Virtual Reality Exposure Therapy for School Avoidance

by Xu Zhang

Medical Devices & Digital Health

Problem: Absenteeism from school due to school-related anxiety or phobia can have serious consequences for children and their families, which affects between 5-28% of school aged children. The currently gold standard clinical intervention for children with school avoidance is exposure therapy. Typically, exposure therapy will involve live role-playing scenarios, or taking patients to school settings to desensitize them to the triggers of their anxiety. However, implementing these live role-playing scenarios or taking patients to real-world settings, can be very costly and time-consuming, and therefore patients may be limited in their ability to repeat exposures. The Covid-19 pandemic since 2020 has further complicated the implementation of exposure therapy due to space and gathering restrictions.

Virtual reality (VR) is a validated tool for exposure therapy for phobias to certain triggers such as heights, flying, and spiders. VR products place users in immersive virtual environments that can feel very real in part because of the one-to-one translation of the user’s movements in virtual space. While VR for exposure therapy for specific phobias is well validated, VR to treat anxiety related school avoidance does not have a comprehensive solution.

Solution: The goal of our project is to replicate and augment evidence-based exposure therapy methods for school avoidance. The components for a real-world exposure therapy setting are the following: an anxiety inducing setting and scenario, a way to monitor the anxiety levels of the patient during the exposure, and a way to adjust the scenario based on these reported anxiety levels.

We believe that this VR solution would both offer an improvement for the patient experience, as well as lower costs for practitioners and institutions treating school anxiety. In a typical school avoidance program, a patient may need an exposure scenario that requires an hour or more to conduct (such as going to a cafeteria and ordering food) and/or the time of multiple clinicians (e.g., to act as peers). A VR exposure can potentially reduce 70% of exposure setup and transition time, multiple patients may do exposures at once, and the exposures can be repeated, possibly allowing for increased capacity in the program or reduced clinical resources, and reducing the need for patients to return to the program. This product could be marketed directly to hospitals and therapists in private practice as a way to augment their current practices to treat patients more efficiently and effectively.