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      The use of virtual reality in assessment and treatment of anxiety and related disorders

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          Abstract

          In recent years the development of new virtual environments has been qualitatively high and fast at the same time, but the dissemination of virtual reality (VR) in clinical practice is still scarce. The aim of this review is to give an insight into the state of the art of the use of VR as an assessment tool and treatment intervention in anxiety and related disorders as posttraumatic stress disorder and obsessive–compulsive disorders.

          Besides an overview into the efficacy of VR, a summary will be given on assumed working mechanisms in virtual reality exposure therapy and how this aligns with current theoretical models. Further, it will be discussed how VR is accepted by patients and research into the reluctance of therapist to use this technology during treatment with focus on the therapeutic alliance and how it may be influenced by the use of VR. Finally, we discuss clinical and future issues as, for example, dissemination into clinical practice and what VR has to offer therapists in future. This not only in adult population but as well in younger patients, as young adolescents VR has a great potential as it connects easily with its playful elements to this population and might be a low threshold step to offer treatment or preventive interventions.

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          Most cited references90

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          Self-efficacy: Toward a unifying theory of behavioral change.

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            Maximizing exposure therapy: an inhibitory learning approach.

            Exposure therapy is an effective approach for treating anxiety disorders, although a substantial number of individuals fail to benefit or experience a return of fear after treatment. Research suggests that anxious individuals show deficits in the mechanisms believed to underlie exposure therapy, such as inhibitory learning. Targeting these processes may help improve the efficacy of exposure-based procedures. Although evidence supports an inhibitory learning model of extinction, there has been little discussion of how to implement this model in clinical practice. The primary aim of this paper is to provide examples to clinicians for how to apply this model to optimize exposure therapy with anxious clients, in ways that distinguish it from a 'fear habituation' approach and 'belief disconfirmation' approach within standard cognitive-behavior therapy. Exposure optimization strategies include (1) expectancy violation, (2) deepened extinction, (3) occasional reinforced extinction, (4) removal of safety signals, (5) variability, (6) retrieval cues, (7) multiple contexts, and (8) affect labeling. Case studies illustrate methods of applying these techniques with a variety of anxiety disorders, including obsessive-compulsive disorder, posttraumatic stress disorder, social phobia, specific phobia, and panic disorder. Copyright © 2014 Elsevier Ltd. All rights reserved.
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              Emotional processing of fear: exposure to corrective information.

              E Foa, M Kozak (1986)
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                Author and article information

                Contributors
                k.meyerbroker@uu.nl
                Journal
                Clin Psychol Psychother
                Clin Psychol Psychother
                10.1002/(ISSN)1099-0879
                CPP
                Clinical Psychology & Psychotherapy
                John Wiley and Sons Inc. (Hoboken )
                1063-3995
                1099-0879
                14 June 2021
                May-Jun 2021
                : 28
                : 3 , Virtual Reality in Clinical Practice ( doiID: 10.1002/cpp.v28.3 )
                : 466-476
                Affiliations
                [ 1 ] Department of Clinical Psychology Utrecht University Utrecht The Netherlands
                [ 2 ] Altrecht Academic Anxiety Centre Utrecht The Netherlands
                [ 3 ] Institute of Psychology University of Münster Münster Germany
                Author notes
                [*] [* ] Correspondence

                Katharina Meyerbröker, Utrecht University, Department of Clinical Psychology, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands.

                Email: k.meyerbroker@ 123456uu.nl

                Author information
                https://orcid.org/0000-0002-3122-6331
                https://orcid.org/0000-0002-2331-9140
                Article
                CPP2623
                10.1002/cpp.2623
                8362145
                34097318
                7b53a0a9-0acb-45fa-ba18-84f01e4fda45
                © 2021 The Authors. Clinical Psychology & Psychotherapy published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 28 May 2021
                : 23 March 2021
                : 30 May 2021
                Page count
                Figures: 0, Tables: 0, Pages: 11, Words: 11127
                Categories
                Comprehensive Review
                Comprehensive Reviews
                Custom metadata
                2.0
                May/June 2021
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.0.5 mode:remove_FC converted:13.08.2021

                Clinical Psychology & Psychiatry
                anxiety disorders,ocd,ptsd,virtual reality,virtual reality exposure

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