Alcohol treatment preferences and the acceptability of virtual reality therapy for treating alcohol misuse in adult drinkers

Alcohol misuse affects a large part of the population worldwide, with high relapse rates reported even post-treatment. Treatments are also not always available, for example during the COVID-19 pandemic when social distancing measures affected the availability of in-person approaches. Novel treatments like Virtual Reality Therapy (VRT), delivered via a standard VR headset or a mobile device, may offer a flexible alternative for reducing drinking and assisting relapse prevention, but little is known about their acceptability. We therefore explored the acceptability of VRT alongside the treatment preferences of adult drinkers in an online survey. Participants were asked to consider and rank order a range of treatments typically offered by healthcare services alongside standard and mobile VRT in order to determine their relative preferences. Acceptability of each treatment was also established. Additional questions addressed potential predictors of VRT's acceptability including familiarity with each treatment option presented, prior experience of VR, hazardous drinking, perceived stigma, treatment uptake attitudes, gender, ethnicity, and mental health. Of 259 participants, more than half (52.9%) were drinking at hazardous levels. The majority of respondents (86.9%) expressed a preference for in-person treatments. Cognitive Behavioral Therapy, Counseling, and 12-Step Facilitation Therapy were considered the most acceptable treatments, whereas VRT, and particularly mobile VRT, were perceived as less acceptable than traditional treatments. Treatment familiarity and preferences, prior VR experience, mental health, treatment uptake attitudes, and perceived stigma were all associated with the acceptability of VRT. Psychoeducation and familiarization processes in delivery protocols, and in-person delivery of VRT, could increase the acceptability of VRT, particularly for people who are not regular technology users, or who require concurrent mental health support.