Lack of research on efficacy of virtual reality exposure therapy (VRET) for anxiety disorders in children and adolescents: A systematic review
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Summary: Anxiety disorders are one of the most prevalent mental disorders in children and adolescents which may effectively be treated by several forms of exposure therapy. An emerging approach to exposure is virtual reality exposure therapy (VRET), but a literature search synthesis focusing specifically on the use of VRET in children and adolescents is still lacking. This systematic review sets out to provide an overview concerning VRET for the treatment of anxiety disorders in this age group. Four published trials covering an overall sample of 100 participants between the ages of 8 and 16 years were found during a systematic literature search and were included in the current review. Results reveal that participants show clinical improvements regarding anxiety symptoms after VRET. Nevertheless, the high potential of virtual reality as a tool for treating children and adolescents with anxiety disorders is contrasted by a considerable lack of controlled trials. Despite the evidence of VRET in adult samples, there is a need for more research with younger cohorts in order to be able to support this promising field of application.
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The application of VR in youth mental health remains critically underexplored.
“its application in youth mental health remains critically underexplored [5,6]”
From A Virtual Reality–Based Cognitive Defusion Application for Youth Depression and Anxiety: Mixed Methods Experimental Study. (2025) · cites this paper as [6]
The Discussion says research on virtual reality exposure therapy (VRET) for children and adolescents with anxiety disorders is “still scarce at best” and calls for more trials. That supports an underexploration claim for this treatment and condition, but not the broader claim about VR across youth mental health. (LLM, conf=0.86)
Experimental — accuracy not yet measuredRelatively limited research has explored the potential therapeutic applications of VR beyond exposure-based cognitive behavioral therapy approaches, and research in youth is highly limited.
“However, relatively limited research has explored the potential therapeutic applications of VR beyond exposure-based cognitive behavioral therapy (CBT) approaches, and research in youth is highly limited [2,5,6,16].”
From A Virtual Reality–Based Cognitive Defusion Application for Youth Depression and Anxiety: Mixed Methods Experimental Study. (2025) · cites this paper as [6]
The Discussion (page unavailable) says research on VRET for children and adolescents with anxiety disorders is “scarce at best,” supporting the claim that research in youth is limited in that context. The paper focuses on exposure therapy; it does not establish how much research has explored therapeutic uses of VR beyond exposure-based CBT. (LLM, conf=0.86)
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Gutiérrez-Sánchez, M. D. J., González-Islas, J., Huerta-Ortiz, L.-M., Franco-Árcega, A., Vázquez-Vázquez, V., & Suárez-Navarrete, A. (2024) · Applied Sciences · doi:10.3390/app142210569 · Cited by 2 · see citing works
Virtuelle Realitäten: Neue Therapiemöglichkeiten bei Angststörungen
Schöttler, M., & Felnhofer, A. (2025) · KJP up2date · doi:10.1055/a-2409-9510 · Cited by 2 · see citing works
Self-citationChancen virtueller Realitäten in der Therapie von Kindern und Jugendlichen
Felnhofer, A. (2023) · Pädiatrie & Pädologie · doi:10.1007/s00608-023-01112-1 · Cited by 1 · see citing works
Self-citationVirtual Reality and Mental Health
Haws, J. K., & Lack, C. W. (2025) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2025.08.021 · Cited by 1 · see citing works
Extended reality interventions for health and procedural anxiety: An overview of reviews
Arthur, T., Robinson, S., Harris, D., Wilson, M., Vine, S. J., & Meléndez‐Torres, G. J. (2026) · Digital Health · doi:10.1177/20552076251411512 · Cited by 1 · see citing works
Çocukluk Dönemi Korkuları ve Bir Müdahale Aracı Olarak Sanal Gerçeklik Uygulamasının Kullanımı
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Should we use more Digital Therapy in Clinical Practice?
Kothgassner, O. D., & Felnhofer, A. (2021) · Digital Psychology · doi:10.24989/dp.v2i1.1980
Self-citationApplication of Virtual Reality-based Stress and Anxiety Management
Maktoof, M. A. J., Saleh, A. S., Adile, M., Ahmed, M. S. M., & Mohammed, A. (2023) · International Conference on Emerging Research in Computational Science (ICERCS) · doi:10.1109/icercs57948.2023.10434068
“In their study, Kothgassner et al. used VR therapy to help persons with mood disorders control their stress [32].”
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VIRTUAL REALITY EXPOSURE THERAPY FOR ANXIETY DISORDERS: A SYSTEMATIC REVIEW
Kotlarski, W., Kotlarska, K. M., Mainka, T. S., & Sergejuk, E. (2026) · International Journal of Innovative Technologies in Social Science · doi:10.31435/ijitss.2(50).2026.5534
APPLICATIONS OF VIRTUAL REALITY TECHNOLOGY IN PSYCHIATRY – A REVIEW
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Virtual Reality for Social Recovery
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- Authors
- Kothgassner, O. D., & Felnhofer, A.
- Affiliations
- Medical University of Vienna (AT)
- Corresponding author
- Kothgassner, Oswald D.
- Felnhofer, Anna
- Venue
- neuropsychiatrie
- Published
- 2020-05-05
- Volume
- 35
- Issue
- 2
- Pages
- 68-75
- ISSN
- 0948-6259 (ISSN-L)
- 2194-1327
- PMC
- PMC8245387
- OpenAlex
- W3023238954
- Cited by
- 61
- References
- 30
- Citations by year
- 2026: 9 · 2025: 16 · 2024: 6 · 2023: 12 · 2022: 8 · 2021: 10
- FWCI
- 5.46
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Neuropsychiatrie (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Medical University of Vienna
- Topics
- Physical Sciences › Computer Science › Human-Computer Interaction › Virtual Reality Applications and Impacts
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- virtual reality exposure therapy, anxiety disorders, children, adolescents, exposure therapy, treatment efficacy, clinical trials, virtual reality
- MeSH terms
- Adolescent, Adult, Anxiety, Anxiety Disorders, Child, Humans, Implosive Therapy, Virtual Reality Exposure Therapy
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