Therapeutic Setting
Dr. Claudia Ruff works in her practice with children and adolescents who have developmental delays, anxieties, and behavioral issues. A central area of focus is exposure therapy, which has recently been supported by Virtual Reality (VR).
Initial situation
In the presented case, it concerns an 11-year-old girl who has been in psychotherapy for a long time. She lives as a foster child with her grandparents, there are significant developmental delays, and fetal alcohol syndrome (FAS) is also a consideration.
Particularly challenging: The girl struggles with orientation in space and time, and new situations trigger fear and refusal. This was also the case during the planned family trip to the zoo. The petting zoo, in particular, caused her great concern. The fear of direct contact with animals was very pronounced.
Decision for Virtual Reality
A real training session at the zoo would have been hardly practical. At the same time, managing fear seemed important, as the family increasingly lacked shared positive activities. Instead of transferring the burden to the foster parents, Dr. Ruff decided to conduct the exposure herself in practice using VR.
Procedure and Results
At the beginning, the patient became familiar with the VR headset featuring relaxing videos and found it pleasant. After a brief, age-appropriate review of the anxiety management model, the exposure followed:
- two-time confrontation with animal videos that initially caused moderate to strong fear
- rapid habituation during the sessions
- already after the second VR exposure, the anxiety was significantly reduced
The result was immediately visible: Shortly thereafter, the family visited the zoo together and had a positive, anxiety-free outing.
Special Advantages of VR
Dr. Ruff emphasizes how much VR facilitates practical work:
- Elimination of elaborate on-site exhibitions
- better planning and dosing capability
- gradual increase in difficulty that would be hardly implementable in vivo
- Relief for children and parents, as fewer exercises are required outside of therapy
Application Focus Areas
The VR headset is primarily used in practice for exposure therapy for specific phobias, as well as in the areas of relaxation and mindfulness. It frequently utilizes animal and medical videos, as well as the virtual aquarium, and for girls, horse scenarios are also common.
Recommendation to colleagues
„The use of VR has already proven itself in my practice after a short time. The technology is easy and safe to use and is generally well accepted by children and adolescents. I find it important to immerse myself in VR once before the first application.
👉 This reference case impressively demonstrates how VR can enrich work in child and adolescent psychotherapy: practical, efficient, and with high acceptance among young patients.
