Development of a VR tool for exposure therapy for patients with social anxiety

Asge Matthiesen

Research output: ThesisPh.D. thesis

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Virtual reality (VR) used as a tool, developed for use within exposure therapy, has overthe last fewyears shown great potential in relation to providing alternatives to patientswith mental disorders within the public health sector. With the existing technology andthe rapidly growing developmentwithin the VR area, it can be difficult to keep up withand fully understand the unrealized potentialthis technology can contain. Severalresearch projects today are investigating the use of virtual reality exposure therapy(VRET) as an alternative to the traditional method, cognitive exposure therapy, which isconsidered the gold standard for treating most anxiety-related disorders. The way thetreatment takes place in-vivo today is that the patient is exposed to one or more of theanxiety-provoking triggers that can arise in the real world and thereby learns to masterhis anxiety.The problem arises in that a part of the patients diagnosed with social anxietyoften either interrupt ongoing treatment or never start this treatment. This calls for aninvestigation of one or more treatment alternatives. The VR8 project is one of theresearch projects investigating the use of VR as a tool for an alternative to standardexposure therapy. This part will be explored in the development of six VR scenarios foruse in a clinical treatment strategy. In this project, six VR scenarios are developed thatcontain several triggers that can be used to either increase or decrease the degree ofanxiety in the patients. Furthermore, a tool is developed that can be used by clinicians ina practical design, as all six scenarios contain a way for clinicians to regulate this anxietyusing guided control and biofeedback. A methodological framework is also beingdeveloped that can be used to develop this type of scenarios and VR simulations. Thepurpose of this PhD project was to investigate how to design and develop interactive 360-degree videos where patients can be exposed to anxiety-inducing situations in acontrolled and clinical context, developed in close collaboration with clinicians. Themethodological progress was mainly based onmethods such as the iterative designprocess, the waterfall method, formative evaluation, and the double diamond model. Thisdevelopment process is highlighted in this thesis and contains four iterations with sixconcrete VR scenarios that can and must be used in a future randomized controlstudy. Throughout this development process, the various processes will be explained and thedevelopment from concept to finished prototype will be described. The technicalapproach is also described using the equipment that has been used for the use anddevelopment of these scenarios. Below will be the final framework, which appears as aproposal for a methodological approach that can be used for the development of 360-degree VR scenarios. In the discussion, emphasis will be placed on the need and theapproach to precisely this methodological differentiation from previously known andused methods. The conclusion of this project is that, based on previously known methods,six existing effective interactive 360-degree VR scenarios have been developed that canbe used for clinical treatment in psychiatry and are to be used in alarger randomizedclinical control study. A new framework has been developed that can be used to developsuch scenarios again and contribute to a future elucidation of the methodological needsthat may arise when exploring VR as a tool for treatment.
Original languageEnglish
Awarding Institution
  • University of Southern Denmark
  • Majgaard, Gunver B., Principal supervisor
  • Larsen, Lasse Juel, Co-supervisor
Publication statusPublished - 4. Sept 2023


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