5 The use of VR in the treatment of panic disorders and agoraphobia (original) (raw)
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The use of VR in the treatment of panic disorders and agoraphobia
Studies in health technology and informatics, 2004
Panic disorder with agoraphobia (PDA) is considered an important public health problem. The efficacy of cognitive-behavioral therapy (CBT) for PDA has been widely demonstrated. The American National Institute of Health recommended Cognitive-Behavioral programs as the treatment of choice for this disorder. This institution also recommended that researchers develop treatments whose mode of delivery increases the availability of these programs. Virtual Reality based treatments can help to achieve this goal. VR has several advantages compared with conventional techniques. One of the essential components to treat these disorders is exposure. In VR the therapist can control the feared situations at will and with a high degree of safety for the patient, as it is easier to grade the feared situations. Another advantage is that VR is more confidential because treatment takes place in the therapist's office. It is also less time consuming as it takes place in the therapist's office. C...
Journal of CyberTherapy and Rehabilitation, 2012
Our objective was to compare the effects of Virtual reality exposure therapy (VrEt), cognitive behavior therapy (cBt), and a waitlist control condition in patients with panic disorder with agoraphobia (PdA). ninety two outpatients were initially randomized in three arms, 29 treated with VrEt, 31 with cBt, and 32 assigned to the waitlist. At the end of a 12-week period, the patients assigned to the waitlist were re-randomized in VrEt or cBt groups. no between-group significant differences appeared at the end of the first phase, however a lower responder rate was observed in the waitlist group. After the second randomization, response rates were not different in the VrEt and cBt groups (respectively 38.7% and 48.5%; p=0.46). during the 9-month follow-up period, the response rates remained stable without differences between groups. thus, VrEt seems to be an effective treatment for PdA with short-term and long-term therapeutic results equivalent to those obtained with cBt.
Virtual Reality Exposure in the Treatment of Panic Disorder With Agoraphobia: A Case Study
Cognitive and Behavioral Practice, 2007
In this work we present a case example of the use of virtual reality exposure for the treatment of panic disorder with agoraphobia. The assessment protocol and procedure (including a baseline period) and the cognitive-behavioral treatment program are described. The clinical measures were categorized into target behaviors, panic and agoraphobia measures, global functioning, and general psychopathology measures. The patient's expectations and satisfaction with regard to the virtual treatment were also assessed. The results showed an important reduction in all clinical measures after treatment with virtual exposure and the patient reached the therapeutic goals established during the pretreatment assessment. The patient also reported a good acceptance of virtual exposure. The goals achieved in the virtual environment generalized to real agoraphobic situations and to other real situations not treated. Three-, 6-, and 12-month follow-up assessments were conducted and long-term therapeutic gains were maintained.
Virtual reality exposure in the treatment of panic disorder and agoraphobia: A controlled study
2007
Abstract The main goal of this study was to offer data about the efficacy of virtual reality exposure (VRE) in the treatment of panic disorder with or without agoraphobia (PDA). The study was a between-subject design with three experimental conditions (VRE group, in vivo exposure [IVE] group and waiting-list [WL] group) and repeated measures (pre-treatment, post treatment and 12 month follow-up). The treatment programmes lasted 9 weekly sessions.
Psychotherapy and Psychosomatics, 2013
avoidance measures and cognitive measures. Further, it was shown that initial changes in agoraphobic cognitions during the CBT phase predicted later changes in agoraphobic avoidance behavior. Conclusion: These data support the notion that therapeutic processes involved might be the same in VRET and exposure in vivo. However, given the slight superiority of exposure in vivo above VRET, the costs involved in the implementation of VRET and the lack of long-term follow-up, VRET cannot yet be recommended for patients with agoraphobia.
The combined use of virtual reality exposure in the treatment of agoraphobia
Actas españolas de psiquiatría
This study compares the differential efficacy of three groups of treatments for agoraphobia: paroxetine combined with cognitive-behavioral therapy, paroxetine combined with cognitive-behavioral therapy and virtual reality exposure, and a group with only paroxetine. 99 patients with agoraphobia were finally selected. Both combined treatment groups received 11 sessions of cognitive-behavioral therapy, and one of the groups was also exposed to 4 sessions of virtual reality treatment. Treatments were applied in individual sessions once a week for 3 months. The three treatment groups showed statistically significant improvements. In some measures, combined treatment groups showed greater improvements. The virtual reality exposure group showed greater improvement confronting phobic stimuli. Treatments combining psychopharmacological and psychological therapy showed greater efficacy. Although the use of new technologies led to greater improvement, treatment adherence problems still remain.
Behavioural and Cognitive Psychotherapy, 2021
Background:Cognitive behavioural therapy (CBT) is an effective treatment for panic disorder with agoraphobia (PDA). However, implementation of some of the procedures involved, particularly in vivo exposure, can be time consuming and taxing for routine health care services. CBT with exposure taking place in virtual reality (VR-CBT) is a more time-efficient option and has shown promising results in the treatment of PDA. However, VR-CBT requires expensive equipment and appropriate virtual environments, which historically has been costly and cumbersome to produce. Thus, access to VR-CBT has been sparse in regular care environments.Aims:The aim of this study was to investigate whether VR-CBT using filmed virtual environments produced with a low-cost 360-degree film camera can be a feasible and acceptable treatment for PDA when implemented in a primary care context.Method:This was an open feasibility trial with a within-group design, with assessments conducted at pre-test, post-test, and ...
Clinically Significant Virtual Environments for the Treatment of Panic Disorder and Agoraphobia
CyberPsychology & Behavior, 2004
The aim of this work is the description of virtual environments designed to apply exposure therapy in the treatment of panic disorder and agoraphobia. The program allows the simultaneous exposure to two different kinds of stimuli usually avoided by panic disorder and agoraphobia sufferers (external and interoceptive). The characteristics of the virtual environments are described, as well as the target behaviors that can be simulated with these virtual environments.
International Journal of Clinical and Health Psychology, 2011
Currently, some psychopharmacological treatments, cognitivebehavioral therapies (CBT), and a combination of both are considered effective treatments for agoraphobia. Among psychological treatments, new therapeutic alternatives such as virtual reality exposure treatment (VRET) have been developed. The aim of this experimental study was to evaluate the ef¿ cacy of VRET combined with two antidepressant drugs (venlafaxine and paroxetine) in a sample of agoraphobia patients (N = 64), using a virtual system consisting of seven scenarios. Five types of treatment were compared: four combined treatment groups and one psychopharmacological treatment. Measures were taken at pre-treatment, posttreatment, and six-month follow-up; agoraphobia and anxiety measures were used as dependent variables. Results showed that all groups were statistically effective, both at post-treatment and six-month follow-up. However, based on clinical ef¿ cacy, results showed that combined treatment groups including VRET appeared to be better than traditional techniques at decreasing agoraphobia and anxiety measures and keeping them lower over time. Int J Clin Health Psychol, Vol. 11. Nº 2 190 GONZALEZ LORENZO et al. Ef¿ icacy of virtual reality exposure therapy and agoraphobia KEY WORDS. Agoraphobia. Virtual reality. Cognitive-behavioral treatment. Pharmacological treatment. Experimental study.