Many studies confirm that VRGET (also called experiential cognitive therapy or “ECT” in European countries) is more effective than conventional imaginal exposure therapy that uses mental imagery to provoke a feared object or situation. The effectiveness of VRGET is comparable to in vivo exposure therapy in which an anxious person is directly exposed to a feared object or situation. Like in-vivo and imaginal exposure therapy, VRGET has the goal of desensitizing the patient to a situation or object that would normally cause anxiety or panic. Many individuals who struggle with generalized anxiety or phobias frequently can’t tolerate the stress caused by conventional exposure therapy and often remain chronically impaired because they are never able to become desensitized to a feared object or situation.
VRGET is an effective treatment of many anxiety problems including specific phobias such as fear of flying and fear of heights, generalized anxiety, panic disorder with agoraphobia and post-traumatic stress disorder. One study found that VRGET and conventional cognitive-behavioral therapy were equally effective treatments of panic disorder with agoraphobia, however individuals who underwent VRGET required 1/3 fewer sessions to achieve the same level of improvement in symptoms. In one study 2/3 of adults diagnosed with a specific anxiety disorder reported significant reductions in 4 of 5 anxiety measures.
VRGET is as effective as conventional exposure therapy for fear of flying, and is more cost-effective because both patient and therapist avoid significant time commitments and the need to use airplanes (i.e., for ‘in vivo’ exposure). In a pilot study individuals who overcame fear of flying using VRGET combined with biofeedback were able to fly without the use of conventional medications or alcohol 3 months after treatment ended. VRGET is also beneficial for severely traumatized patients diagnosed with PTSD. A virtual environment that simulates the devastation that took place following the September 11, 2001 attacks of the World Trade Towers has been successfully used to treat individuals who suffered from severe PTSD following the attacks. VGRET is proving to be an effective treatment of PTSD in combat veterans returning from the middle-east conflicts.
Future integrative approaches to phobias, panic attacks, PTSD and other severe anxiety problems will combine VRGET with biofeedback in outpatient settings or in the patient’s home via broadband internet connections, with conventional cognitive-behavioral approaches, mind-body practices, and appropriate prescription medications when they are called for.
A small percentage of individuals experience transient disorientation, nausea, dizziness, headache and blurred vision when in a virtual environment. “Simulator sleepiness” is a feeling of generalized fatigue that occurs infrequently. Intense sensory stimulation during VRGET can trigger migraine headaches, seizures, or gait abnormalities in individuals who have these medical problems and should not be used by individuals diagnosed with these medical problems. Individuals who abuse alcohol or narcotics should not use VRGET. Finally, individuals diagnosed with schizophrenia or another psychotic disorder should not use VRGET because immersion in a virtual environment can make delusions worse and (further) impair a psychotic individual’s ability to distinguish reality from fantasy.
You can find out more about virtual reality graded exposure therapy (VRGET) and other safe and effective complementary and alternative treatments of anxiety, and learn practical tips for using them in “Anxiety: the Integrative Mental Health Solution,” by James Lake M.D.