Combining cognitive-behavioral therapy with virtual reality technology could help people suffering from social anxiety disorder, according to preliminary research published in the journal Behavioural and Cognitive Psychotherapy.

“I am interested in the topic of virtual reality (VR) based therapies as the open a lot of new possibilities. VR surroundings are accessible, interactive and customizable to fit the needs of a patient,” explained Chris N. W. Geraets, a PhD student at the University of Groningen and corresponding author of the study.

“Specific triggers which cause anxiety can be incorporated in the VR worlds to form the perfect safe environment for practice. Especially for patients with severe generalized anxiety disorders who tend to be reluctant to engage in therapy this form of therapy can be a good first step in treatment.”

In the study, psychotherapists provided cognitive behavioral therapy to 15 patients with generalized social anxiety disorder. This type of therapy often requires patients to be exposed to situations that provoke their anxiety. But for the study, this was accomplished with the aid of virtual reality environments.

The patients attended up to 16 one-hour VR sessions, which were provided once or twice a week. During each session, the patients navigated one of four virtual environments: a street, bus, café or supermarket.

Two patients dropped out of the study. But the remaining participants reported less anxiety at social encounters, less paranoia in everyday life, less social interaction anxiety, fewer depressive symptoms and an improved quality of life following the treatment.

“Even though VR is not real, it is real enough to get psychological and physical reactions. We can use this to give therapy with VR exposures too hard to treat groups with low thresholds,” Geraets told PsyPost.

The findings provide some initial evidence that virtual reality-based therapy can be effective in the treatment of social anxiety. But more research is needed.

“We still need to study whether VR-CBT works faster or better than regular CBT. We expect this might be the case as a larger emphasis is placed on the behavioral part of the therapy and thus experiencing in VR surroundings and practicing with behavior,” Geraets explained.

“Furthermore, even after the therapy there was still room for improvement in symptoms. So I think we need to learn more about how we can best integrate this type of therapy”

“VR software and hardware are being improved continuously. One thing we missed was flexible interaction, at present this is actually possible with the software we use,” Geraets added.

The study, “Virtual reality-based cognitive behavioural therapy for patients with generalized social anxiety disorder: a pilot study“, was authored by Chris N.W. Geraets, Wim Veling, Maartje Witlox, Anton B.P. Staring, Suzy J.M.A. Matthijssen, and Danielle Cath.