One-session virtual reality exposure treatment for fear of flying: 1-year follow-up and graduation flight accompaniment effects

The efficacy of a brief 1-session virtual reality (VR) exposure treatment of fear of flying (FOF) was demonstrated in a prior study (Muhlberger, Wiedemann, & Pauli, 2003). The current study further evaluated the exposure's effects on a posttreatment graduation flight, with patients accompanied or not by their therapist, and its long-term efficacy (1-year follow-up). Flight-phobic participants completed a brief cognitive preparation and four VR exposure flights conducted in one individual session. Patients were randomly assigned to a graduation flight either alone or with the therapist and other patients. FOF was assessed before and after the treatment session, after the graduation flight, and 12 months later. Fear responses were assessed during VR and graduation flights. Treatment efficacy was reflected in significant FOF reductions, which were maintained over the 12-month follow-up period. Eighty-seven percent and 67% of the assigned patients completed graduation flights accompanied and alone, respectively, but this difference was not significant. However, completion of a graduation flight was a strong predictor for long-term treatment efficacy. A brief 1-session VR treatment effectively reduced FOF for up to one year. Completion of graduation flights may be important for long-term treatment efficacy, but an accompanying therapist presumably is less important.