Fear of Driving is defined in the current mental disorders classification system as a situational phobia within specific phobias. It is characterized by an intense and persistent fear that increases with the anticipation or exposure to the driving stimuli. Recent studies have shown that the prevalence of this phobia is 4% of the population, although the percentage of people with some type of driving-related fear could raise up to 22%. The symptoms of this phobia can cause significant discomfort and serious interference with the daily lives of the patients.
Certain factors affect the intensity of the patient’s emotional reaction to driving. The typical and most important ones are: speed, weather, amount of traffic, distance to be covered, time of day, characteristics of the road, type of car, if they are driving alone or with company, where the patient is driving through, etc.
Virtual Reality has been proved to be a good alternative to traditional exposure techniques in the treatment of driving phobia. This technology is especially useful in repeating the exposure as many times as necessary in order to recreate the unpredictable circumstances that occur in the real situation. Moreover, VR naturally eliminates the chances of suffering an accident and the therapist has total standardization and control over the exposure session parameters.
According to Bados (2006), the problems with panic and agoraphobia are very frequent in clinical practice; specifically, these are the anxiety problems which people consult about most and they constitute around 50-60% of the phobia cases attended in the clinic (Bados, 2009). In general, if population data of primary health care is analyzed, numbers will show a higher prevalence than in the general population.
Virtual reality (VR) seems to be a good alternative regarding traditional techniques of exposure in the treatment of agoraphobia. Unlike in vivo exposure, virtual reality allows standardization and control over the exposure session parameters. Moreover, this technology is particularly useful for repeating the exposure of the feared situations as many times as necessary (Botella et al, 2004). It also prevents panic attacks, losing the risk of reinforcing the existing fear.
Fear of heights —also known as acrophobia— is a condition that affects 3–5% of the general population. It is not necessarily pathologic, and it only implies a problem if the anxiogenic response is uncontrollable, if it can drive the patient into a panic attack or into suffocation sensations, etc. This phobia belongs to the category of “specific phobias”, which may provoke an intense and anxious response to a specific stimulus —in this case, when people are exposed to heights. Fear of he
ights is considered natural, even adaptative, since the avoidance response could be positive when people feel they are in a risk environment.
There are several agents implied in the development and maintenance of this phobia and Coelho, Waters, Hine and Wallis (2009) consider both non associative —hereditary— and associative —conditioned— factors in their model. So, it is considered as a multi-causal phenomena because not all the patients that seem to suffer this phobia have developed it in a conditioned or learned way. Moreover, it was found in a longitudinal study realized by Poulton , Davies, Menzies, Langley and Silva (1998) that those who took part in the study and suffered significant lesions and falls before the age of 9 do not show a phobic response when they are 18.
However, some people manifest a phobic behavior pattern when they are exposed to heights, such as feeling anxious or even presenting panic attacks. In these cases, treating the patient is essential since it is shown a high level of acrophobia, so one could try to avoid any place not situated at ground level. The avoidance response intensity depends on the patient’s particular condition but it is particularly important to understand how the avoidance response intensity manifests itself through a continuum, which is a scale of high positions going from climbing up stairs to situate the patient on a cli. This is an important indicator and it has to be taken into account not just when analyzing the impact and the relevancy of the disorder but when the stage.
Finally, it is worth mentioning that Virtual Reality is a good alternative compared to traditional exposure techniques in the treatment of acrophobia because of several reasons. Firstly, the therapist holds greater control of exposure variables, as opposed to the difficulty of obtaining an optimal environment to treat this phobia.
Secondly, it is less expensive in terms of logistics, treatment time and effort because it does not require the patient and therapist to move around to find suitable places for in vivo exposure: the situation is modeled in a virtual environment . And, last but not least , there are fewer probabilities of the patient not wishing to be exposed to this treatment. Moreover, the use of VR exposure as a technique is at least equally efficient as in vivo exposure treatment (Emmelkamp, & cols; 2002).
I have been researching virtual reality as a tool to add to my practice. There is sound research behind utilizing virtual reality.
Here is the list
Acrophobia-The environments for this therapeutic area are a set of tools that will allow a fear of heights to be evaluated and treated.
Addictive disorders- The environments for this therapeutic area will help in the evaluation, treatment, and management of problems related to substances: alcohol, tobacco, and cannabis.
The environments for this therapeutic area are a set of tools that will allow a fear of heights to be evaluated and treated.
Agoraphobia- The environments for this therapeutic area will help to evaluate and treat agoraphobia: Being in a public square, a street, taking the subway, etc.
Bullying -The environments for this therapeutic area will help to evaluate and treat some clinical aspects generated by abuse at school or bullying.
Claustrophobia -The environments for this therapeutic area are a set of virtual tools that allow for the evaluation and treatment of the fear of closed spaces, the fear of running out of oxygen, and the fear of being immobilized.
Depression -The environments for the Depression therapeutic area are a set of tools to help you evaluate and manage sadness. With these environments, you’ll be able to use different treatment strategies to improve these symptoms.
Eating disorders -The environments for this therapeutic area are geared towards evaluating and treating body image distortion and distress related to eating.
Fear of animals -The environments for this therapeutic area are a set of videos and virtual environments for the evaluation and treatment of the most common fears related to animals: pigeons, dogs, insects, and cats.
Fear of driving-The environments for this therapeutic area are driving situations, using two scenes: a highway and a city.
Fear of flying -The environments for this therapeutic area will be useful to evaluate and treat a fear of flying. It includes environments in the living room at home before leaving for the airport, in the taxi on the way to the airport, at the boarding gate, and flying (takeoff, flight, and landing).
Fear of the dark -The environments for this therapeutic area will help carry out psychological treatment related to fear of the dark and of storms. Geared towards juveniles and adults.
Generalized anxiety-Virtual environments to evaluate and treat worrying, rumination, and anticipatory anxiety related to various things: excessive worrying about children, diseases, or even work.
Medical procedures -The environments for this therapeutic area will be helpful in evaluating and treating patients with distress and anxiety related to medical interventions (for example, a fear of needles).
Mindfulness -The environments for this therapeutic area are geared towards training patients on and having them practice mindfulness exercises, acceptance, gratitude, experiential avoidance, psychological flexibility, cognitive defusion, etc.
Neurodevelopment -The environments for this therapeutic area will help to evaluate and treat in symptomatology related to autism spectrum disorders.
OCD -The environments for this therapeutic area will help to evaluate and treat obsessive thoughts and help with managing compulsions and neutralizations.
Pain managementThe environments for the Pain management therapeutic area are a set of tools that will help you evaluate and handle chronic and acute pain, along with its affective, cognitive, and behavioral components.
The environments for this therapeutic area will be helpful in evaluating and treating patients with social anxiety in situations of interaction with other people.
The environments for this therapeutic area will allow the patient to practice different control techniques for activation and relaxation.
The environments for the Sleep-wake disorders therapeutic area contain activation control tools to help treat problems related to complaints of dissatisfaction with the quality and the quantity of sleep.
The environment for this therapeutic area will help to evaluate and treat social anxiety in a situation where the patient has to interact with other people.
Somatic & related
The environments for the Somatic and related therapeutic area are a set of tools that will help you evaluate and handle the physical symptoms of malaise, along with the affective, cognitive, and behavioral components.
The environments for the Sport performance therapeutic area are a set of tools to help evaluate and manage activation, emotional regulation, and attention management to increase well-being and improve performance.
Stress & trauma
The environments for the Stress & trauma and therapeutic area include tools that help the therapist evaluate and treat the patient in these areas. It contains an EMDR environment as well as environments to work on problems related to traumatic life events.