The Effectiveness of Virtual Reality-Based Treatments in Reducing Specific Phobias and Increasing Exposure Tolerance in Patients

The present study aimed to investigate the effectiveness of virtual reality-based treatments in reducing the severity of specific phobias and enhancing exposure tolerance in patients with phobic disorders. This study employed a quasi-experimental clinical trial design with a pretest–posttest control group. The statistical population consisted of all patients with specific phobias who referred to counseling centers and psychotherapy clinics in Tehran in ۲۰۲۵. From this population, ۴۰ eligible participants were randomly assigned to two groups of ۲۰: a virtual reality-based exposure therapy group and a traditional in vivo exposure therapy (control) group. Data were collected using the Spielberger Phobia Questionnaire (SPQ), the State–Trait Anxiety Inventory (STAI), and the Exposure Tolerance Index (ETI). The experimental group underwent eight ۴۵-minute sessions of virtual reality exposure therapy, while the control group received traditional in vivo exposure therapy. Data analysis was performed using repeated-measures ANOVA and independent t-tests in SPSS version ۲۶. Participants included individuals diagnosed with specific phobias (e.g., fear of heights, animals, flying, or injections) based on DSM-۵ criteria, aged ۱۸–۴۵ years, and without severe psychiatric comorbidities. The results revealed a significant difference between the two groups in terms of phobia severity reduction (p < ۰.۰۱). Patients receiving virtual reality-based treatment exhibited greater reductions in anxiety and fear scores and a marked increase in exposure tolerance compared to those in the traditional exposure group. Follow-up assessments two months later indicated relative stability of therapeutic effects in the virtual reality group, whereas partial relapse was observed in the traditional exposure group. Furthermore, patient satisfaction and treatment acceptance were significantly higher in the virtual reality condition. Findings suggest that virtual reality-based treatments can serve as an effective and safe alternative to traditional exposure therapy for patients with specific phobias. The use of virtual environments enhances the sense of control, reduces anxiety, facilitates gradual exposure, and improves patients’ tolerance toward fear-inducing situations. Given the demonstrated efficacy, safety, and acceptability of this approach, virtual reality exposure therapy can be considered a novel and efficient method for treating anxiety and phobic disorders. Future studies are recommended to employ larger sample sizes and longer follow-up periods to further examine the durability of treatment effects.

Keywords:

Virtual Reality , Specific Phobia , Exposure Therapy , Anxiety , Exposure Tolerance , Cognitive-Behavioral Therapy