Results of a trial from the University of Otago, Christchurch, suggest new hope for around one in 12 people worldwide suffering from fear of flying, needles, heights, spiders and dogs .
The trial, led by Associate Professor Cameron Lacey, from the Department of Psychological Medicine, studied phobic patients using headphones and a smartphone app treatment program – a combination of 360 degree reality video exposure therapy Virtual (VR) and Cognitive Behavioral Therapy (CBT).
Participants downloaded a fully self-guided smartphone app called ‘oVRcome’, developed by Christchurch tech entrepreneur Adam Hutchinson, aimed at treating patients with phobia and anxiety.
The app was paired with a headset to immerse participants in virtual environments to help them address their phobia.
The results of the trial, which have just been published in the Australian and New Zealand Journal of Psychiatryshowed a 75% reduction in phobia symptoms after six weeks of treatment program.
“The improvements they reported suggest there is great potential for using virtual reality and mobile phone apps as a means of self-guided treatment for people struggling with often crippling phobias,” says the professor. Associate Lacey.
“Participants demonstrated strong acceptability of the app, underscoring its potential to provide an easily accessible and cost-effective treatment at scale, particularly useful for people unable to access in-person exposure therapy to treat their phobias. “
A total of 129 people took part in the six-week randomized controlled trial, between May 2021 and December 2021, with a follow-up of 12 weeks. Participants had to be between the ages of 18 and 64, afraid of flying, heights, needles, spiders and dogs. Weekly questionnaires were emailed to them to record their progress. People experiencing adverse events could request to contact a clinical psychologist at any time.
“Participants with all five types of phobia showed comparable improvements in the scale of severity measures for specific phobia over the course of the trial. The average severity score improved from 28/40 (moderate to severe symptoms) at 7/40 (minimal symptoms) after No participants dropped out due to intervention-related adverse events.
“The oVRcome app involves what is called ‘exposure therapy’, a form of CBT exposing participants to their specific phobias in short bursts, to build their phobia tolerance in a clinically approved and controlled way” , says Associate Professor Lacey.
“Some participants reported significant progress in overcoming their phobias after the trial period, with one feeling confident enough to now book a family holiday abroad, another queuing for a Covid vaccine and another reporting that they now felt confident not only knowing there was a spider in the house, but that they could eventually remove it themselves.”
The app’s curriculum included standard components of CBT, including psychoeducation, relaxation, mindfulness, cognitive techniques, exposure via virtual reality, and a relapse prevention model. Participants were able to select their own levels of exposure to their particular phobia from a large library of VR videos.
“This means exposure therapy levels could be tailored to an individual’s needs, which is a particular strength. The more traditional in-person exposure treatment for specific phobias has a notoriously high dropout rate in due to discomfort, inconvenience and lack of motivation in people looking for fears to expose themselves to.Thanks to this VR application treatment, trial participants had increased control over exposure to their fears, as well as control over when and where exposure occurs,” says Associate Professor Lacey.
The researchers say this trial was novel, due to the cost-effective availability of the app and headsets and the fact that multiple phobias were tested at once. They say most comparative VR studies to date have focused on high-end VR devices that are only available in research and limited clinical settings. A Dutch study looked at a low-cost Dutch-language VR program using moving pictures that demonstrated improvement in symptoms of height fear, but this study only looked at one specific type of phobia.
Associate Professor Lacey said public demand to take part in the trial was unprecedented, demonstrating the growing need and desire for phobia treatment in the community.
“An estimated ten percent of New Zealanders have been hesitant to take part in the government’s COVID-19 vaccination program due to needle phobia. This has not been helped by a significant shortage of psychologists. A petition in Parliament last year claimed that New Zealand is short of 1,000 psychologists, resulting in inflated wait times nationwide, making it difficult for people to access much-needed help. We need to continue our research and explore the use of more cost-effective and easily accessible home solutions, such as this oVRcome app, to provide people with the treatment and support they need.”
This study builds on existing research from the Department of Psychological Medicine on structured psychotherapy for mental distress.