In a small pilot study, researchers from the University of Barcelona in Spain compared the efficacy of Virtual Reality (VR) to the efficacy of Imaginal Exposure (IE) for 15 people suffering from fear of flying (FF).

It is already established that exposure therapy is the most effective treatment for this kind of phobia, but there are very few studies comparing kinds of exposure therapy.

This study compared the effectiveness of these two approaches using two manualized interventions based on the exposure technique. Patients with FF (N = 15) were randomly assigned to either VR (n = 7) or IE therapy (n = 8), consisting of a total of eight sessions: two assessment sessions (pre-treatment and after the real flight) and six exposure therapy sessions, which were conducted twice a week.

During each exposure session, subjective perceived anxiety was measured every 5 minutes. Participants were also asked to sit through a real flight immediately after the treatment.

The results showed no differences between the two treatments in relation to reduced clinical symptoms associated with the fear of flying, although participants in the VR group experienced less anxiety during the real flight after treatment.

Additionally, at 6-month follow-up, danger expectations and flight anxiety continued to decrease in participants who had received the VR exposure therapy, and four of these seven participants took at least one more flight.

These numbers are too small to establish VR as a preferred treatment, however.  Larger studies are needed.

Citation:  Rus-Calafell M, Gutiérrez-Maldonado J, Botella C, Baños RM. Virtual reality exposure and imaginal exposure in the treatment of fear of flying: a pilot study. Behavior Modification. 2013 Jul;37 (4) pp:568-90. doi: 10.1177/0145445513482969. Epub 2013 Apr 12.