Thursday, July 17, 2008

Efficacy of virtual reality exposure therapy to treat driving phobia: a case report

AUTHORS: Wald J, Taylor S
JOURNAL: Journal of Behavior Therapy and Experimental Psychiatry 2000, 31, 249-257

ABSTRACT: An AB case design was used to examine the efficacy of virtual reality exposure therapy (VRET) in treating driving phobia. After a one week baseline, the patient received three treatment sessions over a ten day period. Treatment included practice of four VR driving scenarios. Peak anxiety decreased within and across sessions. Ratings of anxiety and avoidance declined from pre-treatment and post-treatment, with gains maintained at seven month followup. Phobia-related interference in daily functioning similarly decreased. The results suggest that it would be useful to further evaluate the efficacy of VRET for driving phobia in controlled clinical trials.

SUMMARY: A case study in which one woman received a sum total of three (of a planned eight) sessions with a virtual reality driving simulator. After treatment the subject drove more often and experienced less anxiety while driving.

MY THOUGHTS: I am rather surprised that the authors squeezed nine pages out of a case study that was curtailed to less than half of its intended length--well, partly thought very repetitive introduction and discussion sections. The subject apparently had a significant and chronic problem, however in the absence of any control the conclusions that can be drawn here are very limited. The subject was also actively seeking (and found) employment that required driving, highly likely to exhibit placebo effects, and quite possibly self-selecting (the way the subject was identified and selected is not described).

TAKE HOME MESSAGE: If a subject's driving anxiety is a conditioned phobia, virtual reality technology might be part of an effective program of systematic desensitization. Generally treatment programs put someone right into the car, and the authors of this paper correctly outline how this can be stressful, embarrassing and even potentially dangerous with some people. However a single, heavily confounded, case study doesn't really raise the effectiveness of this technique above the level of anecdote.

1 comment:

Dollface said...

Interesting case study, although I agree with you that there doesn't seem to be enough evidence to draw any major conclusions.

However, as someone with driving anxiety the thought of VR driving sounds really beneficial. I'm so scared of getting back into a car and either embarrassing or harming myself. It would be nice to get more comfortable with driving without actually risking my life (which, at this point, is the outcome I think about when I think about driving.)