Grant: Project Grant

BACKGROUND: Sexual Aversion Disorder (SAD) affects 1 in 10 adults and is characterized by fear, disgust, and avoidance of sexual contexts. The most effective treatment for SAD is exposure-based sex therapy, which involves graded and repeated exposure to fear- and disgust-eliciting sexual situations. Yet, access to such treatments remains limited in Canada, leaving many without adequate care. One-session Virtual Reality Exposure Therapy (VRET) is a time-efficient treatment that immerses individuals in digital scenarios mimicking real-life situations, offering a promising approach for SAD patients to safely confront and process feared sexual contexts. Our team developed and pilot-tested a one-session VRET for SAD, demonstrating its potential as an effective, acceptable, and safe treatment. PRIMARY AIM: To assess the effectiveness of one-session VRET for SAD in reducing (1) sexual fear, (2) sexual disgust, and (3) sexual avoidance. RESEARCH PLAN: This clinical trial will randomly assign 208 adults with SAD to either a group that will receive one-session VRET (EXP) or a waitlist control group (CTL). VRET effectiveness will be assessed by comparing participants' SAD symptoms at baseline (T1) with their levels at one week (T2), three months (T3), and six months (T4) post-treatment, and by measuring symptom differences between the EXP and CTL groups. VRET includes interventionist-guided exposure to 15 VR scenarios that progressively increase in sexual explicitness. OUTCOMES: EXP and CTL groups will complete validated measures of sexual fear, disgust, and avoidance at T1, T2, T3, and T4, with the CTL group being offered VRET after completing T3. IMPLICATIONS: If effective, this VRET will provide an innovative, time-efficient, and scalable treatment for Canadians with SAD, facilitating its clinical implementation through diverse knowledge mobilization efforts, clinical partnerships, and open-access availability of the VRET application.