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Using Virtual Reality Environments to Augment Cognitive Behavioral Therapy for Fears and Phobias in Autistic Adults

Lookup NU author(s): Dr Morag Maskey, Professor Jacqueline Rodgers, Dr Barry Ingham, Professor Mark FreestonORCiD, Dr Marie Labus, Professor Jeremy Parr



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Fears and phobias are common in people on the autism spectrum and can impact on their ability to undertake usual daily activities. Graded exposure to the anxiety provoking stimulus is a recognised method of treatment for fears/phobias in the non-autistic population, but may pose specific difficulties for autistic people. For example, real life exposure can be too anxiety-provoking to allow treatment to take place, and imaginal exposure can be problematic. To address this, we developed an intervention that combines cognitive behaviour therapy with immersive virtual reality (VR) exposure, to reduce anxiety. Following successful trials of this intervention with young people on the autism spectrum, we report a pilot study using the same intervention with autistic adults. Eight adults (aged 18-57 years) received one psychoeducation session and then four 20 minute sessions of graded exposure with a therapist in an immersive VR room (known as the Blue Room). Each participant completed all sessions showing the intervention is feasible and acceptable. Outcomes were monitored at six weeks and six months post intervention. Five of the eight participants were classified as intervention responders and at six months after the end of intervention were experiencing real life functional improvements. These preliminary findings show that VR graded exposure alongside CBT may be an effective treatment for autistic people with phobias.

Publication metadata

Author(s): Maskey M, Rodgers J, Ingham B, Freeston M, Evans G, Labus M, Parr JR

Publication type: Article

Publication status: Published

Journal: Autism in Adulthood

Year: 2019

Volume: 1

Issue: 2

Pages: 134-145

Print publication date: 13/04/2019

Online publication date: 14/02/2019

Acceptance date: 02/11/2018

Date deposited: 06/02/2019

ISSN (print): 2573-9581

ISSN (electronic): 2573-959X

Publisher: Mary Ann Liebert


DOI: 10.1089/aut.2018.0019


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