ArticleInternet interventions2026
Facing fear through play: A smartphone-based proof-of-concept intervention using inverted augmented reality.
Article in Internet interventions, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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3 authors.
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Abstract
Background: Despite the well-documented efficacy of exposure therapy for phobic disorders, its real-world implementation remains limited due to barriers in accessibility, acceptability, and generalization. Objective: This proof-of-concept study examined the feasibility and preliminary effects of a novel gamified augmented reality (AR) intervention designed to support in vivo exposure by embedding playful, non-threatening virtual stimuli into real-world anxiety-provoking contexts. Methods: Twenty individuals with various phobic disorders participated in a multiple-baseline design. At a randomly assigned time point, participants used a smartphone-based AR application, or in some cases, a VR headset version, to interact with virtual game elements within individualized fear-relevant environments. The task involved physically navigating individualized fear-relevant environments while collecting color-coded virtual objects presented via augmented reality within the real-world setting. Results: Linear mixed-effects analyses indicated a significant reduction in self-reported situational fear following the intervention, with a large within-subject effect size estimate (Cohen's d = 2.21). Secondary outcomes related to anxiety sensitivity, agoraphobic cognitions, and depressive symptoms also showed pre-post improvements with small to moderate effect sizes. No significant differences were observed across device types or treatment settings. Conclusion: The findings provide preliminary support for a low-threshold, smartphone-based AR approach that may complement exposure-based interventions in naturalistic settings. However, given the small and heterogeneous sample and the absence of a control group, these results should be interpreted cautiously. Future randomized controlled studies with larger and more homogeneous samples, validated behavioral outcome measures, and follow-up assessments are needed to clarify efficacy, mechanisms of change, and long-term effects.
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