Virtual Reality Exposure Therapy for Post-Traumatic Stress Disorder and Other Anxiety Disorders
Abstract
Anxiety disorders, including phobias and post-traumatic stress disorder, are common and disabling disorders that often involve avoidance behavior. Cognitive-behavioral treatments, specifically imaginal and in vivo forms of exposure therapy, have been accepted and successful forms of treatment for these disorders. Virtual reality exposure therapy, an alternative to more traditional exposure-based therapies, involves immersion in a computer-generated virtual environment that minimizes avoidance and facilitates emotional processing. In this article, we review evidence on the application of virtual reality exposure therapy to the treatment of specific phobias and post-traumatic stress disorder and discuss its advantages and cautions.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Virtual reality exposure is considered an effective treatment for several anxiety disorders, on par with in vivo exposure.
“Virtual reality exposure (VRE) in particular is considered an effective treatment for several anxiety disorders2, on par with in vivo exposure/IVE3,4, though doubts were expressed about the quality of this evidence5.”
From The effectiveness of virtual reality based interventions for symptoms of anxiety and depression: A meta-analysis (2018) · cites this paper as [3]
Cites
Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005) · Archives of General Psychiatry · doi:10.1001/archpsyc.62.6.617 · Cited by 12,052 · see citing works
(1992) · Applied Ergonomics · doi:10.1016/0003-6870(92)90318-p · Cited by 5,774 · see citing works
Emotional processing of fear: Exposure to corrective information.
Foa, E. B., & Kozak, M. J. (1986) · Psychological Bulletin · doi:10.1037/0033-2909.99.1.20 · Cited by 5,396 · see citing works
The empirical status of cognitive-behavioral therapy: A review of meta-analyses
Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006) · Clinical Psychology Review · doi:10.1016/j.cpr.2005.07.003 · Cited by 3,215 · see citing works
(2007) · Medical Entomology and Zoology · Cited by 1,118 · see citing works
Prolonged Exposure Therapy for PTSD: Therapist Guide: Emotional processing of traumatic experiences
Foa, E. B., Hembree, E., & Rothbaum, B. (2007) · doi:10.1093/med:psych/9780195308501.001.0001 · Cited by 1,050 · see citing works
Self-citationParsons, T. D., & Rizzo, A. A. (2008) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2007.07.007 · Cited by 994 · see citing works
Self-citationVirtual reality exposure therapy for anxiety disorders: A meta-analysis
Powers, M. B., & Emmelkamp, P. M. G. (2008) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2007.04.006 · Cited by 904 · see citing works
A survey of psychologists’ attitudes towards and utilization of exposure therapy for PTSD
Becker, C. B., Zayfert, C., & Anderson, E. (2004) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(03)00138-4 · Cited by 759 · see citing works
Effectiveness of computer-generated (virtual reality) graded exposure in the treatment of acrophobia
(1995) · American Journal of Psychiatry · doi:10.1176/ajp.152.4.626 · Cited by 694 · see citing works
Virtual Reality Exposure Therapy for Vietnam Veterans With Posttraumatic Stress Disorder
Rothbaum, B. O., Hodges, L. F., Ready, D. J., Graap, K. M., & Alarcón, R. D. (2001) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v62n0808 · Cited by 531 · see citing works
Self-citationDavis, M. S. (2002) · The Concise Dictionary of Crime and Justice · doi:10.4135/9781452229300.n390 · Cited by 507 · see citing works
A controlled study of virtual reality exposure therapy for the fear of flying.
Rothbaum, B. O., Hodges, L., Smith, S., Lee, J. H., & Price, L. (2000) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.68.6.1020 · Cited by 501 · see citing works
Self-citationVirtual reality in the treatment of spider phobia: a controlled study
Garcia-Palacios, A., Hoffman, H., Carlin, A., Furness, T. A., & Botella, C. (2002) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(01)00068-7 · Cited by 490 · see citing works
Virtual reality treatment versus exposure in vivo: a comparative evaluation in acrophobia
Emmelkamp, P. M. G., Krijn, M., Hulsbosch, A. M., de Vries, S., Schuemie, M. J., & van der Mast, C. A. P. G. (2002) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(01)00023-7 · Cited by 475 · see citing works
Virtual reality and tactile augmentation in the treatment of spider phobia: a case report
Carlin, A. S., Hoffman, H. G., & Weghorst, S. J. (1997) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(96)00085-x · Cited by 442 · see citing works
Garcia-Palacios, A., Botella, C., Hoffman, H., & Fabregat, S. (2007) · CyberPsychology & Behavior · doi:10.1089/cpb.2007.9962 · Cited by 410 · cited 1× · see citing works
“Garcia-Palacios and colleagues [ 4 ] surveyed 150 individuals with specific phobias and fear of public speaking regarding the acceptability of VRE and in vivo exposure treatments.”
BackgroundDoes imaginal exposure exacerbate PTSD symptoms?
Foa, E. B., Zoellner, L. A., Feeny, N. C., Hembree, E. A., & Alvarez-Conrad, J. (2002) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.70.4.1022 · Cited by 393 · see citing works
Does imaginal exposure exacerbate PTSD symptoms?
Foa, E. B., Zoellner, L. A., Feeny, N. C., Hembree, E. A., & Alvarez, J. (2002) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.70.4.1022 · Cited by 392 · see citing works
Difede, J., & Cukor, J. (2007) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v68n1102 · Cited by 357 · see citing works
Self-citationVirtual reality exposure therapy for PTSD Vietnam veterans: A case study
Rothbaum, B. O., Hodges, L., Alarcon, R., Ready, D., Shahar, F., Graap, K., Pair, J., Hebert, P., Gotz, D., Wills, B., et al. (1999) · Journal of Traumatic Stress · doi:10.1023/a:1024772308758 · Cited by 328 · see citing works
Self-citationKlinger, E., Bouchard, S., Légeron, P., Roy, S., Lauer, F., Chemin, I., & Nugues, P. (2005) · CyberPsychology & Behavior · doi:10.1089/cpb.2005.8.76 · Cited by 327 · see citing works
Difede, J., & Hoffman, H. G. (2002) · CyberPsychology & Behavior · doi:10.1089/109493102321018169 · Cited by 320 · see citing works
Self-citationBrief Virtual Reality Therapy for Public Speaking Anxiety
Harris, S. R., Kemmerling, R. L., & North, M. M. (2002) · CyberPsychology & Behavior · doi:10.1089/109493102321018187 · Cited by 314 · see citing works
Virtual reality treatment of claustrophobia: a case report
Botella, C., Baños, R. M., Perpiñá, C., Villa, H., Alcañiz, M., & Rey, A. (1998) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(97)10006-7 · Cited by 247 · see citing works
Virtual reality exposure in the treatment of panic disorder and agoraphobia: A controlled study
Botella, C., García‐Palacios, A., Villa, H., Baños, R. M., Quero, S., Alcañiz, M., & Riva, G. (2007) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.524 · Cited by 242 · see citing works
Virtual Reality Treatment in Acrophobia: A Comparison with Exposure in Vivo
Emmelkamp, P. M. G., Bruynzeel, M., Drost, L., & van der Mast, C. P. A. G. (2001) · CyberPsychology & Behavior · doi:10.1089/109493101300210222 · Cited by 241 · see citing works
Rothbaum, B. O., Anderson, P., Zimand, E., Hodges, L., Lang, D., & Wilson, J. (2006) · Behavior Therapy · doi:10.1016/j.beth.2005.04.004 · Cited by 240 · see citing works
Self-citationRedefining therapeutic success with virtual reality exposure therapy
Garcia-Palacios, A., Hoffman, H. G., Kwong See, S., Tsai, A., & Botella, C. (2001) · CyberPsychology & Behavior · doi:10.1089/109493101300210231 · Cited by 212 · see citing works
Twelve-month follow-up of virtual reality and standard exposure therapies for the fear of flying.
ROTHBAUM, B. O., Hodges, L. F., Anderson, P. L., Price, L. R., & Smith, S. G. (2002) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.70.2.428 · Cited by 197 · see citing works
Self-citationRepeated exposure of flight phobics to flights in virtual reality
Mühlberger, A., Herrmann, M. J., Wiedemann, G., Ellgring, H., & Pauli, P. (2001) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(00)00076-0 · Cited by 187 · see citing works
Virtual reality exposure therapy using a virtual Iraq: Case report
Gerardi, M., Rothbaum, B. O., Ressler, K., Heekin, M., & Rizzo, A. (2008) · Journal of Traumatic Stress · doi:10.1002/jts.20331 · Cited by 187 · see citing works
Self-citationVirtual reality exposure in the treatment of social anxiety
Anderson, P. L., ROTHBAUM, B. O., & Hodges, L. F. (2003) · Cognitive and Behavioral Practice · doi:10.1016/s1077-7229(03)80036-6 · Cited by 168 · see citing works
Self-citationVirtual Reality Therapy: an Effective Treatment for the Fear of Public Speaking
North, M. M., North, S. M., & Coble, J. R. (1998) · International Journal of Virtual Reality · doi:10.20870/ijvr.1998.3.3.2625 · Cited by 161 · see citing works
Effectiveness of virtual reality exposure in the treatment of arachnophobia using 3D games
Bouchard, S., Côté, S., St-Jacques, J., Robillard, G., & Renaud, P. (2006) · Technology and Health Care · doi:10.3233/thc-2006-14103 · Cited by 156 · see citing works
Beck, J. G., Palyo, S. A., Winer, E. H., Schwagler, B. E., & Ang, E. J. (2006) · Behavior Therapy · doi:10.1016/j.beth.2006.04.001 · Cited by 154 · see citing works
Virtual reality exposure therapy for the treatment of fear of flying: A controlled investigation.
Maltby, N., Kirsch, I., Mayers, M., & Allen, G. J. (2002) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.70.5.1112 · Cited by 147 · see citing works
Interfaces that heal: coupling real and virtual objects to treat spider phobia
Hoffman, H. G., Garcia-Palacios, A., Carlin, A., Furness III, T. A., & Botella-Arbona, C. (2003) · International Journal of Human-Computer Interaction · doi:10.1207/s15327590ijhc1602_08 · Cited by 144 · see citing works
Dissemination of exposure therapy in the treatment of posttraumatic stress disorder
Cahill, S. P., Foa, E. B., Hembree, E. A., Marshall, R. D., & Nacasch, N. (2006) · Journal of Traumatic Stress · doi:10.1002/jts.20173 · Cited by 142 · see citing works
Virtual reality exposure therapy for active duty soldiers
Reger, G. M., & Gahm, G. A. (2008) · Journal of Clinical Psychology · doi:10.1002/jclp.20512 · Cited by 124 · see citing works
Myths regarding exposure therapy for PTSD
Feeny, N. C., Hembree, E. A., & Zoellner, L. A. (2003) · Cognitive and Behavioral Practice · doi:10.1016/s1077-7229(03)80011-1 · Cited by 115 · see citing works
Fear of flying treatment methods: virtual reality exposure vs. cognitive behavioral therapy.
Krijn, M., Emmelkamp, P. M. G., Ólafsson, R. P., Bouwman, M., Gerwen, L. J. V., Spinhoven, P., Schuemie, M. J., & van der Mast, C. P. A. G. (2007) · PubMed · Cited by 98 · see citing works
Virtual reality exposure therapy for the treatment of fear of flying: A controlled investigation.
Maltby, N., Kirsch, I., Mayers, M., et al. (2002) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.70.5.1112 · Cited by 97 · see citing works
McLay, R. N., McBrien, C., Wiederhold, M. D., & Wiederhold, B. K. (2009) · CyberPsychology & Behavior · doi:10.1089/cyber.2009.0346 · Cited by 69 · see citing works
Preliminary Research on the Efficacy of Virtual Reality Exposure Therapy to Treat Driving Phobia
Wald, J., & Taylor, S. J. (2003) · CyberPsychology & Behavior · doi:10.1089/109493103769710488 · Cited by 67 · see citing works
Virtual Reality Exposure for Veterans with Posttraumatic Stress Disorder
Ready, D. J., Pollack, S. J., ROTHBAUM, B. O., & Alarcón, R. D. (2006) · Journal of Aggression Maltreatment & Trauma · doi:10.1300/j146v12n01_11 · Cited by 48 · see citing works
Self-citationBusWorld: Designing a Virtual Environment for Post-Traumatic Stress Disorder in Israel: A Protocol
Josman, N., Somer, E., Reisberg, A., Weiss, P. L., García‐Palacios, A., & Hoffman, H. G. (2006) · CyberPsychology & Behavior · doi:10.1089/cpb.2006.9.241 · Cited by 38 · see citing works
Josman, N., Reisberg, A., Weiss, P. L., García‐Palacios, A., & Hoffman, H. G. (2008) · CyberPsychology & Behavior · doi:10.1089/cpb.2008.0048 · Cited by 34 · see citing works
Difede, J., Hoffman, H. G., & Jaysinghe, N. (2002) · Psychiatric Services · doi:10.1176/appi.ps.53.9.1083 · Cited by 31 · see citing works
Self-citationSnowdon, D., & Churchill, E. F. (1998) · Virtual Reality · doi:10.1007/bf01409792 · Cited by 5 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Hollis, C., Falconer, C. J., Martin, J. L., Whittington, C., Stockton, S., Glazebrook, C., & Davies, E. B. (2017) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12663 · Cited by 846 · see citing works
Philippe, T. J., Sikder, N., Jackson, A., Koblanski, M. E., Liow, E., Pilarinos, A., & Vasarhelyi, K. (2022) · JMIR Mental Health · doi:10.2196/35159 · Cited by 436 · see citing works
Rothbaum, B. O., Price, M., Jovanovic, T., Norrholm, S. D., Gerardi, M., Dunlop, B., Davis, M., Bradley, B., Duncan, E. J., Rizzo, A., et al. (2014) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2014.13121625 · Cited by 388 · see citing works
Self-citationFodor, L. A., Coteț, C. D., Cuijpers, P., Szamoskozi, Ș., David, D., & Cristea, I. A. (2018) · Scientific Reports · doi:10.1038/s41598-018-28113-6 · Cited by 284 · see citing works
Effect of multiple context exposure on renewal in spider phobia
Shiban, Y., Pauli, P., & Mühlberger, A. (2013) · Behaviour Research and Therapy · doi:10.1016/j.brat.2012.10.007 · Cited by 162 · see citing works
Embodying Compassion: A Virtual Reality Paradigm for Overcoming Excessive Self-Criticism
Falconer, C. J., Slater, M., Rovira, A., King, J. A., Gilbert, P., Antley, A., & Brewin, C. R. (2014) · PLoS ONE · doi:10.1371/journal.pone.0111933 · Cited by 155 · see citing works
Evidence on Virtual Reality-Based Therapies for Psychiatric Disorders: Meta-Review of Meta-Analyses
Dellazizzo, L., Potvin, S., Luigi, M., & Dumais, A. (2020) · Journal of Medical Internet Research · doi:10.2196/20889 · Cited by 135 · see citing works
Crescentini, C., Chittaro, L., Capurso, V., Sioni, R., & Fabbro, F. (2016) · Computers in Human Behavior · doi:10.1016/j.chb.2016.02.031 · Cited by 81 · see citing works
Heo, S., & Park, J.-H. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192315911 · Cited by 61 · see citing works
“VR can offer multi-sensory stimuli tailored to a patient’s individual trauma in a highly interactive, ecologically valid, and emotionally engaging virtual environment, which recapitulates a patient’s traumatic event with computer-generated visual, auditory, olfactory, and haptic experiences for therapeutic purposes [1…”
BackgroundWong Sarver, N., Beidel, D. C., & Spitalnick, J. S. (2014) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2013.843461 · Cited by 59 · see citing works
Nason, E. E., Trahan, M., Smith, S., Metsis, V., & Selber, K. (2020) · Journal of Technology in Human Services · doi:10.1080/15228835.2019.1692760 · Cited by 28 · see citing works
Exposure Therapy for Anxiety Disorders
Steinman, S. A., Wootton, B. M., & Tolin, D. F. (2016) · Encyclopedia of Mental Health · doi:10.1016/b978-0-12-397045-9.00266-4 · Cited by 27 · see citing works
What can virtual reality offer to stroke patients? A narrative review of the literature
Szczepańska-Gieracha, J., Cieślik, B., Rutkowski, S., Kiper, P., & Turolla, A. (2020) · NeuroRehabilitation · doi:10.3233/nre-203209 · Cited by 26 · see citing works
- Authors
- Gerardi, M., Cukor, J., Difede, J., Rizzo, A., & Rothbaum, B. O.
- Affiliations
- Emory University (US)
- Weill Cornell Medicine (US)
- University of Southern California (US)
- Corresponding author
- Rothbaum, Barbara Olasov
- Venue
- Current Psychiatry Reports
- Published
- 2010-06-10
- Volume
- 12
- Issue
- 4
- Pages
- 298-305
- ISSN
- 1523-3812 (ISSN-L)
- 1535-1645
- OpenAlex
- W2144575360
- Cited by
- 154
- References
- 50
- Citations by year
- 2026: 3 · 2025: 11 · 2024: 10 · 2023: 16 · 2022: 10 · 2021: 10 · 2020: 14 · 2019: 9 · 2018: 11 · 2017: 8 · 2016: 12 · 2015: 6 · 2014: 12 · 2013: 4 · 2012: 8
- FWCI
- 1.88
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Current Psychiatry Reports (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Physical Sciences › Computer Science › Human-Computer Interaction › Virtual Reality Applications and Impacts
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- virtual reality exposure therapy, post-traumatic stress disorder, specific phobia, anxiety disorders, avoidance behavior, imaginal exposure, in vivo exposure, cognitive behavioral therapy, virtual worlds
- MeSH terms
- Anxiety Disorders, Clinical Trials as Topic, Computer Simulation, Humans, Implosive Therapy, Therapy, Computer-Assisted, User-Computer Interface, Treatment Outcome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review