Virtual Reality and Phobias


On this website you can find information about the research project called Virtual Reality and Phobias, started in 1999. Itís a project in which different universities collaborate. Delft University of Technology is working together with the University of Amsterdam, faculty of psychology. The major topics of this research project are discussed below. The Technical University of Delft is responsible for the topics on Human Computer Interaction and the technical aspects of VR. The University of Amsterdam is concerned with virtual reality exposure therapy and the psychological aspects of virtual reality. Under News you find recent results. Under Publications you find a lot of articles, reports and video's produced by the project, including its partners.

***This web site is not maintained anymore, since April 2009.

All contents are ported to a wiki which is maintained every week

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If there are any questions feel welcome to contact Charles van der Mast. [last updated: April 24, 2009]

Virtual Reality and Phobias

Phobias are the most common form of anxiety disorders, which themselves are the most common psychiatric disorders. In 1998 a study was done in the Netherlands on the prevalence of psychiatric disorders in the general population (Bijl, Ravelli & van Zessen). This study shows that the lifetime-prevalences of agoraphobia, social phobia and specific phobias are respectively 3.4, 7.8 and 10.4 %. This means that 3.4 % of the general population is or has been suffering from agoraphobia during his life. 7.8 % and 10.4 % of the population is or has been suffering from respectively a social phobia or a specific phobia during his life.

Phobias can often be treated effectively by using gradual exposure therapy. During gradual exposure therapy patients are subjected to anxiety-provoking stimuli in a gradual order, from the least difficult stimulus to the most difficult one. While patients are subjected to those anxious situations, they canít avoid the stimuli and they are staying in that situation to allow the anxiety to attenuate. Traditionally those stimuli are looked for in actual physical situations (in vivo) or by having the patient imagine the stimulus (in vitro).

Virtual Reality (VR) allows a third option of exposure therapy in a virtual setting that is safer, less embarrassing, and less costly than reproducing the real world situations. Besides situations can be created that are difficult to find in real life and itís more realistic than imagining the danger. Already some experiments have proven VR to be a useful tool in treating specific phobias such as fear of heights, fear of spiders, fear of flying and claustrophobia, as well as agoraphobia. However most research that is done on VR exposure consists of single case studies and controlled group studies are necessary to support the conclusions of case studies. Research in this area is still in its infancy, but is progressing rapidly.


To take Virtual Reality (graded) Exposure (VRE) from the experimental lab and into the daily practice of psychologists more research is needed. Delft University of Technology and the University of Amsterdam have taken up this challenge. Within four years we have built a fully functional system optimal for the given situation. Furthermore we have substantial data to support the effectiveness of VRE for the treatment of phobias (fear of heights, claustrophobia, fear of flying). The domain is being approached from these two angles:

Human Computer Interaction

Both angles are being represented by a group in the project team.

In 1999 we completed a pilot study with low budget VR equipment. The aim of this study was to evaluate the effectiveness of low-budget virtual reality exposure versus exposure in vivo in a within group design in ten individuals suffering from acrophobia (phobia of heights) (Emmelkamp, Bruynzeel, Drost & van der Mast). Click here for more information and pictures.

Furthermore we completed another study in which we evaluated the effectiveness of low-budget virtual reality exposure versus exposure in vivo. According to this study there were no differences between the effectiveness of gradual exposure in vivo and VRE. Both conditions improved significantly and didnít differ in their degree of improvement. The decline in fear of heights was sustained at six months follow-up. It seems that VRE has the same effectiveness as exposure in vivo, even when measured on a behavioral avoidance test. Click here for more information. We got very interesting results on usability of the therapist user interface, on navigation techniques in virtual reality, on comparison of virtual reality modalities (HMD verses CAVE), and more. We are collaborating with many international partners, especially with the Universidad Politecnica de Valencia.

Our system is being used for fear of heights and claustrophobia in the clinics of in the Hague since spring 2005.

Our system is being used for fear of heights and fear of flying in the clinics of foundation in Leiden since summer 2006.

Currently (2006), we're investigating (in the lab) the use of VR for the treatment of agoraphobia and fear of flying. In the future we hope to redesign our system with modules for agent-support of the therapist and for tele-care. We are collaborating with clinicians from PsyQ in the Hague,  and from VALK in Leiden. Internationally we are collaborating with UPV in Valencia (Technical University of Valencia, Spain). See our latest Publications and under News on this site.

==> We are developing now (2008) worlds and avatars for social phobias. Look under News.

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April 24, 2009 Charles van der Mast