Last Updated on Tuesday, 20 July 2010 14:37

About 10 -  25% of us are estimated to suffer from fear of flying. According to a presentation by Dr. Page Anderson, director of clinical services for Virtually Better Inc., Decatur, Georgia, at the World Congress of Behavioural and Cognitive Therapies, exposure therapy using office-based virtual reality technology results in marked improvements in people who fear flying.

Dr. Anderson reported the findings of a randomized controlled study conducted by Dr. Barbara Rothbaum and colleagues, from the Emory University, Atlanta.

The 49 patients participating in the study were assigned to three groups: the virtual reality exposure therapy (VRE), standard exposure therapy (SE), or a wait-list control.

Both therapeutic groups showed significant improvements when compared to the wait-list control, as assessed by two fear-of-flying questionnaires. Additionally, immediately after treatment, these patients were 3.5 times more willing to fly compared to those on the wait-list, which was measured by a post-treatment flight from Atlanta to Houston. The treatment benefits were maintained even after 6 months of completing the therapy. Patients in both the treatment groups showed similar improvements, with 93% of them in each group having flown within 6 months post-treatment.

The treatment comprised 8 sessions over a period of 6 weeks, with 4 sessions of anxiety management training, which was followed by either VRE, which involved exposure to a virtual airplane or SE, which was exposure to an actual airplane at the airport.

The anxiety management sessions included:

• Explaining the rationale for exposure therapy

• Retraining for breathing

• Instructing on how to manage the physical signs of anxiety like increased heart rate

• Cognitive restructuring to overcome irrational thoughts

• Instructing on stoppage of thought to combat ruminative thinking

The SE therapy included two trips of a total duration of 4 hours to the Atlanta airport, where they were made to go through pre-flight experiences like ticketing and being in the waiting area, seating on a stationary airplane, and imaginary takeoff, cruising, and landing.

Those in the VRE group underwent 4 sessions, each lasting for an hour in a special chair in the Virtually Better Inc. offices. A woofer was fit under the seat of this chair in order add noise and vibrations. Patients were made to wear a head-mounted visual display and then, listen to sounds that simulated the environment on an aircraft. The patients were exposed to a hierarchy of events, and they were allowed to progress across these events at their own pace.

These events included:

• Being seated on the plane when the engines were off

• Being seated on the plane when the engines were on

• Taxiing

• Taking off

• Having a smooth flight

• Landing

• Going through a thunderstorm

• Going through a turbulent flight

Dr. Anderson said that the initial focus of Virtually Better Inc. was on the benefits virtual reality therapy would offer for the therapist. This therapy consumed less time of the therapist and was more cost-effective, when compared to stepping out of office in order to accompany patients to the airport. At the same time, the appeal of this therapy to patients cannot be underestimated. Many patients who would never want to get on an airplane are more than willing to deal with their fears in the virtual world.

Additionally, other patients who do not want to undergo psychotherapy give in to virtual reality therapy because, according to them, it is the computer which is helping them overcome their fears and not the therapist.

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