Virtual Reality Exposure Therapy Does Not Provide Any Additional Value in Agoraphobic Patients: A Randomized Controlled Trial
Abstract
Background: A number of studies have demonstrated the efficacy of virtual reality exposure therapy (VRET) in specific phobias, but research in seriously impaired patients with agoraphobia is lacking. In this randomized controlled trial with patients with agoraphobia and panic disorder, VRET and exposure in vivo were compared in terms of outcome and processes involved. Methods: Patients with panic disorder with agoraphobia (n = 55) were randomly assigned to receive 4 sessions of cognitive behavioral therapy (CBT) followed by either 6 sessions of VRET or 6 sessions of exposure in vivo or to a waiting list control condition. Results: Analyses showed that both active treatment packages were significantly more effective than no treatment and that no differences between VRET and exposure in vivo were found in three out of four outcome measures. On the panic disorder severity scale, however, CBT plus exposure in vivo was more effective than CBT plus VRET. The results show clear synchrony of temporal processes involved in VRET and exposure in vivo on weekly avoidance measures and cognitive measures. Further, it was shown that initial changes in agoraphobic cognitions during the CBT phase predicted later changes in agoraphobic avoidance behavior. Conclusion: These data support the notion that therapeutic processes involved might be the same in VRET and exposure in vivo. However, given the slight superiority of exposure in vivo above VRET, the costs involved in the implementation of VRET and the lack of long-term follow-up, VRET cannot yet be recommended for patients with agoraphobia.
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Meyerbröker's study presents results favoring the in vivo condition above the VRET condition in one out of four measures.
“Meyerbröker's study [29] only presents results favoring in vivo condition above VRET condition in one out of four measures.”
From Recent Progress in Virtual Reality Exposure Therapy for Phobias: A Systematic Review (2017) · cites this paper as [29]
Kampmann et al. [22•], Botella et al. [18•], and Meyerbröker et al. [29] present results in favor of the in vivo condition.
“On the contrary, just Kampmann et al. [22•], Botella et al. [18•], and Meyerbröker et al. [29] present results in favor of the in vivo condition.”
From Recent Progress in Virtual Reality Exposure Therapy for Phobias: A Systematic Review (2017) · cites this paper as [29]
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- Authors
- Meyerbroeker, K., Morina, N., Kerkhof, G. A., & Emmelkamp, P. M. G.
- Affiliations
- University of Amsterdam (NL)
- ORCID
- Emmelkamp, P.M.G.
- Venue
- Psychotherapy and Psychosomatics
- Publisher
- S. Karger AG
- Published
- 2013
- Volume
- 82
- Issue
- 3
- Pages
- 170-176
- ISSN
- 0033-3190 (ISSN-L)
- 1423-0348
- OpenAlex
- W2034466669
- Semantic Scholar
- bac02b33806a5eca3ba3523cd8e7fb41e8b858ff
- Cited by
- 70
- References
- 26
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 4 · 2023: 6 · 2022: 6 · 2021: 14 · 2020: 5 · 2019: 7 · 2018: 5 · 2017: 2 · 2016: 3 · 2015: 5 · 2014: 6 · 2013: 2
- FWCI
- 7.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychotherapy and Psychosomatics (publishedVersion)
- PubMed (publishedVersion)
- UvA-DARE (University of Amsterdam) (publishedVersion)
- Utrecht University Repository (Utrecht University) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- Koninklijke Nederlandse Akademie van Wetenschappen
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Physical Sciences › Computer Science › Human-Computer Interaction › Virtual Reality Applications and Impacts
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- virtual reality exposure therapy, agoraphobia, panic disorder, cognitive behavioral therapy, agoraphobic avoidance, treatment outcomes, therapeutic process
- MeSH terms
- Adolescent, Adult, Aged, Agoraphobia, Analysis of Variance, Anxiety, Avoidance Learning, Humans, Implosive Therapy, Middle Aged, Outcome and Process Assessment, Health Care, Severity of Illness Index, Waiting Lists, Cognitive Behavioral Therapy, Panic Disorder, Young Adult, Intention to Treat Analysis, Self Report, Virtual Reality Exposure Therapy
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