The number of mental illnesses is growing - and with it the need for good therapies. What is the benefit of treating depression and anxiety with virtual reality? Researchers from New Zealand have evaluated studies.
The Guidelines for the Treatment of Panic Disorder, Social Anxiety Disorder and Generalised Anxiety Disorder and the Guidelines for the Treatment of Mood Disorders of the Royal Australian and New Zealand College of Psychiatrists recommend cognitive behavioural therapy, in which patients themselves identify and change thought patterns that negatively influence their actions, as a first-line treatment for anxiety and depression. Phobic anxiety disorders are often treated with expression therapy. In this form of behavioural therapy, the patient is exposed to the feared object or situation and is supposed to realise that the fear is unfounded.
However, exposure therapy strongly interferes with the patient's privacy because it often takes place in public. Treatment with virtual reality (VR for short) is therefore a welcome alternative and is now widely used to treat a variety of mental illnesses. Computer simulations are used to create imaginary stressful situations. Patients with depression and anxiety are treated with this technology, for example to treat arachnophobia or fear of heights. Many patients would find this form less private and frightening, and therapists could thus adapt the treatment even more individually to the patients' needs, as a study by the Ruhr University in Bochum, Germany comparing acceptance and rejection rates showed.
If the two forms of therapy are already successful on their own, how effective are they when the two are combined? Researchers from the Department of Natural and Computational Sciences at Massey University in Auckland and other institutions in New Zealand investigated this. Among other things, they wanted to know which interventions using virtual reality have been studied in the last four years in the treatment of depression and anxiety disorders? They also wanted to find out whether behavioural therapy was used in virtual reality expression therapy or in addition to a virtual reality intervention, and how effective this method is in treating anxiety or depression. Their review study incorporates data from 34 studies published between 2017 and 2021.
74% of these studies dealt with anxiety, 12% with depression and the rest with distressing factors such as stress or post-traumatic stress disorder. The most common anxieties included social phobias, generalised anxiety disorder and speech anxiety. Virtual reality environments or scenarios were predominantly workplaces or job interviews. Conference rooms or classrooms were used for anxiety about public speaking, and nature experiences such as underwater worlds for anxiety as well as depression.
According to the authors, most of the studies reviewed showed that the use of virtual reality to support the treatment of anxiety or depression was effective in a range of settings and that they had potential in clinical settings. Nine studies specifically mentioned the use of cognitive behavioural therapy. In 56% of the studies it was delivered within a virtual reality environment and in the rest it was an adjunct to virtual reality expressive therapy. In addition, in most studies there was a follow-up session after the intervention to assess the effects of the therapy and whether improvements in anxiety or depression were maintained in participants. Most studies indicate efficacy and acceptability in a range of clinical settings.