This multinational randomized controlled trial (RCT) is conducted in inpatient units for alcohol dependence and dual diagnoses in Denmark, Germany, and Poland. A total of 204 patients with alcohol dependence are randomized (1:1:1) to virtual reality–based approach–avoidance training (VR-DUAL Action Bias) plus treatment as usual (TAU), standard PC-based AAT plus TAU, or TAU alone. The interventions comprise six sessions delivered over two weeks. Outcomes are assessed at baseline, post-intervention, and at 3-month follow-up. Primary outcomes include alcohol consumption (abstinence, drinking days, heavy drinking days), and secondary outcomes include craving and approach–avoidance bias.
This is the first cross-national RCT to examine stimulus-relevant AAT delivered in a virtual reality environment. Given that virtual reality has shown potential to enhance psychological interventions, and that AAT is effective as an add-on to TAU, this study examines whether delivery in more ecologically valid environments strengthens treatment effects. If effective, VR-DUAL Action Bias may be implemented as a scalable, low-cost add-on or continuing care intervention to enhance existing evidence-based treatments.