January 16, 2001
Rothbaum looks to 'virtually'
cure fear of flying
By Heather Szafranski
Virtual reality exposure therapy (VRE) is a potentially efficient and cost-effective treatment for fear of flying, according to a study published in the December issue of the Journal of Consulting and Clinical Psychology.
Fear of flying is a significant problem, affecting about 25 million
adults in the United States, said Barbara Rothbaum, principal investigator
of the study and associate professor of psychiatry and behavioral sciences.
Avoidance of flying causes sufferers serious vocational and social
Virtual reality offers a new human-computer interaction paradigm in which
users are no longer simply external observers of images on a computer
screen, but are active participants within a computer-generated, three-dimensional
The most effective treatment for fears and phobias is to expose
the sufferer to the feared object in a therapeutic manner, Rothbaum
said. Exposure most often occurs when patients imagine the feared
situationimaginal exposureand/or put themselves in the actual
situationin vivo exposureuntil the fear subsides.
The obvious drawbacks of these two methods, she continued,
are lack of realism [with imaginal exposure] and higher cost, greater
impracticality and reluctance with in vivo exposure. Virtual reality technology
offers the potential to make exposure more realistic than imaginal exposure
and more practical than in vivo exposure.
For their research, Rothbaums team studied 49 patients, ages 24
to 69, with fear of flying and assigned them to one of three groups: VRE,
standard exposure (SE) or wait list (WL). Forty-five patients completed
the study, and, in addition to standard pre- and post-treatment methods
and follow-ups at six and 12 months post-treatment, a post-treatment test
flight was conducted to assess participants anxiety and avoidance
for an actual airplane flight.
After it was determined that participants met certain criteria to participate
in the study, they were treated for eight individual sessions over six
weeks. VRE treatments comprised simulations of sitting in an airplane,
airplane take-offs and landings, and flying in both calm and stormy weather,
and they were provided twice weekly for two weeks according to a treatment
manual designed by the researchers. The treatments included recorded sounds
of flight attendants, takeoffs, landings and weather effects outside the
Participants sat in a specially designed seat with an embedded 100-watt
subwoofer and an attached airplane seatbelt. VR-generated scenes placed
participants in a passenger seat by the window on a commercial airplane.
As they moved their heads to the left, they were able to see out the left-hand
window. As they moved their heads to the right, the empty seats to the
right side of the airplane and the right-side window came into view.
At six months after treatment, 11 of 14 VRE participants and nine of
13 SE parti-cipants had flown since the graduation flight of the study.
Overall, by the six-month followup, 14 of the 15 remaining VRE and SE
participants had flown since the termination of treatment, either on the
graduation flight or otherwise.
Results of this study indicated that VRE and SE treatments were equally
effective both in decreases in symptoms, as measured by standardized questionnaires,
and by the number of participants able to fly on a real airplane following
In addition, anxiety ratings during the actual flight indicated that
VRE-treated patients were as comfortable as SE-treated patients. When
WL participants were asked to choose which treatment they would receive,
an overwhelming majority of participants chose VRE, indicating a clear