Cristiane Maluhy Gebara & Tito Paes de Barros Neto
University of São Paulo, Brazil
Cristiane Maluhy Gebara holds a degree in Psychology from Paulista University (1990) and completed her Master’s degree at the University of São Paulo. She is a specialist in Behavioral Medicine from the Federal University of São Paulo. She is a Teacher and Researcher of Anxiety Program (AMBAN), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo; Supervisor of the Impulse Control Disorder Outpatient Clinic (AMITI), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo. She also has extensive experience in the field of Psychology, with emphasis on cognitive behavioral therapy, treating adolescents, adults and couples. She is the Creator of the Virtual Reality Program to treat Social Phobia – VRSP Program.
Tito Paes de Barros Neto holds a degree in Psychiatry (1984) and completed his Master’s degree at Faculty of Medicine of the University of São Paulo. He is a specialist in cognitive behavior therapy. A supervisor, a teacher and a researcher of Anxiety Program (AMBAN), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo. Author of the book “Sem medo de ter medo.” (No fear of having fear), Segmento Farma Ed., 2016. 6a ed.
Statement of the Problem: The defining feature of social phobia (SP) is an excessive fear of social situations and the interaction with other people, bringing feelings of humiliation, fear of judgment and inferiority. The exposure is among the cognitive behavioural therapy of choice in the treatment of SP. The principle of exposure consists of confronting and accustoming the patient to the stress situations. It can be in vivo or imaginable. The Virtual Reality Exposure (VRE) has advantages over imaginable or in vivo exposures, like it provides standardized and controlled environments, with scenes that can be repeated, achieving therapeutic goals; it is held within the office, preserving the privacy of the subject when he presents a sharp discomfort to experience real situations.
Methodology: A VRE software for SP treatment was developed, (VRSP program) to evaluate and improve it based on quantitative and qualitative analysis. The scenes created anxiety-generating social situations in three dimensions (3D). Two virtual scenarios were created: One on a street and one at a party. The scenes consisted of walking down the street, approaching people on the street, entering the party, engaging in conversation at the party, welcoming guests at the party, and talking and giving a speech at the party. 21 patients with a DSM-IV diagnosis of SP took part in the trial and the treatment consisted of up to 12 sessions of exposure to relevant images, each session lasting 50 minutes.
Findings: Improvements in social anxiety were seen in all scales and instruments used, including at follow-up 6 months after the end of treatment and the average number of sessions was seven, as the participants habituated rapidly to the process.
Conclusion: The VRSP program (English, Spanish and Portuguese versions), can reduce social anxiety, leads to greater treatment adherence, so can be a useful tool for therapists to have in their offices.