Virtual reality exposure therapy for fear of spiders: an open trial and feasibility study of a new treatment for arachnophobia

Abstract

Purpose

This analogue pilot study examined the feasibility (i.e. preliminary results, safety, acceptability) of a new single-session treatment for adults with a fear of spiders.

Materials

It used state-of-the-art consumer available VR-hardware for therapist-assisted exposure (VRET–AP). The VRET-AP is largely adapted from Öst’s one-session treatment for arachnophobia (Öst, 1987), with the aim of addressing shortcomings of previous VRET treatments, such as marked differences in procedures compared to available and evidence based in-vivo treatments.

Method

Participants (N = 12) were screened for fear of spiders using the Spider Phobia Questionnaire (SPQ), Fear Questionnaire (FQ) and the Behavioral Approach Test (BAT), prior to and directly after treatment in a repeated measures quasi-experimental design. In addition, acceptance and completion rates were measured and participants were interviewed about their experience of the treatment. Mean ratings as well as Reliable Change Index (RCI) for individual trajectories were analyzed.

Results

The results from the preliminary data indicates potential for improvements with large effect sizes (d = 0.90-1,384) in all measurements of spider fear at post-treatment. Reliable Change Index (RCI) analysis showed that spider fear diminished in all twelve participants although the change was certain in only two. None deteriorated. All that responded accepted the treatment and all 11 participants completed all levels in the treatment. No concerns or adverse effects were reported in the interviews which largely confirm the quantitative results.

Conclusion

VRET-AP is a feasible alternative for delivering effective treatment for fear of spiders and the results motivate larger, randomized trials of VRET-AP involving participants diagnosed with arachnophobia.

Keywords:

• Exposure therapy
• one-session treatment
• spider phobia
• arachnophobia
• virtual reality
• anxiety
• CBT

Acknowledgements

Dr Jonas Alhstedt at Lund University Bioimaging Center for designing the VR-environment and providing technical assistance during data collection, and professor Sean Perrin at the Department of Psychology at Lund University for reading and providing valuable insight on our manuscript.

Ethics approval statement

The study was scrutinized and approved by the Swedish Ethical Review Authority, DNR 2020-04785.

Ethics and integrity statement

All data is fully anonymous. A licensed psychiatrist and psychologist with experience within the field developed the treatment and oversaw all treatment. The participants had access to further treatment through the researchers after the intervention if needed. The research was scrutinized and approved by the Swedish Ethical Review Authority, DNR 2020-04785.

Patient consent statement

All participants gave their written and informed consent to participate.

Permission to reproduce material from other sources

No material from other sources is reproduced in this research.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Additional information

Notes on contributors

Jacob Andersson

Jacob Andersson, LP, is a Licensed Psychologist in Stockholm child and adolescent psychiatric care. His research interest concern technology’s potential to innovate and improve mental health treatment with a focus on the application of virtual reality for psychotherapy interventions.

Joel Hallin

Joel Hallin, MD, is a Physician at Lund University hospital, with a research interest in technology and its various applications within the field of medicine, ranging from AI to VR.

Anders Tingström

Anders Tingström, MD, PhD, is a Professor and Chief Physician in Psychiatry at Lund University, Sweden. He has centered his research on studies of neuronal plasticity in animal models of depression. This specialized work contributes to the understanding and treatment of depressive disorders.

Jens Knutsson

Jens Knutsson, LP, PhD, is an associate Professor at Lund University, practicing in the field of adolescent bipolar disorder. Knutsson’s research interest is clinical psychology with a focus on treatment effects and processes within psychotherapy of anxiety disorders and multi-family treatment of adolescent bipolar disorder.