Virtual reality could soon become the first-line therapy for people scared of heights
Virtual reality could soon become the first-line therapy for people scared of heights, according to the authors of a systematic review on acrophobia treatments.
Their evaluation of 16 meta-analyses found that virtual reality might be just as efficacious as in-vivo exposure and the dropping price and greater availability of the technology made it an attractive option going forward.
Virtual-reality equipment, which exposed patients to computer-generated height scenarios, could be used in the therapist’s office and had high acceptability.
Combining virtual-reality exposure with medication was an emerging therapy that showed promise, the authors said.
Medication, such as D-Cycloserine (Closina), is thought to help patients learn the process required to overcome the fear associated with the phobia trigger, the authors said.
The systematic review revealed that desensitisation, in-vivo exposure and virtual-reality exposure were all likely to be effective, in the short term at least.
Desensitisation trains patients in self-control and relaxation methods, before slowly introducing the fear-producing stimulus.
This was done either in picture form or imagined in the studies included in this review. In-vivo exposure takes it further by presenting real-world situations the patient is fearful of, but ensuring that anxiety is kept at a manageable level.
In more recent years, however, virtual-reality exposure seemed to be overtaking the former two interventions as the therapy of choice for acrophobics, they found.
Neurolinguistic programming was another intervention studied, which operates in a similar way to virtual reality exposure, but using the patient’s imagination instead of a device.
“Neurolinguistic programming has also been shown to be a brief, effective treatment, easily delivered with minimal training required for practitioners, so this too may prove a popular choice for clients and clinicians alike,” they wrote.
This study is one of the few, if only, comparisons of treatment for acrophobia. But the authors said that the current evidence base for the long-term benefit of any of the interventions was limited.
Nevertheless, treatment times have been dropping substantially over the last few decades, from a median of 218 minutes in 1980 to 60 minutes by 2016.
In New Zealand, 13% of patients visiting their GPs had a phobia, the authors wrote in background information.
MJA 2017; online 4 April
