Treating Fear of Flying (aviophobia) in Virtual Reality

Aviophobia or fear of flying is an anxiety disorder of the family of specific phobias. It is very common, affecting about 10% of the French population and 20% of the world population.

The AI revolution !

We use Artificial Intelligence both through a coach named Camille and through virtual characters within the scenes. Camille provides support and acts as a trusted companion to whom you can share your concerns without fear of judgment. On the other hand, the virtual characters faithfully replicate real-life social behaviors. You will be able to interact with them in various everyday contexts, such as a party, a date, a job interview, or a spontaneous conversation on the street. Learn more

Receive the C2Care method for free, combining Artificial Intelligence and Virtual Reality !

ARTICLE : WRITTEN BY JULIE FACCINI

March 13, 2020

Aviophobia or fear of flying is an anxiety disorder of the family of specific phobias. It is very common, affecting about 10% of the French population and 20% of the world population. 

In order to treat this anxiety disorder, therapy through exposure to virtual reality appears to be the most appropriate therapeutic solution with an effectiveness proven by the scientific literature. Indeed, cognitive-behavioral therapies are today the most effective therapeutic method in the treatment of phobias. Exposure is central and determining in the therapeutic success. By definition, to achieve this success, it is necessary to expose the patient to aircraft-related stimuli, which are complex in in vivo exposure. C2Care has developed a software with optimal technological properties to meet the needs of behavioral, cognitive and emotional treatment of aviophobia. The application: an airport with ultra-realistic graphics, the key stages of an airplane trip with a sequential and controllable narrative process, multiple intra-environmental interactions, a maximized feeling of presence. 

Fear of flying is subject to inter-individual variability and requires individualized and personalized treatment. One of the essential steps in this treatment will be the prioritization of anxiety-provoking situations : In concrete terms, certain phases of a plane trip activate the patients’ anxiety to a different degree. Thus, in order to respect the postulates of the exhibition, the patient will be able to live virtually a plane trip in its integrity or, according to the typology of the disorder, to place the subject directly on the problematic stage(s). Among these, the software allows to live :

The entrance to the airport

This stage is one of the most anxiety-provoking for patients. During this phase, they will experience realistic interactions allowing them to apprehend the anxiety-provoking stimuli in their entirety: waiting at the counter, destination displayed in a modular fashion, interaction with the flight attendant, ticket withdrawal, sound stimuli… Multi-sensorial immersion offers a complete exposure ground for maximized behavioral work.

Boarding gate

Here, the patients begin a complex passage for an aviophobe: the wait before boarding. The therapist will be able to program the wait before the announcement on the flight attendant’s microphone. The situation of waiting in an anxiogenic context gives access to the emotional, cognitive and behavioral experience of the patient. Stimulating the flow of these substrates is the essential key to achieving optimal therapeutic work. In addition, sound and visual stimuli act as emotional triggers to facilitate the goal of habituation. 

Entering the plane

The patient will be immersed at the entrance of the plane where he will be welcomed by the hostess. As in reality, the patient will discover the interior of the plane as he takes his seat while waiting for takeoff. Once this step is completed, the wait ontarmac before the departure of the plane could be proposed as an alternative exposure situation.

The take-off

Take-off is an anxiety-provoking phase for many people, including non-phobics. This is why, in a therapeutic framework and with regard to the disorder encountered by aviophobes, it is essential to be able to expose the subjects in a virtual context where the degree of realism is preeminent. C2Care engineers have worked on the development of this software with this perspective. Here, the patient will experience the sensations inherent to the take-off: sound and visual stimuli, height sensations… The therapist will have control over the addition or removal of stimuli in order to vary the severity of the exposure. This phase, like all the other steps in the software, can be repeated as often as necessary until the dysfunctional response is extinguished..

Flight

The exhibition is carried out in a flight context with a weather modulable by the therapist. With a view on the window, the patient will be able to observe his environment from the plane seat. Seated next to other passengers, the realism of the virtual experience will be in adequacy with the experienced reality. The in-flight exposure can be graduated by adding anxiety-provoking cues (rain, baby noises…). In addition, under the control of the therapist, exposure to areas of turbulence are made possible. This type of exposure provides the therapist and the patient with a global apprehension of the specificity of the disorder, thus allowing the patient to confront reality with solid knowledge.

The landing

Again, this is an important step in the management of aviophobia. Landing arouses many worries and a very strong activation of anxiety. The C2Care Aviophobia software artificially generates the animation of the factors that maintain the disorder in order to desensitize the patients. In order to allow the extinction of the dysfunctional response, this typical scenario can be repeated as many times as necessary.

The exit of the plane

During this last stage, patients will almost automatically display avoidance behaviour and will try to get out of the plane as quickly as possible. This behavioral manifestation has the effect, in the short term, of reducing anxiety but, in the long term, reinforces the disorder. It is therefore necessary to target this phase in the exposure work in order to achieve completeness. The therapist will be able to determine himself the waiting time before getting off the plane. The patient will thus be exposed in the plane, placed behind the queue. 

Aviophobia has made its treatment complex because of the difficulty of access to suitable environments. The present software, a real virtual airport, makes it possible to overcome all the difficulties inherent in in vivo exposure. In addition to the functionalities listed above, the graduation can be refined by a subtlety present in the variations of the stimuli: insistence of the glances, change of the facial expressions of the avatars, addition of disturbing noises. The patient can benefit from a visual aid to cardiac coherence. The bluffing realism is the consequence of the use of the latest technologies (scan) for the creation of this software. Thanks to the multitude of sequenced situations, therapists will be able to respond to therapeutic requests in a personalized manner. Indeed, the importance and the respect of the hierarchy of the situations was underlined in the controller where the therapist will be able to choose the adequate scenario for each stage of the treatment. In this sense, the therapist will be able to respond to even the most urgent requests of aviophobes faced with an imminent displacement situation since the scenes are infinitely reproducible.

Are you a healthcare professional? Discover our solutions to treat your patients’ phobias

Are you an individual? Discover our services to treat your fear of flying

Do you need further information or have any specific questions ?

FAQ

Virtual reality (VR) is an innovative technology that enables patients to be exposed to immersive and controlled environments, facilitating the management of numerous psychological and psychiatric disorders. Its use in mental health offers several advantages:
  • Gradual and Controlled Exposure: VR allows patients to confront anxiety-inducing situations in a secure environment, gradually adjusting the intensity of stimuli to promote habituation and emotional regulation.
  • Realistic and Reproducible Environments: Unlike traditional techniques, VR provides immersive scenarios that can be consistently reproduced, ensuring a coherent and effective approach.
  • Increased Patient Engagement: The interactive and immersive nature of VR enhances treatment adherence and motivates patients to continue their therapy.
  • Personalized Treatment: Virtual environments can be adapted to meet the specific needs of each patient.
  • Versatile Applications: VR is used to treat anxiety disorders (phobias, post-traumatic stress disorder, obsessive-compulsive disorders), addictions, mood disorders, and even cognitive remediation.
The use of virtual reality in healthcare is not new! It has been studied and utilized for over 30 years in the medical and psychological fields. As early as the 1990s, researchers began exploring its potential for treating anxiety disorders, particularly phobias and post-traumatic stress disorder. Since then, numerous scientific studies have confirmed its effectiveness in addressing various psychiatric, neurological, and cognitive disorders.
Today, VR is widely integrated into therapeutic and medical practices, with clinically validated protocols. It is used in hospitals, clinics, and psychologists' offices worldwide to provide patients with innovative, effective, and safe treatments.
To use virtual reality, one must immerse themselves in a virtual environment. There are several ways to achieve this.
In the past, the CAVE system (Cave Automatic Virtual Environment), a 3D setup consisting of multiple screen walls, was the primary method used. This system allowed users to be fully immersed in the virtual world, with their movements detected in real-time. However, this technology was expensive and not widely accessible.
Since around 2016, with the introduction of virtual reality headsets like the Oculus Rift and HTC Vive, VR has become much more accessible. These headsets immerse users in virtual reality through an enclosed screen that projects digital images. The user's head movements are tracked, enabling them to look around and interact with the environment as they would in the real world.
Today, VR headsets are wireless and standalone, providing maximum comfort and ease of use without requiring external sensors or cables.
A virtual environment is an immersive digital simulation created through virtual reality. It allows users to navigate in a 3D space that accurately replicates everyday situations or specific contexts.
In mental health, these environments are designed to help individuals gradually face certain situations, manage their emotions, or enhance cognitive skills. By interacting with these virtual spaces, patients can engage in meaningful experiences tailored to their needs.
You need to equip yourself with a virtual reality headset. Our software is compatible with Meta Quest 2, 3, and 3S. 
You will then only need an internet connection. 
Numerous studies confirm that virtual reality is safe to use. However, some restrictions are in place to protect users from potential adverse effects.
For instance, individuals with epilepsy and pregnant women should avoid this type of therapy.
As with any immersive technology, prolonged use may cause visual fatigue or mild discomfort, particularly for those sensitive to motion sickness. Therefore, it is recommended to take regular breaks and adjust session durations according to individual needs.
Virtual environments are designed to be gradual and controlled, minimizing the risk of excessive anxiety. Most users quickly adapt to immersion and experience the benefits of this innovative approach from the first sessions.
Anxiety disorders and phobias can be effectively treated using virtual reality. Patients are gradually and progressively exposed to anxiety-inducing situations in various environments while remaining in a safe space. This process helps develop a sense of habituation, ultimately reducing or even eliminating anxiety over time.
Behavioral and substance addictions can also be addressed through virtual reality. By incorporating synthetic stimuli into the environments that trigger craving responses, patients struggling with addiction can work on their cravings to diminish the urge to consume.
Additionally, multiple environments—such as bars, casinos, and social settings—enable cognitive work on dysfunctional beliefs associated with specific temptation scenarios.
Regarding eating disorders, virtual reality software helps target key etiological factors, such as body dysmorphia, allocentric lock (a tendency to focus on others rather than oneself), and food cravings.
Currently, our TERV (Virtual Reality Exposure Therapy) solutions include multiple software programs designed to address critical psychiatric, psychological, and neuropsychological determinants such as relaxation, cognitive stimulation, behavioral activation, and social skills training.
Reminiscence therapy is also a major therapeutic tool in treating depression. By allowing patients to relive sensations linked to past pleasurable activities (such as sports, driving, or traveling), virtual reality stimulates hypoactive brain areas, enhancing therapeutic success. VR serves as an excellent mediator for reigniting engagement in enjoyable activities.
Moreover, cognitive stimulation for elderly individuals is another area where virtual reality proves beneficial. By leveraging technology to make stimulation activities more engaging and accessible, patients and nursing home residents can improve executive functions and memory through specially designed applications.
Today, virtual reality in mental health care is advancing rapidly. Researchers, clinicians, and developers continue to explore new therapeutic targets to offer innovative and effective treatment solutions in the near future.
VR can be used by all healthcare professionals assisting patients with anxiety, phobias, post-traumatic stress disorders, addictions, or other psychological challenges.
It is particularly beneficial for psychologists, psychiatrists, neuropsychologists, specialized nurses, as well as psychomotor therapists, physiotherapists, dietitians, sophrologists, and hypnotherapists. With a wide range of immersive environments, VR enhances therapeutic approaches and provides innovative tools to improve patient care.
Healthcare providers incorporating virtual reality exposure therapy (VRET) expand their range of treatment options. VRET is a well-established therapeutic technique with scientific validation from cognitive-behavioral therapy research.
  • Professional Differentiation: Integrating VR into practice allows therapists to stand out from traditional treatment options.
  • Scientific Validation: VRET is backed by extensive research, reinforcing its credibility as an effective treatment method.
  • Improved Patient Engagement: The interactive nature of VR fosters greater patient involvement in therapy.
  • Time-Saving: VR provides direct access to various exposure environments without needing external logistics.

One of the considerable advantages of virtual reality is that it is effective on a wide spectrum of populations. Existing data from the literature on the subject shows us that it is entirely possible to expose a wide age group to virtual reality, with real therapeutic benefits.

The studies attest, in fact, to excellent feasibility and significant results; particularly in adults, in the treatment of anxiety disorders (including school phobia), autism, addictions, eating disorders, neuropsychological disorders, psychotic disorders and mood disorders.

The results are identical for adolescents with a significant added value concerning therapeutic engagement where virtual reality promotes adolescents' interest in their therapy.

Among elderly subjects, study results encourage the use of virtual reality with the aim of working on cognitive stimulation, on behavioral disorders but also on anxiety.

One of the major advantages of virtual reality is its effectiveness across a broad spectrum of the population. Existing literature on the subject shows that virtual reality can be used with individuals of various age groups, providing significant therapeutic benefits.
Studies confirm excellent feasibility and significant results, particularly among adults in the treatment of anxiety disorders (including school phobia), autism, addictions, eating disorders, neuropsychological disorders, psychotic disorders, and mood disorders.
The results are equally promising for adolescents, with a notable advantage in terms of therapeutic engagement, as virtual reality enhances their interest and participation in treatment.
For older adults, research supports the use of virtual reality to improve cognitive stimulation, behavioral disorders, and anxiety management.
However, people with epilepsy and pregnant individuals are not advised to undergo this type of therapy.
Yes, all our environments are grouped within a single application.
Our technical support team is available Monday to Friday, from 9:00 AM to 1:00 PM and 2:30 PM to 5:30 PM (Paris time), at technical@c2.care
You can cancel at any time by filling out the form at the bottom of the page.