Virtual Reality versus Phobias

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Many of us have fears that to others seem irrational. A lot of otherwise healthy individuals seek medical treatment to overcome their phobias. With exposure therapy patients are encouraged to confront the feared object. Through repetition of this process and supportive guidance the patients adopt strategies that break patterns of avoidance of the feared conditions. With the help of virtual reality, people can experience environments and circumstances they wouldn’t necessarily find in their everyday context. But phobic individuals are still restricted to visit the therapists at their clinical environment. Headsets such as the Google Cardboard make exposure therapy available on users’ smartphones and treatment accessible from their homes. The goal of my thesis was to design a service experience that provides the optimal conditions for remote treatment of phobias with support from the therapist throughout the exposure sessions. Additionally, prototyping virtual environments and interactions revealed the medium’s value and full potential.

Inspiration and Method

During the process, I consulted experts (e.g. clinical therapists, a VR startup for mental health) that supported my literature research and provided feedback on my explorations. User advisors shared their experience with their phobias and evaluated my concepts on every stage of the explorative phase. I used generative methods to collaborate with users and advisors to collect insights regarding how the service should be communicated to appeal to the audience, what inspires trust towards the therapist and what concerns and potential failures I needed to address in the treatment journey.

For the prototyping sessions, I used Unity to add interactions to 360 degrees footage. I provided alternatives for the user’s transitions in space and between gradual levels of the exposure. I tested various forms of interactions between the users and the system, to manipulate the amount of control the user has. Finally, the therapist’s presence in the experience was implemented by different approaches, to understand the level of comfort they evoke.


As an outcome from the research, I collected experience principles for the optimal exposure to lead the experience design. Based on the principles, I created scenarios of virtual stages, appropriate for different levels of exposure. Starting from a less challenging setting, where the user has a more passive role, the stages gradually become more challenging. The interactions between the user and the virtual reality environment change and the user is immersed in more surprising encounters with the fear cues. Through VR, the transition from one stage to the other happens effortlessly. Depending on the level of challenge required, the technology enables the therapist to customize the next exposure session and encourage patients to step out of their comfort zone in a safe and controlled setting. Similarly, the therapist’s presence in the VR environment becomes more saturated when the level of challenge increases.

In addition to the VR exposure, the user has access to a progress report, information regarding the mechanisms of phobias, personalized articles about the object of fear and recommendations on how to be prepared before challenging situations. These are accessible on a mobile application, which is also the portal of the VR experience and communication with the therapist. Additional home assignments strengthen the learning outcome of the exposure sessions and act as material for maintenance after the end of the main course of the treatment.