# Immersive Phobia Therapy through Adaptive Virtual Reality and Biofeedback
## 4 Testing the PhoVR System
### Results
One psychotherapist indicated that the phobic stimuli are capable of triggering emotions just for patients suffering from severe phobias, and another psychotherapist stated that the phobic stimuli in VR are completely inefficient. One psychotherapist indicated that the PhoVR system is highly effective for phobia therapy, and another psychotherapist stated that it can be of real help, but improvements are needed. Five other psychotherapists considered the system useful for certain patients suffering from certain phobic pathologies. The psychotherapists identified the following weaknesses in the system:  
* More phobias could be addressed;
* Familiarization with the system may take some time;
* The difficulty of performing certain movements;
* The feeling of dizziness caused by the VR equipment. Various suggestions for improvement were made, including the following recommendations:  
* Addressing multiple phobias;
* Working on the feeling of realism;
* Greater freedom of movement with the left hand, perhaps with the body as well;
* A longer virtual environment with more dispersed tasks;
* Using real images from a natural environment;
* Improvement from a visual qualitative point of view. As regards the modality of conducting the therapy scenarios, the psychologists requested to have control during the whole course of the therapy. Suggestions for further development involve exploiting other types of phobias as well as increasing the number and types of scenarios. Both automatically collected performance indicators and post-use feedback validated the concept and utility of the system and indicated very high degrees of attractiveness, usability, and ergonomics, as presented above. Testing the PhoVR system for acrophobia and clautrophobia therapy is of interest to psychotherapists. In current practice, psychotherapists use imaging techniques because real-world exposure would be difficult and even dangerous. Virtual reality exposure therapy represents an extremely useful alternative for increasing the efficiency of the therapy. In its current form, where the level of realism is limited by the technical possibilities of the autonomous VR equipment, PhoVR can be used for patients with more severe phobias, where even a less realistic phobic stimulus is able to trigger a significant phobic reaction. The majority of psychotherapists indicated that using the PhoVR system within a center that would provide access to its services is a more feasible option. The reason given was that the number of patients with phobias such as acrophobia and clautrophobia who come to the office for therapy is relatively small and thus does not justify the system's purchase. If the evolution of the virtual reality equipment market leads to a decrease in their price (possibly with an increase in performance), the purchase option for individual offices becomes feasible. Regarding the modality of conducting therapy scenarios, the psychologists requested the transfer of control over the course of the scenario from the automatic version to the psychotherapist-orchestrated psychotherapy. Social phobias, including the fear of speaking in public, send the patients more frequently to therapy because they involve situations that cannot be avoided in everyday life. After the tests, both the participants and psychotherapists provided positive feedback regarding the realism of the public speaking scenarios and the effectiveness of the therapy sessions. Also, on this occasion, the feasibility of using the PhoVR system in practice was analyzed both at the level of psychological offices and for individual therapy in the case of people with occupations that frequently require holding public lectures. As a general conclusion, the system has a high potential, given the fact that the psychotherapists showed interest in conducting therapy sessions and using it in practice.