Virtual reality app reduces phobias through NZ trial

Results from a New Zealand University trial suggest fresh hope for the estimated one-in-twelve people worldwide suffering from a fear of flying, needles, heights, spiders and dogs.

The trial, led by Associate Professor Cameron Lacey, from the Department of Psychological Medicine, at the University of Otago, studied phobia patients using a headset and a smartphone app treatment programme, a combination of Virtual Reality (VR) 360-degree video exposure therapy and cognitive behavioural therapy (CBT).

Participants downloaded a fully self-guided smartphone app called oVRcome, developed by New Zealand-based tech entrepreneur Adam Hutchinson, aimed at treating patients with phobia and anxiety. The app, paired with a VR headset, immerses participants in virtual environments so as to relax and distract with technology to help people overcome anxiety disorders and social anxiety through VR exposure therapy. Anxiety and phobias include heights, spiders, flying, and dogs.

The results from the trial, just published in the Australian and New Zealand Journal of Psychiatry, showed a 75% reduction in phobia symptoms after six weeks of the treatment programme.

"The improvements they reported suggests there is great potential for the use of VR and mobile phone apps as a means of self-guided treatment for people struggling with often-crippling phobias," Lacey says.

"Participants demonstrated a strong acceptability of the app, highlighting its potential for delivering easily accessible, cost-effective treatment at scale, of particular use for those unable to access in-person exposure therapy to treat their phobias," he says.

Hutchinson was inspired to develop oVRcome after becoming increasingly alarmed by mental health statistics. Recognising that accessibility was a key issue, he began working with a team of clinical psychologists to develop an accessible smart-phone based tool to help. It is estimated that up to 80% of anxiety sufferers do not seek treatment currently. Barriers include cost, location of the patient, the stigma of going to a psychologist and the lack of trained psychologists.

A total of 129 people took part in the six-week randomised, controlled trial, between May 2021 and December 2021, with a 12-week follow-up. Participants needed to be aged between 18-64 years, have a fear of either flying, heights, needles, spiders and dogs. They were emailed weekly questionnaires to record their progress. Those experiencing adverse events could request contact from a clinical psychologist at any stage.

Participants experiencing all five types of phobia showed comparable improvements in the Severity Measures for Specific Phobia scale over the course of the trial. There were no participant withdrawals due to intervention-related adverse events.

"The oVRcome app involves what's called exposure therapy, a form of CBT exposing participants to their specific phobias in short bursts, to build up their tolerance to the phobia in a clinically-approved and controlled way," Lacey says.

Some participants reported significant progress in overcoming their phobias after the trial period, with one feeling confident enough to now book an overseas family holiday, another lining up for a Covid vaccine and another reporting they now felt confident not only knowing there was a spider in the house but that they could possibly remove it themselves.

The app programme consisted of standard CBT components including psychoeducation, relaxation, mindfulness, cognitive techniques, exposure through VR, and a relapse prevention model. Participants were able to select their own exposure levels to their particular phobia from a large library of VR videos.

"This means the levels of exposure therapy could be tailored to an individuals needs which is a particular strength. The more traditional in-person exposure treatment for specific phobias have a notoriously high dropout rate due to discomfort, inconvenience and a lack of motivation in people seeking out fears to expose themselves to," Lacey says.

"With this VR app treatment, trialists had increased control in exposure to their fears, as well as control over when and where exposure occurs."

Hutchinson adds, "The trial has allowed us to explore efficacy and benefit from robust learnings.

"We are really pleased to learn that users were able to build confidence and take steps toward conquering their phobias. While there has been large growth in the number of apps treating anxiety and mental health issues, only a few have been rigorously clinically studied," he says.

"The findings from the trial give us real confidence as we launch the product internationally. We know that we can make a difference for so many."