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Treatment Plans: Studying the Appropriate Number of Sessions for VR Therapy

As a clinician considering integrating new technology into your practice, you may have several questions. Of course, the impact on your client’s outcomes [1] is of vital importance, as is the ease of use.

But there are practical questions too. How will your clients respond to VRET, either in session or when it’s applied as additional ‘homework’? How many treatment sessions are needed for an individual to see the benefits of VRET? A 2021 study from researchers at Yonsei University College of Medicine, Seoul asked this question. In their article, titled Appropriate Number of Treatment Sessions in Virtual Reality-Based Individual Cognitive Behavioral Therapy for Social Anxiety Disorder [2] and published in the Journal of Clinical Medicine, these researchers examined the effect of VRET-delivered CBT on subjects suffering from social anxiety disorder.


In today’s post, we’re going to dive into this article, exploring both the findings on the efficacy of VR technology as well as answering some practical questions about integrating VR into your clients’ care. Let’s take a look.





Methodology and Background


Although it has been consistently found that VR-based CBT is an effective treatment for social anxiety disorder, the number of treatment sessions across studies varies considerably, from four to 16 [3]. The South Korean researchers set out to explore an optimum treatment program in this study.


The researchers recruited 115 patients diagnosed with social anxiety disorder (SAD), excluding anyone with other significant psychiatric illnesses (except SAD), substance abuse, any neurological or serious physical disorders, and pregnancy. These patients undertook a ten-week course of virtual reality-based CBT, administered by a therapist. This methodology mirrors how clinicians and therapists can offer VRET to their clients through our clinician portal.


Study participants completed four sets of questionnaires before and after treatment. These included the Brief Fear of Negative Evaluation Scale (BFNE), the Liebowitz Social Anxiety Scale (LSAS), the Social Phobia Scale (SPS), and the Social Interaction Anxiety Scale (SIAS). The BFNE questionnaire was repeated every session, while the others were only measured before and after the ten-week course.


Results and Implications


Of 115 participants, 52 averaged six sessions and were termed the early termination group, 43 averaged ten sessions and were termed the normal termination group, and 20 were in the session extension group, completing an average of 13 sessions.


Promisingly, the authors found that “VR technology benefits treatment outcomes not only for the cost and effort of delivering treatment but also for the effectiveness of treatment”, accurately replicating the results found in our own clinical trials.


The below image shows the mean BFNE score for each group across multiple sessions.





With only two participants extending beyond 13 sessions, a small sample size in the Session Extension Group skews the right end of the chart. Despite this, the results are positive, demonstrating a clear reduction in BFNE score across sessions.


The researchers also attempted to answer the question of the appropriate number of sessions for VR-based CBT in patients with social anxiety disorder. They found that a course of nine to 10 sessions was effective in the treatment of social anxiety disorder and, notably, found that extending sessions wouldn’t lead to additional benefits if the client did not respond in the first ten sessions.


This is why oVRcome offers a personalized and customizable approach to VR therapy: your clients' exposure hierarchies can be adjusted based on real-time data to ensure every client responds effectively.


How can oVRcome Benefit Your Practice?


These findings have two important implications for oVRcome, and the clinicians applying VRET and CBT in their practice. Firstly, it has an immediate impact, offering benefits from the first or second session, so clients can see fast results thanks to the integration of virtual reality in your practice. Additionally, with oVRcome, you can prescribe additional exposure therapy as ‘homework’, further accelerating your clients’ results.


Secondly, it shows the importance of a personalized approach to VR-based CBT and exposure therapy. By creating customized hierarchies of exposure, and through integrating client data available in the dashboard, you can adjust your client's treatment to improve their outcomes. This ensures every client gets the best possible treatment.


Wrapping Up


Meta-analysis has demonstrated the efficacy of VRET for phobias and anxiety disorders (Stein et. al), while our own clinical trials have proven that oVRcome works, and provides long-lasting results. Now you can tap into the power of oVRcome in your clinical practice.


And we’ve made oVRcome easy to access: join our clinician community today and we’ll add your first client for free. That includes a free one-month subscription for your client and a VR headset. With VRET, the future of exposure therapy has arrived. Are you ready to take your practice to the next level?


References:


  1. Lacey, C., Frampton, C., & Beaglehole, B. (2022). OVRcome – Self-guided virtual reality for specific phobias: A randomised controlled trial. Australian & New Zealand Journal of Psychiatry. https://doi.org/10.1177/00048674221110779

  2. Jeong, H. S., Lee, J. H., Kim, H. E., & Kim, J. (2021). Appropriate Number of Treatment Sessions in Virtual Reality-Based Individual Cognitive Behavioral Therapy for Social Anxiety Disorder. Journal of Clinical Medicine, 10(5), 915. https://doi.org/10.3390/jcm10050915

  3. Carl, E.; Stein, A.T.; Levihn-Coon, A.; Pogue, J.R.; Rothbaum, B.; Emmelkamp, P.; Asmundson, G.J.G.; Carlbring, P.; Powers, M.B. Virtual reality exposure therapy for anxiety and related disorders: A meta-analysis of randomized controlled trials. J. Anxiety Disord. 2019, 61, 27–36.

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