Cognitive-behavioral therapy augmented with virtual reality in the treatment of generalized anxiety disorders

Virtual reality (VR) was introduced to maximize the effect of cognitive behavioral therapy (CBT) by efficiently performing exposure therapy. The purpose of this study was to find out whether VR-based individual CBT with relatively few treatment sessions is effective in improving social anxiety disorder (SAD). This therapy was applied to 115 patients with SAD who were retrospectively classified into 43 patients who completed the nine or 10 sessions normally (normal termination group), 52 patients who finished the sessions early (early termination group), and 20 patients who had extended the sessions (session extension group). The Brief Fear of Negative Evaluation Scale (BFNE) scores tended to decrease in all groups as the session progressed, and the slope of decrease was the steepest in the early termination group and the least steep in the session extension group. Severity of social anxiety in the last session and symptom reduction rate showed no significant group difference. Our findings suggest that short-term VR-based individual CBT of nine to 10 sessions may be effective. When the therapeutic effect is insufficient during this period, the additional benefit may be minimal if the session is simply extended. The improvement in the early termination group suggests that even shorter sessions of five or six can also be effective.

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Efficacy of Cognitive Behavioral Therapy for Anxiety Disorders: A Review of Meta-Analytic Findings

Psychiatric Clinics of North America ◽

10.1016/j.psc.2010.04.002 ◽

2010 ◽

Vol 33 (3) ◽

pp. 557-577 ◽

Cited By ~ 219

Author(s):

Bunmi O. Olatunji ◽

Josh M. Cisler ◽

Brett J. Deacon

Keyword(s):

Cognitive Behavioral Therapy ◽

Anxiety Disorders ◽

Behavioral Therapy ◽

Cognitive Behavioral

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One-year randomized trial comparing virtual reality-assisted therapy to cognitive–behavioral therapy for patients with treatment-resistant schizophrenia

npj Schizophrenia ◽

10.1038/s41537-021-00139-2 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Laura Dellazizzo ◽

Stéphane Potvin ◽

Kingsada Phraxayavong ◽

Alexandre Dumais

Keyword(s):

Virtual Reality ◽

Cognitive Behavioral Therapy ◽

Psychiatric Symptoms ◽

Behavioral Therapy ◽

Controlled Trial ◽

Comparative Trial ◽

Cognitive Behavioral ◽

Treatment Resistant ◽

Auditory Verbal Hallucinations

AbstractThe gold-standard cognitive–behavioral therapy (CBT) for psychosis offers at best modest effects. With advances in technology, virtual reality (VR) therapies for auditory verbal hallucinations (AVH), such as AVATAR therapy (AT) and VR-assisted therapy (VRT), are amid a new wave of relational approaches that may heighten effects. Prior trials have shown greater effects of these therapies on AVH up to a 24-week follow-up. However, no trial has compared them to a recommended active treatment with a 1-year follow-up. We performed a pilot randomized comparative trial evaluating the short- and long-term efficacy of VRT over CBT for patients with treatment-resistant schizophrenia. Patients were randomized to VRT (n = 37) or CBT (n = 37). Clinical assessments were administered before and after each intervention and at follow-up periods up to 12 months. Between and within-group changes in psychiatric symptoms were assessed using linear mixed-effects models. Short-term findings showed that both interventions produced significant improvements in AVH severity and depressive symptoms. Although results did not show a statistically significant superiority of VRT over CBT for AVH, VRT did achieve larger effects particularly on overall AVH (d = 1.080 for VRT and d = 0.555 for CBT). Furthermore, results suggested a superiority of VRT over CBT on affective symptoms. VRT also showed significant results on persecutory beliefs and quality of life. Effects were maintained up to the 1-year follow-up. VRT highlights the future of patient-tailored approaches that may show benefits over generic CBT for voices. A fully powered single-blind randomized controlled trial comparing VRT to CBT is underway.

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