Using virtual reality to improve the efficacy of cognitive-behavioral therapy (CBT) in the treatment of late-life anxiety: preliminary recommendations for future research

Int Psychogeriatr. 2015 Jul;27(7):1217-25. doi: 10.1017/S1041610214002300. Epub 2014 Nov 10.


Cognitive-behavioral therapy (CBT) using traditional exposure techniques (i.e. imaginal and in vivo) seems less effective to treat anxiety in older adults than in younger ones. This is particularly true when imaginal exposure is used to confront the older patient to inaccessible (e.g. fear of flying) or less tangible/controllable anxiety triggers (e.g. fear of illness). Indeed, imaginal exposure may become less effective as the person gets older since normal aging is characterized by the decline in cognitive functions involved in the creation of vivid/detailed mental images. One way to circumvent this difficulty is to expose the older patient to a virtual environment that does not require the ability to imagine the frightening situation. In virtuo exposure has proven to be efficient to treat anxiety in working-age people. In virtuo exposure could be employed to improve the efficacy of CBT with exposure sessions in the treatment of late-life anxiety? The current paper explores this question and suggests new research avenues.

Keywords: anxiety; cognitive-behavioral therapy (CBT); in virtuo exposure; older adults; virtual reality (VR).

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Aged
  • Anxiety / epidemiology
  • Anxiety / therapy*
  • Anxiety Disorders / epidemiology
  • Anxiety Disorders / therapy*
  • Cognition
  • Cognitive Behavioral Therapy / methods*
  • Fear / psychology*
  • Humans
  • Research / trends
  • Virtual Reality Exposure Therapy / methods*