Technology-Driven Phobia Treatments Could Be the New Reality for Patients Living in Fear – School of Medicine News


An advanced spider crawls on a real-life ceiling in a demonstration of the technology used in a pilot experiment to treat spider fear.

The fear of spiders is real, but the historical methods of treating the phobia by bringing real arachnids into a clinical setting were not ideal. Now, augmented reality exposure therapy could be the next big thing in the clinical management of phobias.

Participants in a parallel pilot randomized controlled study at Wayne State University School of Medicine were able to touch a live tarantula or the container that contains it after exposure therapy with augmented reality exposure therapy, or ARET. The effects persisted or improved at the month-long follow-up.

Arash Javanbakht, Associate Professor of Psychiatry and Behavioral Neuroscience, led the project that saw 25 arachnophobia men and women aged 18 to 45 years either assigned to ARET for arachnophobia or put on waiting lists.

The team, which included laboratory research coordinator Shantanu Madaboosi and PhD student Lana Ruvolo Grasser, found that ARET can be successfully deployed using the Microsoft HoloLens, a portable device that runs novel software with quick responses and persistent effects. The software connects the doctor’s computer to the AR headset via a local area network (LAN) and provides a three-dimensional representation of the surfaces that surround the participant. A drop-down menu allows the clinician to select a hologram and subtype of the dreaded object – wolf, jumping spider, or black widow – as well as its color, size, direction of movement, and speed.

The detailed results of “Real-Life Contextualization of Exposure Therapy with Augmented Reality: A Clinical Pilot Study of a Novel Treatment” were published last month in the Annals of Clinical Psychiatry.

Participants moved through several levels of exposure in the sessions, gradually increasing the speed, proximity, and number of the expanded spiders crawling on walls and in expanded webs, and changing the environment from an open and airy space to a dark and windowless space.

The replication and expansion of the pilot will further support the use of ARET for spiders and other specific phobias such as dogs, snakes and crowds.

The data were collected at baseline, after one week and after one month, and the individual ARET session took place immediately after the baseline was obtained for the intervention group.

Dr. Javanbakht was first exposed to augmented reality after watching a TED talk about the now-defunct AR startup Meta, which focused on one of the company’s headset prototypes presented by its chief executive officer, Meron Gribetz.

Augmented Reality is an interactive human-computer technology that makes it possible to mix virtually created objects with reality. Instead of creating a completely synthetic environment, AR adds virtually created objects to the real world. AR creates only the virtual object and not the entire environment, requires less processing power than VR, and can be less expensive.

“I thought it might be an amazing exposure therapy opportunity. Exposure therapy is an effective treatment, but its use is limited by the lack of access to dreaded objects – I don’t have dogs and spiders in my clinics – and the inability to provide it in a real context. AR can provide access to a variety of dreaded objects, such as: B. Dogs of various breeds, sizes and behaviors that are fully controlled by the therapist in a real-life context. For me it was the ideal solution, ”he said. “It all led to my contacting Meta’s CEO who was a neuroscientist and the rest is history.”

Arash Javanbakht, MD, wears the HoloLens and discusses the technology at a scientific meeting.

This story began in 2016 when Dr. Javanbakht only started testing in a research setting at WSU and worked as a clinical psychiatrist at the same time. He has not yet used AR technology on clinical patients.

“For the next several months we will be using the Post Traumatic Stress Disorder product for first responders to help them overcome their difficulties being around crowds,” he said.

Dr. Javanbakht focused on the fear of spiders in this first pilot because they’re simple enough to prototype, complicated enough to make sense for next steps, and other studies from conventional and virtual reality therapy on arachnophobia could serve as a reference point for that Studies.

“I would like it to be widely used in clinical settings outside of university for the treatment of phobias, PTSD, and social phobia, as well as in education. I would also like to see smartphones being used to deliver the treatment through telemedicine, which will expand its use significantly, ”he said.

Treatment has its challenges, but raising awareness about the technology might help.

“AR is a very new technology and most people aren’t even aware of its existence. It’s mostly only used in large industrial plants, ”he said. “AR programming is not easy and there aren’t many experts in the field.”

Specifically, WSU has selected Advanced Digital Technologies for Stress, Trauma and Anxiety Research and Treatment (ADT-START), which focuses on the use of technology, as a priority of Bold Moves for philanthropic fundraising.

The project team and a team from Koc University in Istanbul, Turkey started the clinical study out of fear of dogs.


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