Short-Term Treatment of Acrophobia with Virtual Reality Therapy (VRT): A Case Report

ACROPHOBIA (HEIGHT PHOBIA) is classified as a Specific Phobia, Natural Environment Type in the Diagnostic and Statistical Manual of Mental Disorders.1 Natural Environment Type should be specified if objects in the natural environment, such as storms, heights, or water cue the fear. Height phobia generally has a childhood onset and is diagnosed somewhat more frequently in females than in males. This disorder may result in a restricted lifestyle or interference with certain occupations, depending on the severity. There have been relatively few publications that focused on controlled research on the therapy for treating acrophobia. Behavioral therapy has included exposing the subject to anxiety-producing stimuli. These stimuli are generated through a variety of modalities including imaginary (subject generates stimulus via imagination) and in vivo (subject experiences the real world).2 In addition to current in vivo and imaginary modalities, virtual environments (VEs) can also generate stimuli that will be utilized in desensitization therapy. As in in vivo, systematic desensitization provides stimuli for the patient who cannot imagine well. VE based on stereoscopic head-mounted displays with head tracking will produce visual and auditory stimuli. Unlike the in vivo technique, VE allows therapist-assisted systematic desensitization (SD) within the confines of a clinician’s office, thus avoiding public embarrassment and violation of the patient’s confidentiality. VE adds the advantage of greater control over graded exposure stimulus parameters, and the ability to isolate which virtual stimulus parameters are essential in generating a phobic response, as well as greater efficiency and economy in delivering the equivalent of in vivo exposure within the therapist’s office.3 Several studies for treating patients with acrophobia using virtual reality therapy (VRT) have been published and results were relatively good.4,5 The authors have been treating patients with various phobias during the last 2 years and we found rapid improvement of phobic symptoms among patients who received VRT.