In Vivo Versus Augmented Reality Exposure for Small Animal Phobia
Condition: Phobic Disorders
MeSH terms: Phobic Disorders
Study type: Interventional

Summary: 
      The aim of this study is to explore the differential efficacy of in vivo exposure versus
      augmented reality exposure in the treatment of specific phobia (small animals).

      The hypothesis is: There will not be significant statistical differences in the efficacy of
      in vivo exposure therapy versus augmented reality exposure in the treatment of specific
      phobia (small animals).
    

Detailed description: 
      Among anxiety disorders, specific phobias are highly prevalent (around 7.2% and 11.3% in the
      general population). Cockroach or spider phobia is a type of specific phobia, animal type.
      The gold standard for the treatment of specific phobia (included small animal phobia) is in
      vivo exposure. Most phobia sufferers (60-80%) never seek treatment. Besides, not all patients
      benefit from in vivo exposure, given that an important amount of them do not accept the
      intervention or drop out (around 25%) when they are informed about the intervention
      procedure.

      Information and Communication Technologies (ICT) like Virtual Reality (VR) and Augmented
      Reality (AR) are pioneer applications that can improve treatment adherence and acceptance.
      There exist some studies offering preliminary evidence of the efficacy of AR for the
      treatment of small animal phobia. However, there are not any controlled study exploring the
      differential efficacy of ICT-based exposure interventions versus in vivo exposure. In the
      present study the differential efficacy of AR exposure versus in vivo exposure for the
      treatment of small animal phobia is explored with a between subject randomized controlled
      trial. A pre-treatment assessment will be conducted in order to establish the diagnosis and
      evaluate the main outcome measures. All participants will receive an intensive exposure
      session following Öst guidelines, (in vivo exposure in one experimental condition and AR
      exposure in the other experimental condition). After the treatment a post-treatment
      assessment will be carried out as well as follow-up assessments at 3- and 12-month after
      treatment completion.
    

Intervention name(s): In Vivo Exposure for Animal Phobia following Öst´s guidelines; Augmented Reality Exposure for Animal Phobia following Öst´s guidelines
Intervention type(s): Behavioral; Behavioral
Intervention description(s): In vivo exposure is applied using "one-session treatment" guidelines (Öst, Salkovskis and Hellström, 1991). Exposure is conducted in a single extended session lasting up to 3 hours and implemented individually. The treatment includes participant modelling, in vivo exposure, reinforced practice and cognitive challenge. Treatment in a single session is just a starting point; it is recommended that the participants continue to be exposed to the phobic situations after therapy in their daily lives in order to fully surmount their problems. Participants are informed that the treatment required close collaboration between themselves and the therapist. The exposure session is completed in a gradual and planned way.; Augmented Reality (AR) is a variation of Virtual Reality in which the user sees the real world augmented by various virtual elements; it complements reality rather than replacing it completely (Azuma et al., 2001). The most significant aspect of AR is that the virtual elements add relevant and helpful information to the physical information available in the real world. The system includes the options of changing the number, movement and size of small animals. Preliminary data show the utility of the system for the treatment of insect phobia (Botella et al., 2005). AR exposure is applied in the same way than in vivo exposure, that is, in a gradual, planned and controlled way using "one-session treatment" guidelines (Öst, Salkovskis and Hellström, 1991). The therapist can see what the participant sees in AR on a monitor and observe the same stimuli.
Other intervention name(s): In vivo exposure in phobic disorders; In vivo exposure for small animal phobia; Augmented Reality Exposure in phobic disorders; Augmented Reality Exposure for small animal phobia
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Treatment
Keywords: Virtual reality; Augmented reality; In vivo exposure; One session treatment; ICT; Efficacy; Specific phobia; Anxiety disorders