# Immersive Phobia Therapy through Adaptive Virtual Reality and Biofeedback
## 5 Conclusions  
PhoVR is a virtual reality exposure therapy system that contains realistic and immersive environments for acrophobia therapy (four scenarios), claustrophobia therapy (three scenarios), and glossophobia therapy (scenes configurable in terms of room size, audience size, and personality factors) with quests enriched with gamification elements. Integrated hardware ensures biophysical data acquisition (electrodermal activity and heart rate), and a proprietary algorithm classifies the physiological data in order to determine the level of anxiety and identify difficult moments for the patient. The system offers support in difficult moments through visual biofeedback, dynamic adaptation of the 3D environment, and a virtual companion. PhoVR features a control panel dedicated to therapists for managing patients and therapy sessions, automatic data collection, and advanced analysis tools. All components are integrated into a functional prototype that was used for evaluation and validation with phobic subjects and psychotherapists. The feedback from therapists and test subjects is very positive regarding the current concept and realization. The prototype includes all the functions mentioned above and has a high degree of ergonomics, very closely fulfilling the requirements of a final commercial product. Following the tests performed with various subjects and the feedback collected from psychologists, new development opportunities were identified in order to expand the therapy offered by the PhoVR system. Agoraphobia and aerophobia have been identified as other types of phobias that can be targeted using PhoVR. One of the most important elements highlighted by the therapists is the usefulness of customizing the virtual environment. In this sense, as objectives for further development, the partners in this project will investigate the possibility of generating virtual environments specific to certain phobias, based on the descriptions of the therapist or patient. Analyzing patient performance and tracking their progress over time is one of the most important features offered by the PhoVR system. Currently, the control panel provides a visual analysis of the sessions, but this support can be improved with multiple plots and comparative analyses. For more versatility, we will investigate the possibility of configuring the patient's dashboard with statistics widgets and specific analyses that can be configured by psychotherapists. The scenes developed within the PhoVR project can be further optimized from the perspective of real-time playback performance. Within the project, only overall scene optimizations were carried out, but while running the scene, there may be moments that reduce the performance due to local complexity. Thus, a detailed analysis of the complexity of the scenes in each local task point will be considered in future research. If the local performance does not correspond to the established standards, solutions will be identified and local changes will be applied to solve them. Considering the desire to market the PhoVR system to individual users with mild-to-moderate phobias, the aim is to reduce the purchase cost of the system together with its accessories. One of the substantial costs of acquisition is the biometric data measurement hardware. Thus, the possibility of integrating some commercial devices (e.g., fitness trackers) will be investigated. PhoVR is dedicated to the treatment of various psychological disorders, similar to the commercial systems described in [11; 12; 13; 14; 15]. It also provides relaxation techniques, similar to those offered in C2 Care [11], Amelia [12], and Virtually Better [14]. PhoVR features patient live monitoring, therapist orchestration, environment customization, and personalized interventions in real time, similar to C2 Care [11], XRHealth [15], and Amelia [12].