ALCO-VR Project: A randomized clinical trial evaluating virtual reality cue-exposure Therapy for Treatment-Resistant Alcohol Use Disorder patients

Authors

  • Alexandra Ghiţă Department of Health, Medical and Neuropsychology, Institute of Psychology, Leiden University
  • Olga Hernández-Serrano Department of Psychology, UCAM Catholic University of Murcia
  • Jolanda Fernández-Ruiz Department of Clinical Psychology and Psychobiology, University of Barcelona
  • Mariano Gacto-Sánchez Department of Physical Therapy, University of Murcia
  • Miquel Monras Addictive Behaviors Unit, Hospital Clinic of Barcelona
  • Antoni Gual Addictive Behaviors Unit, Hospital Clinic of Barcelona
  • Bruno Porras-García Departament of Basic Sciences, Universitat Internacional de Catalunya
  • Marta Ferrer-García Department of Clinical Psychology and Psychobiology, University of Barcelona, Spain
  • José Gutiérrez-Maldonado Department of Clinical Psychology and Psychobiology, University of Barcelona

DOI:

https://doi.org/10.20882/adicciones.1958

Keywords:

alcohol use disorder, alcohol craving, anxiety, virtual reality, cue-exposure therapy, clinical trial

Abstract

The management of “treatment-resistant” alcohol use disorder (AUD) often presents significant challenges. Virtual reality (VR) applications, specifically VR cue exposure therapy (VR-CET), offer a potentially complementary approach to the standard treatment (TAU). This randomized clinical trial (RCT) aimed to assess VR-CET’s effectiveness when added to TAU, compared to TAU alone, in reducing alcohol craving and anxiety among individuals with treatment-resistant AUD. The study also sought to determine anxiety and craving levels during VR-CET sessions and to explore long-term effects. Eighty-five AUD patients from the Clinic Hospital of Barcelona participated. They were randomly assigned to either an experimental group (EG), receiving VR-CET plus TAU, or a control group (CG), receiving TAU alone. The EG completed six VR-CET sessions alongside TAU, while the CG continued with only TAU. Alcohol craving and anxiety were assessed before and after treatment for both groups, and during VR-CET sessions for the EG. Relapses were monitored at 3-, 6-, and 12-months post-treatment. Results indicated no significant main effects of “type of treatment” (EG vs. CG) on craving or anxiety. However, a significant “time” factor was observed, showing reductions in craving and anxiety from pre-test to post-test, regardless of the treatment type. Within VR-CET sessions, EG participants reported minimal anxiety and craving by the end of the therapy. Importantly, no statistically significant differences in relapse rates were found between the EG and CG at any follow-up period (3, 6, 12 months). The clinical implications of the study, limitations, and research directions are further discussed. 

Author Biography

Olga Hernández-Serrano, Department of Psychology, UCAM Catholic University of Murcia

Departamento de Psicología Profa. Contratado Doctor.

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Published

2025-09-22

Issue

Vol. 37 No. 3 (2025)

Section

Originals