Exposure-based cognitive behavior therapy (CBT) has demonstrated efficacy and is recommended as a front-line treatment for childhood anxiety. Unfortunately, challenges exist that impact the effective implementation of exposure-based CBT in clinical practice. One of the primary challenges is the accessibility and availability of exposure stimuli (e.g., spiders, storms, heights) in CBT sessions. Immersive virtual reality (VR) has shown promise as a scalable and sustainable solution to address this clinical need, but remains largely untested in youth with anxiety disorders. Here, we examine the use of VR exposures in the treatment of youth with an anxiety disorder (i.e., specific phobias). We aimed to investigate: (1) the feasibility and clinical benefit of VR exposures; (2) whether VR exposures elicit changes in physiological arousal and/or subjective distress; and (3) whether habituation serves as a mechanism across physiological and subjective outcomes for VR exposures. Three youth and their parents completed a clinical evaluation, which was followed by a one session treatment (OST) with VR exposures. Afterward, youth and parents completed clinical assessments one-week and 1-month after treatment. Immersive VR exposures were found to be feasible and demonstrated clinical benefit for reducing anxiety severity. Additionally, VR exposures elicited changes in both physiological and subjective outcomes. Finally, physiological habituation to VR exposures was observed among participants who exhibited treatment response at follow-up. Collectively, these findings demonstrate preliminary evidence that VR exposures are feasible, tolerable, and show some therapeutic benefit for treating youth with anxiety.

基于暴露的认知行为疗法（CBT）已被证明有效，并被推荐作为儿童焦虑的一线治疗方法。不幸的是，存在的挑战影响着基于暴露的 CBT 在临床实践中的有效实施。主要挑战之一是 CBT 课程中暴露刺激（例如蜘蛛、风暴、高度）的可及性和可用性。沉浸式虚拟现实 (VR) 已显示出作为一种可扩展且可持续的解决方案来满足这一临床需求的前景，但在患有焦虑症的青少年中仍然很大程度上未经测试。在这里，我们研究了 VR 暴露在治疗患有焦虑症（即特定恐惧症）的青少年中的应用。我们的目的是研究：（1）VR暴露的可行性和临床效益；(2) VR暴露是否会引起生理唤醒和/或主观痛苦的变化；(3) 习惯是否可以作为 VR 暴露的生理和主观结果之间的机制。三名青少年及其父母完成了临床评估，随后进行了 VR 暴露的一次性治疗 (OST)。随后，青少年和家长在治疗后 1 周和 1 个月完成临床评估。研究发现沉浸式 VR 暴露是可行的，并且已证明对于减轻焦虑严重程度具有临床益处。此外，VR 暴露还会引起生理和主观结果的变化。最后，在随访中表现出治疗反应的参与者中观察到了对 VR 暴露的生理习惯。总的来说，这些发现证明了初步证据表明 VR 暴露是可行的、可以忍受的，并且显示出对治疗青少年焦虑症有一定的治疗效果。