Co-Designing a Virtual Reality System to Support Cognitive Behavior Therapy for Social Anxiety

Social anxiety disorder is one of the most common mental health disorders and is characterized by a fear of or avoidance of social situations. Standard treatment recommendations for this disorder include cognitive behavioral therapy (CBT). Virtual reality (VR) shows promise in improving CBT treatment, but it is necessary to understand how to design VR systems that can identify specific fears and effectively address safety seeking behaviours which play a critical role in maintaining the problem. This paper presents a co-design process and design evaluation of a VR system for this purpose, along with an evaluation of its treatment efficacy. Collaborative co-design sessions with experts in social anxiety, digital health, and game development were conducted and the design of the subsequently developed VR system was evaluated with ten participants. Based on the findings from the co-design activities and the design evaluation, this paper contributes system requirements for the development of a VR system to support CBT treatment for individuals with social anxiety disorder. The following therapeutic evaluation of the system with seven participants with reported levels of clinically relevant social anxiety symptoms showed promise that treatment in VR can potentially be used effectively to treat safety-seeking behaviors.