A ground-breaking new study, led by the University of Oxford and funded by the National Institute for Health and Care Research (NIHR), suggests that needle phobia can be successfully treated using an automated VR psychological therapy.

In the first ever clinical trial of a VR treatment for needle fears in adolescents, published in The Lancet: eClinical Medicine, the automated therapy was shown to substantially reduce needle fears in young people aged 12-15.

Needle fears are very common among children and teenagers, affecting around 20 to 50% of adolescents. Yet several key vaccinations are given during the teenage years, including against tetanus, diphtheria, polio, meningitis, and the human papillomavirus (HPV). The HPV vaccine is a key part of the UK government’s plan to eradicate cervical cancer by 2040.

The NHS aims to vaccinate 90-95% of adolescents but currently only reaches 70-75%. Approximately 10-20% of the shortfall is due to fear about needles.

The new treatment, which takes just 2.5 hours in VR, was developed by researchers from the University of Oxford. A group of young people with needle fears collaborated in the design.

Prof Daniel Freeman

Professor Daniel Freeman, Consultant Clinical Psychologist at Oxford Health NHS Foundation Trust and NIHR Biomedical Research Centre: Oxford Health Psychological Treatments Theme Lead said:

“It is crucial that young people feel comfortable with the idea of vaccination, blood tests, and other medical procedures involving needles.

“Needle fear can be successfully treated using gradual exposure to needles and related stimuli. This helps the person learn that they can cope around needles. But because of a shortage of therapists very few people are able to access such help.

“Virtual reality offers an exciting way to get therapy that works for the people that need it. Our needle fears program runs on inexpensive consumer VR headsets. There is a virtual therapist, so treatment is automated.

“People find it easier to approach the objects they fear in VR because they know they’re not real, yet the learning made still transfers to the real world. And VR allows us to present stimuli in ways that are therapeutic but impossible in the real world, making treatments more engaging, accessible, and effective.”

The VR therapy is set in a high school. A virtual coach, Farah, gives the user information about needle fears and overcoming them, encouragement, and guidance about what to do in each part of the program.

The VR therapy is set in a school

Users work through five levels of exposure: looking at needles, picking up needles, using needles, observing needle procedures, and receiving needle procedures. The tasks build up from seeing virtual needles in display cases to piercing balloons with needles to injecting a penguin and a giant to watching a person being vaccinated to a final gym-set school scene, in which a nurse gives a vaccination into the user’s virtual arm.

VR scene of a nurse administering a vaccine into a virtual arm

Dr Eve Twivy, trial clinical psychologist, Department of Experimental Psychology, University of Oxford commented: “VR has previously been used as a distraction from anxiety or pain during needle procedures. Instead, we targeted the fear that makes many people avoid these procedures.

“People may fear that something bad will happen, such as the procedure going wrong, being very painful, or being unable to cope. We wanted to help young people feel less afraid by interacting with virtual needles through a series of playful and informative activities.

“Facing fears is challenging, but young people in our trial were motivated to complete the programme and found it helpful.”

The research is funded by the Beryl Alexander Charity and the NIHR Biomedical Research Centre (BRC): Oxford Health and the NIHR BRC: Oxford.