A pilot study at Virtual Reality Medical Center comparing the effectiveness of Virtual Reality exposure therapy to systematic desensitization with imaginal exposure therapy for treating flying phobia, shows VR wins hands down.

A randomized, controlled, pilot study at the Virtual Reality Medical Center in San Diego, compared the efficacy of virtual reality graded exposure therapy (VRGET) with imaginal exposure therapy for the treatment of fear of flying.

Thirty participants (mean age = 39.8 +/- 9.7) with a confirmed diagnosis of specific phobia fear of flying were randomly assigned to one of three groups: VRGET with no physiological feedback (VRGETno), VRGET with physiological feedback (VRGETpm), or systematic desensitization with imaginal exposure therapy (IET).


Eight sessions were conducted once a week. During each session, physiology was measured to give an objective measurement of improvement over the course of exposure therapy. In addition, self-report questionnaires, subjective ratings of anxiety (SUDs), and behavioral observations (included here as flying behavior before beginning treatment and at a three-month posttreatment follow-up) were included.

In the analysis of results, the Chi-square test of behavioral observations based on a three-month posttreatment followup revealed a statistically significant difference in flying behavior between the groups [chi(2) (4) = 19.41, p < 0.001]. Only one participant (10%) who received IET, eight of the ten participants (80%) who received VRGETno, and ten out of the ten participants (100%) who received VRGETpm reported an ability to fly without medication or alcohol at three-month followup.

Although this study included small sample sizes for the three groups, these results showed VRGET was more effective than IET in the treatment of flying. It also suggests that physiological feedback may add to the efficacy of VR treatment.

Citation: Wiederhold BK, Jang DP, Gevirtz RG, Kim SI, Kim IY, Wiederhold MD. The treatment of fear of flying: a controlled study of imaginal and virtual reality graded exposure therapy. IEEE Trans Inf Technol Biomed. 2002 Sep; 6 (3): pages 218-23. [email protected]