Efficacy of virtual reality-based exposure therapy for the treatment of fear of flying: a systematic review

Abstract Previous research has shown that virtual reality (VR)-based exposure therapy is effective in the treatment of anxiety disorders. However, more information regarding the specific features of this intervention for the treatment of fear of flying (FoF) is needed. The primary aim of this systematic review was to update and analyse the existing data on the efficacy of VR exposure treatment (VRET) in FoF, providing information on the optimal methodological conditions for its administration. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method was employed to select the articles. PsycInfo, Medline and Web of Science were chosen as databases with a wide range of publications related to health and psychology. Thirty-three eligible articles were included in this review. Results showed that participants’ anxiety decreased after being systematically exposed to flight-related VR environments. VRET is at least as effective as other evidence-based treatments, such as cognitive behavioural therapy (CBT) or in vivo exposure therapy (IVET), and therefore is a highly recommended alternative when IVET is difficult to administer, and an excellent complement to enhance CBT efficacy. Regarding sensory cues, the addition of motion feedback synchronised with visual and auditory cues during the exposure to VR environments might improve the efficacy of VRET for FoF, but more research supporting this statement is still needed.