Virtual Reality Exposure Therapy in the Treatment of Fear of Flying


A new and innovative approach to treating fear of flying has been developed using Virtual Reality Exposure Therapy. This article discusses the development of Virtual Reality Exposure Therapy and reviews a case study of a fear of flying patient seen in our practice. Early results are very promising and may indicate that Virtual Reality Exposure Therapy may also lead to creative interventions with other anxiety disorders.

This is a preview of subscription content, access via your institution.


  1. Agras, S., Sylvester, D., & Oliveau, D. (1969). The epidemiology of common fears and phobias. Comprehensive Psychiatry, 10, 151-156.

    Google Scholar 

  2. American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. Washington. D.C.

  3. Beckham, I. C., Vrana, S. R., May, J. G., Gustafson, D. J., & Smith, G. R. (1990). Emotional processing and fear measurement synchrony as indicators of treatment outcome in fear of flying. Journal of Behavior Therapy and Experimental Psychiatry, 11, 153-162.

    Google Scholar 

  4. Boyd, J. H., Rae, D. S., Thompson, J. W., Burns, B. J., Bourdon, K., Locke, B. Z., & Refier, D. A. (1990). Phobia: Prevalence and risk factors. Social Psychiatry and Psychiatric Epidemiology, 25, 314-323.

    Google Scholar 

  5. Carlin, A. S., Hoffman, H. G., & Weghorst, S. (1996). Virtual reality and tactile augmentation in the treatment of spider phobia: A case report. Behaviour Research and Therapy, 1-8.

  6. Denholtz, M. S., & Mann, E. T. (1975). An automated audiovisual treatment of phobias administered by nonprofessionals. Journal of Behavior Therapy and Experimental Psychiatry, 6, 111-115.

    Google Scholar 

  7. Deran, R., & Whitaker, K. (1980). Fear of flying: Impact on the U.S. air travel industry. Boeing Company Document #BCS-00009-RO/OM

  8. DiBartolo, P. M., Hofmann, S. G., & Barlow, D. H. (1995). Psychosocial approaches to panic disorder and agoraphobia: Assessment and treatment issues for the primary care physician. Mind/Body Medicine, 1(3), 133-146.

    Google Scholar 

  9. Forgione, A. G., & Bauer, F.M. (1980). Fearless Plying. The Complete Program for Relaxed Air Travel Boston: Houghton Mifflin Company.

  10. Girodo, M., & Roehl, J. (1978). Cognitive preparation and coping self-talk; Anxiety management during the stress of flying. Journal of Consulting and Clinical Psychology, 46, 978-989.

    Google Scholar 

  11. Greist, J. H., & Greist, G. L. (1981). Fearless flying: A passenger guide to modern airplane travel. Chicago: Nelson Hall.

    Google Scholar 

  12. Guy, W. (1976). ECDEU assessment manual for psychopharmacology revised. 217-222. NIMH Publ. DHEW Publ No (Adm) 76-338.

  13. Haug, T., Brenne, L., Johnson, B. H., Bemtzen, D., Gotestam, K., & Hugdahl, K. (1987). A threesystems analysis of fear of flying: A comparison of a consonant vs a non-consonant treatment method. Behaviour Research and Therapy, 25, 187-194.

    Google Scholar 

  14. Hodges, L. F., Rothbaum, B. O., Kooper, R., Opdyke, D., Meyer, I., North, M., de Graff, J. J., & Williford, J. (1995). Virtual environments for exposure therapy. IEEE Computer Journal, July, 27-34.

  15. Howard, W. A., Murphy, S. M., & Clarke, J. C. (1983). The nature and treatment of fear of flying: A controlled investigation. Behavior Therapy, 14, 557-567.

    Google Scholar 

  16. Hathaway, S., & McKinley, C., Minnesota Multiphasic Personality Inventory, Published by: The Psychological Corporation, 1970.

  17. Kijima, R., & Hirose, M. (July 1993). Virtual Sandbox: a development of an application of virtual environement for the clinical medicine. Paper presented at the Third International Conference on Artificial Reality and Tele-Existence, Toyko.

  18. Klein, R. A., (1998). Virtual reality exposure therapy (fear of flying): From a private practice perspective. CyberPsychology & Behavior, Fall, Volume 1, Number 3, 311-316.

    Google Scholar 

  19. Klein, R. A. (1999). Virtual reality exposure therapy: A new treatment modality for the fear of flying, Published in: Innovations in Clinical Practice: A Source Book, Volume 17, Leon VandeCreek, Ph.D., Editor, 449-465.

    Google Scholar 

  20. McNally, R. J., & Loura, C. E. (1992). Fear of flying in agoraphobia and simple phobia: Distinguishing Features. Journal of Anxiety Disorders, 6, 319-324.

    Google Scholar 

  21. North, M. M., North, S. M., & Coble, J. R. (1996). Virtual environments psychotherapy: A case study of fear of flying disorder. Presence, 6(1), 127-132.

    Google Scholar 

  22. Roberts, R. J. (1989). Passenger fear of flying: behavioural treatment with extensive in vive exposure and group support. Aviation, Space and Environmental Medicine, 60, 342-348.

    Google Scholar 

  23. Rothbaum, B. O., Hedges, L. F., Kooper, R., Opdyke, D., Williford, J., & North, M. M. (1996). Effectiveness of virtual reality graded exposure in the treatment of acrophobia. American Journal of Psychiatry, 152, 626-628.

    Google Scholar 

  24. Rothbaum, B. O., Hedges, L., Watron, B. A., Kessler, G. D., & Opdyke, D. (1997). Virtual reality exposure therapy in the treatment of fear of flying: A case report. Behaviour Research and Therapy.

  25. Spielberger, C. D., Gorsuch, R. L., & Lushene, R. E. (1970). Manual for the State-Trait Anxiety Inventory (self-evaluation questionnaire). Pale Alto, CA: Consulting Psychologists Press.

    Google Scholar 

  26. Strickland, D. (1996). A virtual reality application with autistic children. PRESENCE: Teleoperators and Virtual Environments, 5, 319-329.

    Google Scholar 

Download references


Rights and permissions

Reprints and Permissions

About this article

Cite this article

Klein, R.A. Virtual Reality Exposure Therapy in the Treatment of Fear of Flying. Journal of Contemporary Psychotherapy 30, 195–207 (2000).

Download citation

  • Virtual reality therapy
  • fear of flying
  • anxiety disorders