Virtual Reality Delivered Exposure for Obsessive-Compulsive Symptoms: A Small-Scale Pilot

Background: Exposure-based therapy is the gold-standard treatment for Obsessive-Compulsive Disorder (OCD). However, a large treatment gap exists for OCD, especially for individuals who do not meet the diagnostic criteria. Virtual reality (VR) has the potential to increase access to exposure-based therapy. Objectives: This study aimed to examine the impact of a single-session VR exposure-based intervention among individuals with below clinical threshold contamination-related OCD symptoms. It also aimed to investigate participant experience and reported acceptability. Methods: In this study, sixteen individuals (N = 16) without a formal diagnosis of OCD but exhibiting heightened fears of toilet contamination were recruited to participate in a VR experience. These participants were tasked with interacting with a simulated public toilet that was intentionally portrayed as unclean. During the single session, participants were exposed twice to the same environment with a short break in between. Participants were asked to report their levels of anxiety and symptoms of OCD during and after the intervention. They were also asked questions regarding VR sickness, acceptability, and sense of presence and plausibility in VR. Results: Though a single session was not effective in reducing contamination symptoms, anxiety was elicited by the Virtual Reality Exposure-Based Therapy (VRET) intervention, demonstrating the potential for the intervention to evoke the hypothesized response. Participants reported minimal VR sickness and found the intervention acceptable. Conclusions: These findings indicate that VRET is a promising intervention for individuals experiencing contamination-related OCD symptoms.