Design and development of virtual reality exposure therapy systems: requirements, challenges and solutions

Virtual Reality technology is being utilized to administer psychotherapy treatments. Virtual Reality Exposure Therapy (VRET) provides a safer and less expensive platform for the exposure therapy treatment of numerous anxiety disorders such as phobias. Though, research studies have demonstrated the effectiveness of VRET, its large scale adoption is yet to be realized. Many VRET solutions have been designed, however, few are widely used or commercially available. Moreover, these solutions lack standardization as there are no significant guidelines available for developing them. Consequently, it prevents the existing VRET systems from being adopted for clinical treatment. Thus, there is a need for determining the critical design requirements to create practically effective, safe and commercially viable VRET solutions. To this end, we put forward key design considerations in designing VRETs. Keeping in view these considerations, we present Defear, a therapist-led VRET solution to facilitate the treatment of phobias. Defear not only provides VRET solutions but also includes wide-ranging features including patient management, meditation, and progress tracking to support therapists in their exposure therapy treatments. Usability assessment showed that Defear was positively and highly rated by the users. Moreover, we also present the challenges in the planning, development, evaluation, and dissemination of VRET applications.