AnxietyExposure therapy in virtual reality (VR) could prove more effective for treating social anxiety disorder than exposure therapy in real life, according to a new study.

Initial findings published in the BJPsych suggest that for people who are so anxious of social situations that they find it almost impossible to visit a therapist, VR could provide a viable alternative.

Social anxiety disorder is characterised by an excessive fear of being negatively judged, embarrassed or humiliated during social interaction and often leads to psychiatric complications such as depression. 

Cognitive behavioural therapy (CBT) incorporating guided exposure to social situations is known to be an effective treatment for social anxiety disorder. A team of Canadian researchers looked at whether this treatment was more effective and practical in virtuo or in vivo. Participants were given 14 weekly sessions of individual CBT exposure therapy either through VR or real life before undergoing assessment. The initial findings suggested that individual CBT delivered with VR was more practical for therapists and more effective in post-treatment than individual CBT in real life.

If these findings are confirmed, this treatment delivered through VR could become the solution for patients whose disorder makes it difficult for them to see a therapist. 

Although experimental and not routine treatment, VR is already used in the UK for paranoia, phobias, dementia and teaching social skills to people with autism. 

Dr Kate Lovett, dean of the Royal College of Psychiatrists said: “Although virtual reality has been around for some time, it is only with recent advances in technology that researchers have been able to start exploring its potential use in mental health treatment. 

“This study has demonstrated that virtual reality could be used as an alternative way of exposing patients to situations they fear, in a manner that is just as effective as and potentially more practical to deliver than traditional “real life” situations. It appears to be well tolerated with minimal side effects. However, these findings will need to be replicated in further studies before its use can be recommended in routine practice. As with all therapy, this trial again demonstrates that the quality of the therapeutic relationship with the therapist is a significant factor in predicting outcomes.”

Dr Lina Gega added: "Recent evidence syntheses have shown that not only can VR have similar effects to conventional treatments, but also that these effects are transferable to real life. The added value of VR as a therapeutic tool hinges on its versatility, efficiency and ability to go beyond what we can do in real life, as well as on its potential to engage populations who for various reasons do not benefit from conventional treatments. Despite the virtues of virtual reality, we are far from making it part of our clinical reality; above all, the proof of the virtual pudding, is in the real-life eating." 

For more information, visit the BJPsych website.