“in vivo” exposure has been deemed as the most effective technique
in the treatment of phobias, it is important to note that this technique
holds certain disadvantages for both the client and the therapist. Indeed,
in using this type of therapy once is confronted with certain limitations
such as the breach of confidentiality during exposure in a public place,
the care of the animals and insects (and their replacement as needed),
the possibility of unforeseen problems (e.g. elevator jamming or malfunctioning),
the climate (e.g. fear of thunderstorms), monetary costs (e.g. fear of
flying). In this sense, the advantages related to the use of virtual reality
offer a therapeutic potential that is particularly interesting for the
treatment of phobias.
reality, when applied to the treatment of phobias, allows individuals
to be exposed to fear stimuli (in the same manner as when performing traditional
therapy) within a computer-generated situation. The use of a helmet that
has been integrated into a screen, the individuals perceive themselves
in a virtual environment where they are gradually exposed to their fears
(in virtuo exposure).
the aim of facilitating the task for clinicians employing virtual therapy
with individuals suffering from anxiety disorders (such as specific phobias),
many types of software have been developed that are designed to treat
certain types of psychopathological states such as: agoraphobia, post-traumatic
stress disorder, specific phobias (e.g. heights, plane travel, enclosed
spaces, public speaking, etc.), attention deficit disorder assessment,
etc. Since these softwares are often very expensive, the Cyberpsychology
Lab uses modified computer games to create its own virtual environments.
The option of adapting computer games for use in virtual therapy offers
numerous advantages, including cost reduction as well as the possibility
to modify a multitude of virtual environments in terms of the particular
needs of the patient.
reality treatment offers many advantages comparing to traditional exposure
techniques for phobias (North, North, & Coble, 1996; Riva, Wierderhold,
& Molinari, 1998; Rothbaum & Hodges, 2002). Here are some examples
control and security
: the virtual environment allows for the control of unexpected occurrences
that may come up during exposure to the real world (jammed elevator,
plane turbulence, traffic jams). In addition, the virtual environment
allows the client to be exposed to certain fears that may be difficult
to reproduce in reality (fear of flying in an airplane) within a secure
of breaching confidentiality : Using gradual traditional
exposure techniques, the therapist must accompany the client into
different locations in order to allow the client to conquer their
fear. However, these techniques require outings into the world outside
of the office, often into a public place (e.g. fear of heights) and
this may hold certain risks for the client. Virtual therapy takes
place in the privacy of the therapist’s office, thus preserving
: Avoidance is the most commonly observed behaviour among phobic individuals.
It may also manifest itself in the course of therapy, during exposure.
In virtual therapy, is more difficult for clients to avoid the phobic
stimulus given that they are confronted with the stimulus under the
therapist’s supervision. The therapist can see on the screen
of their computer the image that has been projected into the virtual
helmet and onto the movement encoders. In this manner, the therapist
can guide the client back to the feared stimulus if the client demonstrates
the client’s rhythm : the therapist can see and hear
what the client is experiencing within the virtual environment. Should
the client’s anxiety levels become too elevated, the client
can easily return to a lower level of anxiety during the course of
treatment or may simply remove the virtual helmet. It is also possible
to repeat the sate of exposure as often as is necessary as well as
to permit the therapist to pace the sessions according to the client’s
context : virtual reality offers clients having difficulty
imagining feared situations or clients having difficulty entering
real life situations, the possibility of conquering a fear stimulus
or object in a secure context.
of animal care : for persons suffering from animal or insect
phobias, traditional « in vivo » therapy can become complicated
and expensive, because the therapist has to house and feed these living
of costs : Virtual therapy allows for the reduction of costs
often encountered with traditional therapy (plane tickets, travel).
In addition, many insurance companies do not cover sessions running
longer than the standard period of time (e.g. when leaving the office).
This is not problematic in virtual therapy given that all of the treatment
components can take place within the confines of an office during
the course of one-hour sessions. The adaptation of video or computer
games for use in virtual reality offers many advantages in terms of
the considerable reduction of consists, the possibility of creating
a multitude of different virtual environments as a function of the
client’s needs and in terms of the implementation of efficient
treatment programs for treating various types of phobia.
accessibility to services
: The prevalence of specific phobia in the general population is high
in North America, yet few people seek treatment. This type of therapy
appears to offer security for potential patients, which in itself
may motivate them to seek help. For the therapist, this technology
allows for diminished travel time (for exposure outside of the office)
thereby freeing them and making them more available to their clients
in the office.
of gains into the real world
: Virtual reality has the potential of becoming an asset for exposure
to fear stimuli in a secure context. Studies conducted by means of
virtual reality have demonstrated its efficacy longitudinally in the
treatment of acrophobia (Bouchard, St-Jacques, Robillard, Côté,
& Renaud, 2004; Emmelkamp, Bruynzeel, Drost, & van der Mast,
2001; Rothbaum & al., 1995; Schuemie & al., 2000), claustrophobia
(Botella & al., 1998; Botella, Banos, Villa, Perpina, & Garcia-Palacios,
2000; Bouchard, St-Jacques, Côté, Robillard, & Renaud,
2004) arachnophobia (Bouchard, Côté, Robillard, St-Jacques,
& Renaud, submitted ; Carlin, Hoffman, & Weghorst, 1997).