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BackgroundDespite being the treatment of choice for phobic disorders, in vivo exposure treatment (IVET) presents some important limitations related mainly to low acceptance and high drop-out rates. Augmented reality (AR) technologies can help to overcome these limitations. Evidence supports the use of AR in exposure treatment for small animal phobia. A new projection-based AR exposure treatment system (P-ARET) that offers the possibility of projecting the animals in a natural and non-intrusive environment has been developed. There are no randomised controlled trials (RCTs) available that have tested the efficacy of this system in cockroach phobia. This paper aims to present the protocol of an RCT that evaluates the efficacy of the P-ARET, versus an IVET group and a waiting list control group (WL), in carrying out exposure treatment for cockroach phobia.Methods/designParticipants will be randomly allocated to one of three conditions: (1) P-ARET, (2) IVET and (3) WL. Both treatment conditions will follow the ‘one-session treatment’ guidelines. As a diagnostic measure, the Anxiety Disorders Interview Schedule for Diagnostic and Statistical Manual for Mental Health Disorders-Version 5 will be used. The Behavioral Avoidance Test will be used as the primary outcome measure. Secondary outcome measures will include an attentional biases task (measured using eye-tracking technology), the Fear of Cockroaches Questionnaire, Cockroach Phobia Beliefs Questionnaire, Fear and Avoidance Scales, Beck Depression Inventory second edition, Disgust Propensity and Sensitivity Scale-Revised-12, State-Trait Anxiety Inventory, Clinician Severity Scale, and Expectation and Satisfaction with the Treatment Scale. The evaluation protocol will include pretreatment and post-treatment evaluations and 1, 6 and 12 months of follow-ups. Intention-to-treat and per-protocol analyses will be performed.Ethics and disseminationThis study has been approved by the Ethics Committee of Universitat Jaume I (Castellón, Spain; 13 December 2019). The results of the presented RCT will be disseminated in presentations at international scientific meetings and peer-reviewed scientific journals.Trial registration numberNCT04563390.

IntroductionIn vivo exposure is the treatment of choice for specific phobia (SP), but this technique presents limitations related to access and acceptability. Augmented reality (AR) offers advantages like maximising strategies such as ‘variability’ (varying stimuli, durations, levels of intensity or the order of the items), control by the therapist, or ‘exposure to multiple contexts’, which can produce positive effects in terms of fear renewal and generalisation of the results. The aim of this study is to test the efficacy of varying the phobic stimuli during treatment with AR: using multiple stimuli (MS) versus a single stimulus (SS) in participants with SP.Methods and analysisParticipants (N=80) with a diagnosis of an SP of cockroaches will be randomised into two conditions: (1) projection-based AR exposure therapy with MS (P-ARET MS); (2) P-ARET with an SS (P-ARET SS). The measures are related to the efficacy results (fear, avoidance and negative thoughts, performance on the behavioural avoidance test (BAT) and preferences). The primary outcome measure is the BAT, and the secondary outcome measures are the BAT through AR, Fear of Cockroaches Questionnaire, Cockroach Phobia Beliefs Questionnaire, Fear and Avoidance Scales Patient’s Improvement Scale, and Beck Depression Inventory Second Edition. Five evaluation moments will be included: preintervention, postintervention, and 1-month, 6-month, and 12-month follow-ups. The treatment will follow the guidelines of the ‘one-session treatment’. Student’s t-tests to compare the two groups on the post-test will be applied. In addition, two-way analysis of variances with repeated measures in one of the two factors (pretest, post-test and follow-ups) will be carried out to compare intragroup differences.Ethics and disseminationThe Universitat Jaume I Ethics Committee (Castellón, Spain) granted approval for the study (CD/64/2019). Dissemination will include publications and presentations at national and international conferences.Trial registration numberNCT04563403.