Today’s Solutions: March 15, 2025

We’ve all spent a little too long inside before, especially with the pandemic restrictions of the last couple of years, and maybe we were a little nervous to rejoin public spaces. For those with agoraphobia — an anxiety disorder where someone can feel particularly fearful in public spaces — this issue runs a little deeper, and they often rely greatly on therapy. 

Psychiatrists get more creative every day, though, treating patients with agoraphobia, and the latest breakthrough employs virtual reality therapy to help them. 

A simulated breakthrough

The idea is simple: use a simulated reality that takes patients through public spaces, like buses or convenience stores, and let them walk through the spaces that make them anxious while knowing that they’re safe. 

“It leads to a real step-change in people’s lives,” said Prof Daniel Freeman of the University of Oxford, the lead researcher in the work. “There’s a little bit of the conscious bit [of the brain] going: ‘OK, it’s OK, I know it’s not real and therefore I can persist, try something new and do something differently.’” 

The study was published in the Lancet Journal of Psychiatry and reported that 174 patients who had difficulties going outside were given the VR “gamechange” therapy alongside their usual therapy. 172 patients just stuck with their usual therapy as a control. The 174 VR patients were instructed to use the VR for 30 minutes per each of six sessions of therapy for six weeks, accompanied each time by a therapist. The patients were encouraged to approach people in the simulations and interact in public spaces like a public bus.

After the six weeks, there was a small but noticeable difference in the VR patients. They were slightly less likely to avoid real-life situations because of their agoraphobia. This didn’t last, however, as there was virtually no difference between the VR group and the control group after six months. 

The real difference, according to Freeman, was in the patients with severe agoraphobia, for whom there were profound benefits. 

A real-life breakthrough

One participant admitted that he had trouble leaving his home to visit his father’s grave, which was understandably taking an emotional toll. With the help of the VR system, he was able to practice getting on the bus and interacting with people. He faced and adapted to his fear of getting on the bus with this virtual help and was able to go visit his father’s grave. 

“It’s helped me for every aspect… I’ve been able to get the bus to my dad’s grave, I’ve been able to put flowers down, spend a little bit of time there and get the bus back,” this participant said to the Guardian. “I’ve been able to go out, interact with a lot more people than what I ever expected… I’m more confident in myself. I’m more confident around other people.”

Source Study: The Lancet PsychiatryAutomated Virtual Reality Therapy… The Lancet Psychiatry.

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