The advent of virtual reality marks an innovative era in the field of therapeutic treatments. At the crossroads between cutting-edge technology and clinical psychology, virtual reality is emerging as a powerful tool allowing health professionals to explore new frontiers in the treatment of certain pathologies. What is virtual reality exposure therapy? Does it really work?
Better understand treatment through exposure to virtual reality
Virtual Reality Exposure Therapy (VRT) is a method from cognitive behavioral therapies (CBT). It represents an innovative approach, leveraging the immersive capabilities of virtual technology to treat various disorders. This method is based on the principle of progressive exposure to anxiety-provoking stimuli within a controlled environment , where the user physically interacts with a world artificially generated by software. Virtual reality offers artificial sensory reproduction, allowing the user to have an immersive experience through a head-mounted display and controllers, navigating and interacting in real time in a three-dimensional, computer-generated environment.
The mechanism of action of virtual reality therapies aims to gradually immerse the patient in virtual environments, facilitating their rehabilitation in the face of phobias and promoting the regaining of their autonomy. The mental simulation during these sessions can thus influence the user's perception in the real world, strengthening their confidence before directly confronting their fears.
By becoming an active actor within these synthetic 3D environments, the user is exposed to sensory stimuli inducing dysfunctional emotions, behaviors and thoughts. This gradual confrontation with feared stimuli allows the patient to achieve progressive desensitization , thus making it possible to carry out therapeutic desensitization.
Benefits of therapy
This innovative approach undoubtedly offers multiple advantages to users. First of all, the creation of three-dimensional and interactive virtual environments allows individuals to confront their fears or traumas in a safe and gradual manner . This progressive treatment offers a safe alternative, where the danger is virtual, thus allowing controlled immersion.
Furthermore, this therapy is distinguished by the possibility of interrupting the exposure at any time immediately, giving patients a level of control impossible to achieve in real exposure. The playful dimension of virtual reality can also promote therapeutic engagement. The quality of the exhibition is optimized using virtual reality technology.
Additionally, VR exposure therapy has economic benefits by reducing costs, especially in scenarios such as therapy for fear of flying, where conducting a session in VR is more affordable. This reduction in costs contributes to greater accessibility to therapeutic exposure, thus broadening the reach of this approach for a greater number of people.
In what cases is this therapy useful?
The areas of application of this therapeutic approach are varied and include, among others:
- Management of phobias such as social phobia, arachnophobia, claustrophobia, amaxophobia (irrational fear of driving), fear of heights and school phobia.
- Addictions to substances such as alcohol or tobacco, games, etc.
- Obsessive compulsive disorder (OCD).
- Manifestations of anxiety , including generalized anxiety disorders.
- Eating disorders.
- Post-traumatic stress.
- Autism spectrum disorders.
The support is adapted individually for each person.
Therapy in practice
Initially, preliminary TERV sessions focus on the patient's understanding of the disorder, assessment of their anxiety level, prioritization of stressful situations, and cognitive restructuring of their thoughts. The first sessions also serve to analyze the current difficulties, to carry out a functional assessment of the disorder and to determine the relevance of the use of virtual reality.
The virtual reality sessions are carefully prepared in advance and supervised at each stage by the psychologist. The practice of therapy is based on the concept of progressive exposure . Indeed, during the sessions (the number of which is not previously defined) the software used facilitates gradual exposure to feared situations, following a hierarchy established in collaboration with the therapist.
During a TERV session, the patient is equipped with a headset (head-mounted display) offering 3D vision , thus immersing his field of vision in a virtual universe disconnected from reality. In this space , the patient interacts with scenes likely to trigger disorders , such as staring into space, driving a car, taking an elevator, speaking in public or traveling on the subway.
Has its effectiveness been proven?
Brain imaging techniques have revealed that human brain activity mobilizes the same brain areas during the actual execution of an action as during its mental simulation. Various studies have also demonstrated the benefits of this intervention, even when carried out in isolation.
Results notably highlight greater effectiveness of TERV compared to certain actions such as placebo or relaxation. At the same time, there is comparable effectiveness between traditional approaches (exposure in vivo or by imagination) and exposure in virtual reality .
Limitations and side effects
The use of virtual reality has limitations and side effects that are essential to take into consideration. First of all, moderate use should be adopted, especially for individuals who already have difficulty establishing a connection with reality. Certain medical conditions, such as epilepsy, vestibular disorders or ophthalmic migraines, are also contraindications to the use of virtual reality .
Some side effects may also occur. The brain relies on three sources of data: the inner ear, muscles and eyes to inform the body of its position and movements. When the headset is worn, a mismatch between visual and sensory information can lead to "cyber malaise" , manifesting as headaches and nausea after prolonged exposure.
It is also crucial to emphasize that virtual reality is not a miracle solution offering instant cure. Its effectiveness depends on a process requiring professional support and personal involvement of the user . Although this therapy may be beneficial in the long term, it is important to recognize that the experience may initially be difficult to go through. It requires significant emotional engagement, highlighting the need for a thoughtful and guided approach to maximize its therapeutic benefits.
In summary, virtual reality exposure therapy represents a promising approach in the management of many disorders. This method indeed offers favorable prospects by allowing progressive exposure to anxiety-provoking stimuli in a controlled environment. The advantages of this approach, such as safety, increased control and reduced costs, offer notable therapeutic potential. However, it is crucial to recognize the limitations and side effects, thus emphasizing the need for moderate and supervised use. Virtual reality thus offers a promising complement to traditional exhibition methods.
Center for integrative therapies and new technologies. Virtual Reality Exposure Therapy (VRT).
Lognoul , J. Nasello , J.-M. Triffaux . (August 2020). Virtual reality exposure therapy for post-traumatic stress states, obsessive-compulsive disorders and anxiety disorders: indications, added value and limits.
CHU CL Namur, psychology department. Virtual reality exposure therapy (VRET) to treat phobias and anxiety disorders.