Related Experiment Video

Updated: Jan 27, 2026

Behavioral Training Procedures for Head-fixed Virtual Reality in Mice

Behavioral Training Procedures for Head-fixed Virtual Reality in Mice

Published on: September 6, 2024

Effectiveness of Self-guided App-Based Virtual Reality Cognitive Behavior Therapy for Acrophobia: A Randomized

Tara Donker^1,2, Ilja Cornelisz^3,4, Chris van Klaveren^3,4

¹Department of Clinical, Neuro- and Developmental Psychology, Section Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.

JAMA Psychiatry

|March 21, 2019

Abstract

Importance:

Globally, access to evidence-based psychological treatment is limited. Innovative self-help methods using smartphone applications and low-cost virtual reality have the potential to significantly improve the accessibility and scalability of psychological treatments.

Objective:

To examine the effectiveness of ZeroPhobia, a fully self-guided app-based virtual reality cognitive behavior therapy (VR CBT) using low-cost (cardboard) virtual reality goggles compared with a wait-list control group and to determine its user friendliness.

Design, Setting, And Participants:

In a single-blind randomized clinical trial, participants were enrolled between March 24 and September 28, 2017, and randomly assigned (1:1) by an independent researcher to either VR CBT app or a wait-list control group. A total of 193 individuals aged 18 to 65 years from the Dutch general population with acrophobia symptoms and access to an Android smartphone participated. The 6 animated modules of the VR-CBT app and gamified virtual reality environments were delivered over a 3-week period in participants' natural environment. Assessments were completed at baseline, immediately after treatment, and at 3-month follow-up. Analysis began April 6, 2018, and was intention to treat.

Intervention:

Self-guided app-based VR CBT.

Main Outcomes And Measures:

The primary outcome measure was the Acrophobia Questionnaire. The hypothesis was formulated prior to data collection.

Results:

In total, 193 participants (129 women [66.84%]; mean [SD] age, 41.33 [13.64] years) were randomly assigned to intervention (n = 96) or a wait-list control group (n = 97). An intent-to-treat analysis showed a significant reduction of acrophobia symptoms at posttest at 3 months for the VR-CBT app compared with the controls (b = -26.73 [95% CI, -32.12 to -21.34]; P < .001; d = 1.14 [95% CI, 0.84 to 1.44]). The number needed to treat was 1.7. Sensitivity and robustness analysis confirmed these findings. Pretreatment attrition was 22 of 96 (23%) because of smartphone incompatibility. Of the 74 participants who started using the VR-CBT app, 57 (77%) completed the intervention fully.

Conclusions And Relevance:

A low-cost fully self-guided app-based virtual reality cognitive behavioral therapy with rudimentary virtual reality goggles can produce large acrophobia symptom reductions. To our knowledge, this study is the first to show that virtual reality acrophobia treatment can be done at home without the intervention of a therapist.

Trial Registration:

Trialregister.nl identifier: NTR6442.

More Related Videos

The use of Biofeedback in Clinical Virtual Reality: The INTREPID Project

The use of Biofeedback in Clinical Virtual Reality: The INTREPID Project

Published on: November 12, 2009

Using a Virtual Reality Walking Simulator to Investigate Pedestrian Behavior

Using a Virtual Reality Walking Simulator to Investigate Pedestrian Behavior

Published on: June 9, 2020

Related Concept Videos

Clinical Trials

Clinical Trials

Clinical trials are prospective experimental studies conducted on humans to determine the safety and efficacy of treatments, drugs, diet methods, and medical devices. Using statistics in clinical trials enables researchers to derive reasonable and accurate conclusions from the collected data, allowing them to make wise decisions in uncertain situations. In medical research, statistical methods are crucial for preventing errors and bias.
There are four phases in a clinical trial. A phase one...

Clinical Trials: Overview

Clinical Trials: Overview

Clinical development focuses on how the drug will interact with the human body and encompasses four key phases of clinical trials, each serving a specific purpose in assessing the safety and effectiveness of new drugs. These phases overlap and build upon one another. Phase I involves a small group of healthy volunteers (typically 20-80 individuals) or, in cases where significant toxicity is expected, patients with the targeted disease, such as cancer or AIDS. The volunteers are tested for...

Cognitive Therapy

Cognitive Therapy

Cognitive therapy, pioneered by Aaron T. Beck in the 1960s, is a structured approach to addressing psychological distress by focusing on the influence of thoughts on emotions and behaviors. All cognitive therapies involve the basic assumption that human beings have control over their feelings, and that how individuals feel about something depends on how they think about it. Unlike psychoanalytic methods that delve into unconscious processes or humanistic approaches emphasizing...

Cognition and Behavior

Cognition and Behavior

Social psychology examines the complex interplay between individual mental processes and social interactions. Historically, the field was divided into two domains: social behavior and social cognition. Researchers focusing on social behavior analyzed actions within social contexts, such as conformity, aggression, or cooperation. Meanwhile, social cognition researchers investigated how people perceive, interpret, and mentally represent their social environments. However, modern perspectives no...

Cognitive Dissonance

Cognitive Dissonance

Social psychologists have documented that feeling good about ourselves and maintaining positive self-esteem is a powerful motivator of human behavior (Tavris & Aronson, 2008). In the United States, members of the predominant culture typically think very highly of themselves and view themselves as good people who are above average on many desirable traits (Ehrlinger, Gilovich, & Ross, 2005). Often, our behavior, attitudes, and beliefs are affected when we experience a threat to our...

Beck's Cognitive Therapy

Beck's Cognitive Therapy

Cognitive therapy is a psychological approach designed to address distortions in thinking, which can lead to negative emotions and unrealistic beliefs. These cognitive distortions often influence how individuals interpret and respond to situations, exacerbating emotional distress. Below are some prevalent cognitive distortions, their characteristics, and examples of how they manifest in thought processes.
Arbitrary Inference
Arbitrary inference involves making conclusions without sufficient...

Articles linked to this work by shared authors, journal, and citation graph.

Synthesising evidence from decades of meditation-based research across populations, interventions, comparisons and outcomes: protocol for a meta-analytic database of randomised controlled trials via the MetaCIH Collaborative.

BMJ open·2026

Effectiveness of a scalable, remotely delivered stepped-care intervention for psychological distress among Polish migrant workers in the Netherlands: The RESPOND randomised controlled trial.

PLoS medicine·2026

Effectiveness of Guided Internet-delivered Cognitive Behavioral Therapy for Insomnia in Autistic Adults (i-Sleep Autism): a Randomized Controlled Trial.

Sleep·2026

Transdiagnostic and symptom-domain associations between mental illnesses and future self-connectedness versus future self-valence.

JCPP advances·2026

Long-term effects of psychotherapies for depression: an advanced meta-analysis.

World psychiatry : official journal of the World Psychiatric Association (WPA)·2026

Stimulating Future-Oriented Thinking and Goal-Achievement Through the Future Self Using Virtual Reality and a Smartphone App: Randomized Controlled Trial.

Journal of medical Internet research·2026

See all related articles