Exploring the effectiveness of virtual exposure therapy in treating adult patients with contamination-based obsessive-compulsive disorder: a review of the literature
Location
Center for Advanced Learning and Simulation (CALS)
Publication Date
April 2025
Start Date
17-4-2025 8:00 AM
Description
Background: Cognitive behavioral therapy (CBT) with exposure response prevention (ERP) is the first line treatment for obsessive compulsive disorder (OCD). Two different modalities, imaginal exposure and in vivo exposure, have shown strengths and limitations for patients with OCD. Different subtypes of OCD have differing responses to each of these modalities, and each approach should be carefully considered for effective treatment. Virtual exposure therapy uses virtual reality (VR) technology to help individuals confront and overcome fears, or anxiety-inducing situations. It involves the use of VR equipment, such as a headset, handheld controllers or motion sensors. An individual experiences a simulated environment depending on their specific fear or anxiety, and can often interact with the virtual world or navigate through it in real-time. In some cases, the therapy might also include objective sensors to track the patient’s physical responses (like heart rate or body movement) to monitor anxiety levels. The therapist typically guides the session, adjusting the environment or pacing to ensure the person is gradually exposed to the fear in a manageable way. This literature review assesses the efficacy of virtual-based exposure therapy for contamination subtype of OCD (C-OCD). Methods: A literature review search examined the current research from the last decade on the effectiveness of an emerging virtual-based exposure therapy for treating C-OCD in adults. Results: In patients with a contamination subtype of OCD (C-OCD), imaginal exposure often lacks realistic stressors, thus provoking a minimal stress response needed to work through the avoidance behavior. In patients undergoing in vivo exposure, limitations include issues related to safety, cost effectiveness, and feasibility. Findings show potential for effective improvement of symptoms of C-OCD when exposed to a safety-controlled, sensible, reproducible, and graded virtual environment. However, technical-supported exposure therapy requires a degree of realism for patients to feel adequately immersed and optimize their sense of presence and acceptability, further revealing the idiosyncratic nature of contamination fears. Conclusions: Costs and time invested in creating a virtual environment are also to be considered and expected to expand as this treatment modality becomes more precise and tailored to one’s symptomatic profile. The few and small-sampled randomized control trials in recent years limit the generalizability of this therapy’s efficacy in treating patients with C-OCD, hence the need for further research.
Recommended Citation
Ezedine, Oriane and Bierma, Shane PhD, "Exploring the effectiveness of virtual exposure therapy in treating adult patients with contamination-based obsessive-compulsive disorder: a review of the literature" (2025). Dept. of Psychiatry Research Symposium. 16.
https://digitalscholar.lsuhsc.edu/psych_rd/2025/presentations/16
Exploring the effectiveness of virtual exposure therapy in treating adult patients with contamination-based obsessive-compulsive disorder: a review of the literature
Center for Advanced Learning and Simulation (CALS)
Background: Cognitive behavioral therapy (CBT) with exposure response prevention (ERP) is the first line treatment for obsessive compulsive disorder (OCD). Two different modalities, imaginal exposure and in vivo exposure, have shown strengths and limitations for patients with OCD. Different subtypes of OCD have differing responses to each of these modalities, and each approach should be carefully considered for effective treatment. Virtual exposure therapy uses virtual reality (VR) technology to help individuals confront and overcome fears, or anxiety-inducing situations. It involves the use of VR equipment, such as a headset, handheld controllers or motion sensors. An individual experiences a simulated environment depending on their specific fear or anxiety, and can often interact with the virtual world or navigate through it in real-time. In some cases, the therapy might also include objective sensors to track the patient’s physical responses (like heart rate or body movement) to monitor anxiety levels. The therapist typically guides the session, adjusting the environment or pacing to ensure the person is gradually exposed to the fear in a manageable way. This literature review assesses the efficacy of virtual-based exposure therapy for contamination subtype of OCD (C-OCD). Methods: A literature review search examined the current research from the last decade on the effectiveness of an emerging virtual-based exposure therapy for treating C-OCD in adults. Results: In patients with a contamination subtype of OCD (C-OCD), imaginal exposure often lacks realistic stressors, thus provoking a minimal stress response needed to work through the avoidance behavior. In patients undergoing in vivo exposure, limitations include issues related to safety, cost effectiveness, and feasibility. Findings show potential for effective improvement of symptoms of C-OCD when exposed to a safety-controlled, sensible, reproducible, and graded virtual environment. However, technical-supported exposure therapy requires a degree of realism for patients to feel adequately immersed and optimize their sense of presence and acceptability, further revealing the idiosyncratic nature of contamination fears. Conclusions: Costs and time invested in creating a virtual environment are also to be considered and expected to expand as this treatment modality becomes more precise and tailored to one’s symptomatic profile. The few and small-sampled randomized control trials in recent years limit the generalizability of this therapy’s efficacy in treating patients with C-OCD, hence the need for further research.