Virtual Reality: A Therapy Approach for Anxiety Disorders

Fear of heights is extremely stressful for those affected. Immersive technologies such as virtual reality therapy are providing to be successful treatment options.

Relief in the Virtual World: The Case of Richard

A man is standing on the first floor of a shopping centre. He attempts to walk about three metres away from the wall towards a metal-framed glass railing from where one can see into the inner courtyard. He breathes heavily, is sweating, takes a few steps, then backs up again, wipes his hands on his jacket and finally makes his way to a concrete pillar next to the railing. He holds on to it. It is impossible for him to stand against the railing and look down.

Richard works as a paramedic. He has suffered from a severe form of acrophobia all his life. This doesn't only affect his private life, but also his job. On missions in high buildings, he invents excuses to avoid having to participate. His fear weighs heavily on him until finally, after his retirement, he decides to undergo therapy: he wants to get rid of his fear with the help of immersive technologies.

The Virtual World as a Safe Space

Over the next few weeks, Richard receives a total of eight sessions of thirty minutes of virtual reality (VR) therapy. The treatment is based on the findings in cognitive-behavioural therapy. Each session is videotaped. A virtual coach guides Richard through the programme as he completes various tasks designed to confront him with his fear of heights. Unlike methods of real world confrontation, in VR therapy the patient experiences the anxiety-inducing situations but can confront them more easily knowing that nothing can happen to him. In this way, the virtual world becomes a safe space within reality.

The video recording shows Richard under great stress as he crosses a virtual suspension bridge. His breathing is heavy and he looks left and right several times before he manages to put his hand on the handrail of the suspension bridge to continue on his way. After four weeks of therapy, Richard again faces the challenge in the shopping centre. He is now able to walk briskly from the wall towards the railing, lean on it and look down. Richard says: "That would have been unthinkable three months ago. I would have totally avoided it, I wouldn't have even tried."

Study Data Prove Efficacy

According to Oxford VR, one in five people will suffer from a fear of heights at some point in their lives. Since most do not receive treatment, we must assume that the number of unreported cases is even higher. VR therapy has established a treatment method that doesn't require a lot of time or personnel, is low-threshold and effective.

A randomised controlled trial conducted by Oxford VR on acrophobia proved this method's effectiveness. Participants showed a significant reduction in their fear of heights by an average of 68% after VR therapy. Half of the people in the VR therapy group experienced a reduction in their fear of heights of more than 75%.

Virtual reality therapy, often in combination with cognitive behavioural therapy, has also been successfully used to treat social phobia, generalised anxiety disorder, logophobia, post-traumatic stress disorder, and depression.

Article translated from the original German version


  1. D. Freeman et al.: "Automated psychological therapy using immersive virtual reality for treatment of fear of heights: a single-blind, parallel-group, randomised controlled trial." DOI: