JMIR Publications

ABSTRACT

Background:

Psychotherapy, and particularly exposure therapy, has been proven to be an effective treatment for many anxiety disorders, including social and specific phobias, as well as post-traumatic stress disorders. Currently, exposures are underutilized and mostly delivered in vivo. Virtual reality exposure therapy offers a more flexible delivery mechanism that has the potential to address some of the implementation barriers of in vivo exposures while retaining effectiveness. Yet, the is little evidence on how patients perceive different exposure therapy methods.

Objective:

To explore the perceptions of individuals with anxiety disorders towards in vivo and VR exposure therapy. Our findings can inform therapists about the degree of patient interest in both methods while exploring the demand for VRET as an alternative and novel treatment approach.

Methods:

Online survey assessing the (a) interest in, (b) willingness to use, (c) comfort with, (d) enthusiasm toward, and (e) perceived effectiveness of exposure therapy when delivered in vivo and through VR. Participants included individuals with specific phobia, social phobia, PTSD, and/or acute stress disorder/reaction. Participants were presented with educational videos about in vivo and VRET and asked to provide their perceptions quantitatively and qualitatively through a rated scale and free-text responses.

Results:

184 surveys were completed and analyzed. 82% and 90.2% of participants reported being willing receive in vivo and VRET respectively. Participants reported higher interest in, comfort with, enthusiasm toward, and perceived effectiveness of VRET compared to in vivo. Most reported in vivo concerns were linked to: (1) increased anxiety, (2) feelings of embarrassment or shame, and (3) exacerbation of current condition. Most reported VRET concerns were linked to: (1) risk of side effects, including increased anxiety (2) efficacy uncertainty, and (3) health insurance coverage. The most frequently mentioned VRET benefits included: (1) privacy, (2) safety, (3) the ability to control exposures, (4) comfort, (5) the absence of real-life consequences, (6) effectiveness, and (7) customizability to a wider variety of exposures.

Conclusions:

On average, our participants expressed positive perceptions toward exposure therapy, with slightly more positive perceptions of VRET over in vivo exposures. Despite valid personal concerns, and some misconceptions, our findings emphasize that VRET provides an opportunity to get much-needed therapy to patients in ways that are more acceptable and less concerning.