been experiencing their fear of heights for a mean of 30 years, the researchers wrote, and 90 met the diagnostic criteria for acrophobia.
Uptake of the VR treatment was very high among the intervention group — all but two participants attending at least one VR session, with the remaining 47 attending an average of 4.67 sessions, the researchers wrote. Treatment with the VR intervention was associated with a significantly greater decrease in Heights Interpretation Questionnaire scores, both at the conclusion of the intervention period (P < .0001) and at a follow-up assessment conducted two weeks later (P < .0001). No adverse events were reported, with intervention group participants reporting very low levels of discomfort following sessions.
Developing this kind of automated VR intervention comes with a large initial investment, but is easily scalable, cheaper to deploy, and could potentially be used in the home, the researchers noted. The current findings also give some credence to the efficacy of similar treatments for other psychiatric disorders — most notably, anxiety — but the extent to which this method may be applicable to other conditions is unclear without directed investigation.
“We believe that transferability can only be determined by investment in high-quality VR treatments that are then tested in clinical trials. This endeavor is very important in mental health research in view of the potential benefits that might result from greatly increasing access to evidence-based treatment for mental health disorders,” they concluded.