Despite strong evidence of effectiveness, exposure therapy is an underutilized treatment for anxiety disorders at a time when effective treatment for anxiety is greatly needed. The significant worldwide prevalence and negative impact of anxiety are documented and highlight the importance of increasing therapist and patient use of effective treatment. Incorporating VR in therapy can increase the ease, acceptability, and effectiveness of treatment for anxiety. VR exposure therapy (VRET) permits individualized, gradual, controlled, immersive exposure that is easy for therapists to implement. VR is presented as a scalable tool that can augment access to and effectiveness of exposure therapy thus improving treatment of anxiety disorders.

Anxiety disorders are among the most common of mental disorders affecting nearly 18.1% of adults. The estimated prevalence of anxiety disorders worldwide is 7.3% , and they cause a high proportion of the global burden of disease. Anxiety symptoms can cause significant distress, impair quality of life, and increase stress. Anxiety increases risk for a range of co-occurring physical conditions, including chronic pain. Given the pervasiveness of anxiety and its impact on mental and physical health, effective treatment is clearly needed, yet a majority of affected individuals remain untreated.

VR consists of a fully immersive, 3-D environment that transports people to engaging, interactive environments that can promote new learning. VR technology can provide patients with a physiologically and emotionally evocative experience which can make VR a valuable tool for mental health treatment. VRET has been used for the treatment of a range of conditions including social anxiety, Post-Traumatic Stress Disorder (PTSD), and panic disorder. Our clinicians can incorporating VR technology into the therapeutic process that can improve the ease, acceptability, and effectiveness of treatments for anxiety.

Exposure therapy for anxiety disorders has a strong evidence base, yet few therapists utilize this method and patient and therapist misconceptions limit its availability. Exposure therapy involves gradual and repeated exposure to feared stimuli with resultant changes in cognitions, behaviors, and emotional and physical responses. Feared stimuli can be almost anything: living organisms, inanimate objects, situations, activities, thoughts, mental images, physical symptoms, and/or affective experiences. Extensive research demonstrates the efficacy of exposure-based therapy for various anxiety disorders, especially phobias. Exposure facilitates extinction of the fear response and helps change dysfunctional assessments of threat and unhelpful responses, reducing the conditioned anxiety associated with feared stimuli. Gradual exposure allows habituation and re-evaluation of the threat to occur.

Clinically, VRET is a practical, empirically-based treatment that makes exposure therapy easier and more acceptable for therapists and patients. It can help patients learn and practice anxiety management skills and permits controlled, gradual exposure, which minimizes distress and optimizes treatment success.

Unfortunately, although exposure therapy can relieve anxiety symptoms ranging from mild to severe, many therapists may not offer it and patients may be reluctant to try it, contributing to the treatment gap for anxiety. However, VR technology is available and being used at Brightside Behavioral Health.

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