The DOI matches its Crossref record; 136 of the 136 references it cites were found in a registry or an index; 2 of the 88 sources its claims cite were checked for support.
Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy
Open accessAbstract
Virtual reality (VR) is an immersive technology capable of creating a powerful, perceptual illusion of being present in a virtual environment. VR technology has been used in cognitive behavior therapy since the 1990s and accumulated an impressive evidence base, yet with the recent release of consumer VR platforms came a true paradigm shift in the capabilities and scalability of VR for mental health. This narrative review summarizes the past, present, and future of the field, including milestone studies and discussions on the clinical potential of alternative embodiment, gamification, avatar therapists, virtual gatherings, immersive storytelling, and more. Although the future is hard to predict, clinical VR has and will continue to be inherently intertwined with what are now rapid developments in technology, presenting both challenges and exciting opportunities to do what is not possible in the real world.
Overview
AI snapshot
Written from the paper’s full text.
TL;DR
This narrative review summarizes the past, present, and future of virtual reality cognitive behavior therapy (VR-CBT), focusing mainly on anxiety disorders. It argues that consumer VR has created a paradigm shift, with automated VR treatments showing strong symptom reductions and growing potential for scalable mental health interventions.
Key findings
- By 2012, k = 21 randomized controlled trials of VR exposure therapy for anxiety disorders were available for meta-analysis, showing that VR exposure outperformed waitlist controls, had similar outcomes to other evidence-based interventions, and had stable long-term effects (Opriş et al. 2012).
- A 2015 meta-analysis found that previously reported within- and between-group effect sizes remained when only trials with in vivo behavioral outcomes were considered, indicating that fear reductions in VR translate to reduced fear in vivo (Morina et al. 2015).
- A 2014 meta-analysis reported an overall significant correlation of r = .28 (95% CI: 0.18–0.38) between self-reported distress and presence during exposure, with significant differences across sample clinical characteristics and VR equipment type (Ling et al. 2014).
- Recent automated VR exposure trials for acrophobia and spider phobia report impressive symptom reductions; one spider phobia trial examined non-inferiority against gold-standard in vivo exposure (Miloff et al. 2019). Adoption remains limited: Steam data in spring 2020 showed around 2% of active users had VR access, roughly 2 million users; Sony reported more than five million PlayStation VR units sold by end of 2019; at least twenty million VR units were distributed worldwide, possibly twice that.
Methods
- Narrative review, not a systematic review or meta-analysis, providing a historical overview and context for VR-CBT and how technology developments have fueled clinical progress.
- Focuses on VR-CBT treatments for anxiety disorders because this application dominates the literature, while also discussing other clinical applications.
- Covers the past (roughly 1968–2013), present (2014–2020), and future, synthesizing milestone studies, meta-analyses, randomized trials, surveys, and technology developments rather than collecting primary data.
Limitations
- The author states the aim is not to provide a systematic review or meta-analysis, the focus is on anxiety disorders, and coverage of VR as an experimental platform for psychopathology and treatment mechanisms is beyond scope.
- The text makes evident that the review is non-exhaustive and selective, and that future-oriented sections are predictions based on gaps, trends, and recent advances rather than demonstrated outcomes.
- The author reports involvement in academia-industry collaborations related to the work, including direct financial reimbursement for consulting for Mimerse, though holds no financial stake in any such company.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
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Verification
Claims the paper makes
66 Not checked yet · 24 Own interpretation · 6 No basis given · 1 Supported so far
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Interestingly enough, all three automated VR exposure applications mentioned above opted to include a virtual therapist of some sort (Donker et al. 2019;Freeman et al. 2018;Miloff et al. 2019), either voiceover or as an embodied agent.”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Virtual Therapists
What the sources say
- Supportedcites Donker et al. 2019 source
The Intervention: VR-CBT App section says Donker et al.'s application used a voice-over provided by a virtual therapist. This supports the part of the three-application statement attributed to Donker et al.; the other applications have separate citations. (LLM, conf=0.94)
- Supportedcites Freeman et al. 2018 source
The Introduction says the study programmed a virtual coach to act as the therapist in VR. Methods > Procedures describes that coach as animated from an actor’s motion capture and voiced by the same person, supporting the citing sentence’s description of Freeman et al.’s application. Page numbers are unavailable in our copy. (LLM, conf=0.94)
- Not checked yetcites Miloff et al. 2019 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
In the paper
“A 2014 meta-analysis reported an overall significant correlation of r = .28(95% CI: 0.18-0.38)between self-reported distress and presence during exposure”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > The Past
What the sources say
- Not checked yetcites Ling et al. 2014 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“VR exposure therapy outperformed waitlist control conditions”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > The Past
What the sources say
- Not checked yetcites Opriş et al. 2012 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“and had stable long-term effects (Opriş et al. 2012).”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > The Past
What the sources say
- Not checked yetcites Opriş et al. 2012 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Internetadministered CBT (iCBT), which enjoys a robust evidence base with demonstrated efficacy equivalent to face-to-face treatments for mental disorders and psychosomatic conditions (Carlbring et al. 2018)”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Introduction
What the sources say
- Not checked yetcites Carlbring et al. 2018 source
boosted- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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In the paper
“albeit with significant differences across sample clinical characteristics and type of VR equipment used (Ling et al. 2014).”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > The Past
What the sources say
- Not checked yetcites Ling et al. 2014 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“revealing that fear reductions in VR does indeed translate to reduced fear also in vivo (Morina et al. 2015).”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > The Past
What the sources say
- Not checked yetcites Morina et al. 2015 source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“and is now implemented in routine care in many countries (Titov et al. 2018).”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Introduction
What the sources say
- Not checked yetcites Titov et al. 2018 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“By 2012, there were k = 21 randomized controlled trials of VR exposure therapy for anxiety disorders available for meta-analysis”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > The Past
What the sources say
- Not checked yetcites Opriş et al. 2012 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“had similar outcomes to other evidence-based interventions”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > The Past
What the sources say
- Not checked yetcites Opriş et al. 2012 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Probably not a substantial claim. 21
- It may state two separate claims as one. 27
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“VR technology has been used in cognitive behavior therapy since the 1990s and accumulated an impressive evidence base”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Abstract
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“yet with the recent release of consumer VR platforms came a true paradigm shift in the capabilities and scalability of VR for mental health.”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Abstract
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“additionally solves practical issues in providing exposure therapy: there is no need to leave the therapy room, either to perform exposure exercises or prepare stimuli material in advance.”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > The Past
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
It may state two separate claims as one.
In the paper
“suggesting that presence is a necessary but insufficient requirement for symptom reduction (Price and Anderson 2007), congruent with the 2004 study.”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > The Past
What the sources say
- Not checked yetcites Price and Anderson 2007 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“revealing the public health and clinical potential of this innovative approach to treatment.”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Automated Treatments
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“One early study reported that nine out of ten spider-fearful individuals would prefer VR exposure over in vivo exposure (Garcia-Palacios et al. 2001)”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > The Past
What the sources say
- Not checked yetcites Garcia-Palacios et al. 2001 source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“although it demonstrated feasibility and replicated the effect size from the preceding efficacy trial, the sample size was relatively small and for ethical and practical reasons, a single-case design was chosen instead of comparison with treatment-as-usual (Lindner et al. 2020a).”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Beyond Efficacy: Demonstrating Effectiveness
What the sources say
- Not checked yetcites Lindner et al. 2020a
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Three high-quality randomized trials have been published recently, featuring three different applications: two on acrophobia with comparison against waiting-list (Donker et al. 2019;Freeman et al. 2018) and one on spider phobia examining non-inferiority against gold-standard in vivo exposure (Miloff et al. 2019).”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Automated Treatments
What the sources say
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“although display properties in themselves also play a role (Saredakis et al. 2020).”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > The Past
What the sources say
- Not checked yetcites Saredakis et al. 2020
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“symptoms resembling motion sickness believed to be caused primarily by sensory conflict between the visual and vestibular/proprioceptor systems”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > The Past
What the sources say
- Not checked yetcites Rebenitsch and Owen 2016 source
- Not checked yetcites Saredakis et al. 2020
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“although they also reported fears about required training, handling the equipment and, financial costs, and reported an overall low degree of acquaintance with the technology (Schwartzman et al. 2012;Segal et al. 2011).”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > The Past
What the sources say
- Not checked yetcites Schwartzman et al. 2012 source
- Not checked yetcites Segal et al. 2011
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“although both professional and even recreational experiences of using VR were still rare, and knowledge of VR exposure therapy still low (Lindner et al. 2019d).”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > The Past
What the sources say
- Not checked yetcites Lindner et al. 2019d
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In another recent study, participants practiced delivering compassion in one virtual body and then experienced a recorded version of this act embodied as the receiving party, leading to reduced depression and self-criticism and increased self-compassion (Falconer et al. 2016).”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Embodiment
What the sources say
- Not checked yetcites Falconer et al. 2016 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“This includes the possibility of using VR head rotation data as a proxy measure of other physiological variables like heart rate that indicate emotional distress, proof-of-concept of which has already been demonstrated (Noori et al. 2019) and is possible with related methods (Lomaliza and Park 2019).”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Full Immersion Through Innovative User Interfaces and Making Use of This Data
What the sources say
- Not checked yetcites Noori et al. 2019 source
- Not checked yetcites Lomaliza and Park 2019
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“By comparison, approximately half of the world's population is now estimated to have access to a smartphone.”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Still Awaiting Mass Adoption by Consumers
hedged- Asserted: passes — The authors put it forward as true.
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- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
In the paper
“The choice of control condition is a long-standing debate and multifaceted issue in psychotherapy research, with placebo interventions remaining the gold-standard despite being hard to implement in research on traditional psychotherapy (Gold et al. 2017).”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Raising Research Quality
What the sources say
- Not checked yetcites Gold et al. 2017 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The advent of modern consumer VR has resolved most of the logistic barriers to running larger clinical trials (but see below), as reflected in the larger sample sizes found in recent studies (Donker et al. 2019;Freeman et al. 2018;Miloff et al. 2019).”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Raising Research Quality
What the sources say
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Patients, in turn, are also likely to have markedly fewer preconceptions of what constitutes a VR psychological treatment, offering good grounds for (double) blinding.”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Raising Research Quality
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
It may state two separate claims as one.
- Rests on an assumption: Patients have markedly fewer preconceptions of what constitutes a VR psychological treatment.
In the paper
“Concerns have been raised about research quality of trials examining VR exposure therapy for anxiety disorders, primarily the reliance on small samples, and no or questionable control conditions (Page and Coxon 2016).”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Raising Research Quality
What the sources say
- Not checked yetcites Page and Coxon 2016 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The fact that modern consumer VR is primarily marketed, and used, as an entertainment platform”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Therapeutic Storytelling
plain- Asserted: passes — The authors put it forward as true.
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- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
In the paper
“Although there is some preliminary, indirect research in support of this approach (Shin 2018), therapeutic effects on psychopathology have yet to be demonstrated.”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Therapeutic Storytelling
What the sources say
- Not checked yetcites Shin 2018 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“VR has a long history of studying negative effects in the form of cybersickness (Rebenitsch and Owen 2016)”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Raising Research Quality
What the sources say
- Not checked yetcites Rebenitsch and Owen 2016 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“At the end of 2019, Sony confirmed having sold more than five million units of their Playstation VR device.”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Still Awaiting Mass Adoption by Consumers
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
In the paper
“One recent study compared exposure to standardized catastrophic scenarios in VR, to imaginal exposure with personalized scenarios, and found no difference in evoked anxiety (Guitard et al. 2019), suggesting that perfect tailoring is at least not necessary.”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Full Immersion Through Innovative User Interfaces and Making Use of This Data
What the sources say
- Not checked yetcites Guitard et al. 2019 source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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It may state two separate claims as one.
In the paper
“A review article from 1996 on “VR psychotherapy” made a number of interesting predictions on the future of the field: while some predictions did turn out true, most ultimately did not (Glantz et al. 1996).”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Conclusions
What the sources say
- Not checked yetcites Glantz et al. 1996 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Recent survey research suggests that ordinary clinicians do continue to see certain risks in using VR in therapy, although positive views outweigh negative (Lindner et al. 2019d).”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Raising Research Quality
What the sources say
- Not checked yetcites Lindner et al. 2019d
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“since so-called sandbox-type paradigms require additional developmental resources, which may not be costeffective in relation to efficacy.”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Full Immersion Through Innovative User Interfaces and Making Use of This Data
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“privacy concerns have already been raised (Slater et al. 2020;Spiegel 2018) and must continue to be discussed within clinical research”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Full Immersion Through Innovative User Interfaces and Making Use of This Data
What the sources say
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“with a recent systematic review identifying k = 152 studies investigating different factors of importance (Oh et al. 2018).”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Social VR
What the sources say
- Not checked yetcites Oh et al. 2018
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The field of VR-CBT is expanding rapidly with new publications every week”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Conclusions
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This question has however received surprisingly little research attention thus far.”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Full Immersion Through Innovative User Interfaces and Making Use of This Data
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The small sample sizes that characterized early (and to a lesser degree, also current) research is not unexpected given the added practical requirements in providing VR treatment, at least with the previous generation of technology”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Raising Research Quality
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The recent release of consumer VR platforms constitutes a true paradigm shift in the development and dissemination of clinical VR”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Conclusions
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
In the paper
“Widespread reports of difficulties in implementing exposure therapy for PTSD in clinical settings (Waller and Turner 2016), for example, stress the importance of considering therapist views in efforts to disseminate new treatments.”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Raising Research Quality
What the sources say
- Not checked yetcites Waller and Turner 2016 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“In fact, human-computer interaction research has shown that head rotation provides an adequate proxy measure of eye gaze: gaze tends to focus around a rotation-controlled crosshair, and gaze shifts above 25° are typically accompanied by subsequent head movement with a lag of 30-150 ms (Sidenmark and Gellersen 2020).”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Full Immersion Through Innovative User Interfaces and Making Use of This Data
What the sources say
- Not checked yetcites Sidenmark and Gellersen 2020 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“so-called creative bibliotherapy-patient reading selected works of fiction, as opposed to self-help material-has a long history yet has received very little research attention (Troscianko 2018) and can therefore not currently be considered an evidencebased treatment.”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Therapeutic Storytelling
What the sources say
- Not checked yetcites Troscianko 2018 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Arguably, clinical researchers have only begun to scratch the surface of the clinical potential of virtual embodiment, especially with regard to how such experiences can be merged with traditional, evidence-based CBT techniques.”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Novel Uses of Virtual Embodiment
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
In the paper
“Despite VR now being an accessible and affordable consumer product (Lindner et al. 2017), mass adoption has yet to occur and growth remains linear rather than exponential, hindering the full public health and clinical potential of VR.”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Still Awaiting Mass Adoption by Consumers
What the sources say
- Not checked yetcites Lindner et al. 2017 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“However, since the expected effect sizes in these studies were large (as with in vivo exposure therapy), even smaller trials may nonetheless have been well powered; further, the fact that VR allows for a greater, even full degree of standardization should decrease outcome variance and thereby sample size requirement (Lindner et al. 2020b).”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Raising Research Quality
What the sources say
- Not checked yetcites Lindner et al. 2020b
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: The expected effect sizes in VR exposure studies were large.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“6DOF technology, although not new but now much more userfriendly, remains underutilized in clinical VR, in particular as core clinical components.”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Full Immersion Through Innovative User Interfaces and Making Use of This Data
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
In the paper
“While research has begun to collect and analyze user engagement metrics and selfreported data from self-guided VR interventions (Donker et al. 2020), there has been surprisingly little research on data that offers deeper insight.”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Full Immersion Through Innovative User Interfaces and Making Use of This Data
What the sources say
- Not checked yetcites Donker et al. 2020
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“publically released hardware statistics from the Steam gaming platform in spring 2020 revealed that around 2% of the platform's active user base has access to VR, equivalent to roughly 2 million users.”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Still Awaiting Mass Adoption by Consumers
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In the first effectiveness trial of VR exposure therapy in routine care, the clinic was reimbursed either through existing occupational healthcare contracts or the patients payed out-ofpocket (Lindner et al. 2020a), in no case with any additional cost included to cover the clinics investment in VR.”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Still Awaiting Mass Adoption by Consumers
What the sources say
- Not checked yetcites Lindner et al. 2020a
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Social VR is growing increasingly popular”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > Social VR
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper relies on this without support.
VR exposure is always safer than in vivo equivalent exposure.
“Further, VR exposure will always be safer than in vivo equivalent exposure”
The paper relies on this without support.
Consumer VR will achieve mass adoption.
“VR and other mixed reality technologies are still awaiting mass adoption, but when this does happen, there will already be a firm evidence base to inform the next generation of VR interventions for mental health.”
The paper relies on this without support.
VR technology will continue to develop rapidly.
“The future of VR-CBT will continue to be inherently intertwined with the development of VR technology, yet the latter now develops at a pace so rapid that clinical researchers are struggling to keep up”
The paper relies on this without support.
The expected effect sizes in VR exposure studies were large.
“since the expected effect sizes in these studies were large (as with in vivo exposure therapy), even smaller trials may nonetheless have been well powered”
The paper relies on this without support.
Patients have markedly fewer preconceptions of what constitutes a VR psychological treatment.
“Patients, in turn, are also likely to have markedly fewer preconceptions of what constitutes a VR psychological treatment, offering good grounds for (double) blinding.”
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?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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 [16]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“Most of this research has focused on VR-based cognitive behavioral treatments (VR-CBTs) [16].”
From A Virtual Reality–Based Cognitive Defusion Application for Youth Depression and Anxiety: Mixed Methods Experimental Study. (2025) · cites this paper as [16]
In the citing paper
“Ellipsis Health is an ML-based mobile app that detects depression using speech analysis of smartphone audio, which can be easily recorded and transmitted, potentially allowing accessible screening and monitoring of depression.”
From Digital health technologies and major depressive disorder (2023) · cites this paper as [114]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > References
“11. Carl, E., Stein, T., A., Levihn-Coon, A., Pogue, J. R., Rothbaum, B., Emmelkamp, P., et al. (2018). Virtual reality exposure therapy for anxiety and related disorders: a meta-analysis of randomized controlled trials. Journal of Anxiety Disorders. https://doi.org/10.1016/j.janxdis.2018.08.003.”
§ Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy > References
“12. Carl, E., Stein, A. T., Levihn-Coon, A., Pogue, J. R., Rothbaum, B., Emmelkamp, P., et al. (2019). Virtual reality exposure therapy for anxiety and related disorders: a meta-analysis of randomized controlled trials. Journal of Anxiety Disorders, 61, 27-36. https://doi.org/10.1016/j.janxdis.2018.08.003.”
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Parenting Stress, Mental Health, Dyadic Adjustment: A Structural Equation Model
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A Systematic Review of Social Presence: Definition, Antecedents, and Implications
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Cited by
Sorted by citations
Torous, J., Linardon, J., Goldberg, S. B., Sun, S., Bell, I., Nicholas, J., Hassan, L., Hua, Y., Milton, A., & Firth, J. (2025) · World Psychiatry · doi:10.1002/wps.21299 · Cited by 323
Artificial intelligence technologies and compassion in healthcare: A systematic scoping review
Morrow, E. M., Zidaru, T., Ross, F., Mason, C. L., Patel, K. D., Ream, M., & Stockley, R. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.971044 · Cited by 308
“Artificial intelligence (AI) technologies are associated with compassion through extending or enhancing human and digital therapeutic bond and therapeutic alignment (Lindner, 2021).”
BackgroundThe sense of embodiment in Virtual Reality and its assessment methods
Guy, M., Normand, J., Jeunet, C., & Moreau, G. (2023) · Frontiers in Virtual Reality · doi:10.3389/frvir.2023.1141683 · Cited by 131
“…to many applications such as entertainment (Zyda, 2005; Atkinson et al., 2020), interactive training (Claude et al., 2014; Bouville et al., 2015), scienti fi c visualisation (Chandler et al., 2015; Dwyer et al., 2018), and virtual therapy (Wallach et al., 2009; Donker et al., 2019; Lindner, 2020).”
Pira, G. L., Aquilini, B., Davoli, A., Grandi, S., & Ruini, C. (2023) · JMIR Mental Health · doi:10.2196/44998 · Cited by 92
“Although the technology was quite raw, it was sufficiently capable of producing convincing 3D images inside a head-mounted display (HMD) or inside a room where the images were projected on the walls (cave automatic virtual environment) [4].”
BackgroundYang, X., Wu, J., Ma, Y., Yu, J., Cao, H., Zeng, A., Fu, R., Tang, Y., & Ren, Z. (2024) · Journal of Medical Internet Research · doi:10.2196/60845 · Cited by 111
“By incorporating VR into CBT, children can practice coping strategies in simulated real-life emotional and social scenarios, potentially enhancing outcomes [68].”
Extended Reality for the Clinical, Affective, and Social Neurosciences
Parsons, T. D., Gaggioli, A., & Riva, G. (2020) · Brain Sciences · doi:10.3390/brainsci10120922 · Cited by 63
“This work can be extended to XR platforms that offer an immersive, presence-inducing experience with a significant potential for mental health assessment and treatment [21].”
BackgroundHalkiopoulos, C., & Gkintoni, E. (2025) · Electronics · doi:10.3390/electronics14061110 · Cited by 68
The effectiveness of self-guided virtual-reality exposure therapy for public-speaking anxiety
Premkumar, P., Heym, N., Brown, D. J., Battersby, S., Sumich, A., Huntington, B., Daly, R., & Zysk, E. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.694610 · Cited by 57
Human Factors Research in Immersive Virtual Reality Firefighter Training: A Systematic Review
Wheeler, S. G., Engelbrecht, H., & Hoermann, S. (2021) · Frontiers in Virtual Reality · doi:10.3389/frvir.2021.671664 · Cited by 44
“…medical, educational, and manufacturing domains, such as the training of laparoscopic surgery (Alaker et al., 2016), in cognitive behavior therapy (Lindner, 2020), the creation of empathy in the user (Kilteni et al., 2012; Shin, 2018), or as a teaching tool in the manufacturing domain (Mujber et…”
BackgroundCognitive Behavior Therapy at the Crossroads
Blackwell, S. E., & Heidenreich, T. (2021) · International Journal of Cognitive Therapy · doi:10.1007/s41811-021-00104-y · Cited by 42
“Lindner (2020) provides an overview of one such example of an interface between technological advances and CBT, the use of virtual reality (VR) in therapy.”
BackgroundFagernäs, S., Hamilton, W., Espinoza, N., Miloff, A., Carlbring, P., & Lindner, P. (2021) · Internet Interventions · doi:10.1016/j.invent.2021.100370 · Cited by 38
“…Fodor et al., 2018; Wechsler et al., 2019) and new research has demonstrated efficacy also in an automated, gamified format (Donker et al., 2019, 2020; Freeman et al., 2018; Lindner et al., 2020b; Miloff et al., 2019) that makes more extensive use of the capabilities inherent to the technology,…”
BackgroundSelf-citationDigital health technologies and major depressive disorder
McIntyre, R. S., Greenleaf, W., Bulaj, G., Taylor, S. T., Mitsi, G., Saliu, D., Czysz, A., Silvesti, G., Garcia, M., & Jain, R. (2023) · CNS Spectrums · doi:10.1017/s1092852923002225 · Cited by 38
“As VR systems now becomemore accessible and affordable, there is potential for large-scale implementation and a paradigm shift in the development and dissemination of VR in clinical practice.(144)”
BackgroundJohansson, M., Romero, D., Jakobson, M., Heinemans, N., & Lindner, P. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1233888 · Cited by 49
“Interventions using cue exposure in virtual reality (41) for smoking cessation have so far shown inconclusive effects (42).”
BackgroundSelf-citationBody and Time: Virtual Embodiment and its Effect on Time Perception
Unruh, F., Vogel, D. H. V., Landeck, M., Lugrin, J.-L., & Latoschik, M. E. (2023) · IEEE Transactions on Visualization and Computer Graphics · doi:10.1109/tvcg.2023.3247040 · Cited by 33
“It has also been shown that VR therapy is effectively used in the treatment of a number of specific psychological disorders, e.g., post-traumatic stress disorders and anxiety disorders [22,40,73].”
BackgroundBzdúšková, D., Marko, M., Hirjaková, Z., Kimijanová, J., Hlavačka, F., & Riečanský, I. (2022) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2021.773091 · Cited by 35
“Future studies are needed to directly test this possibility since it has potentially important consequences for the therapy of acrophobia using VR (Lindner, 2021).”
BackgroundThe Influence of Avatar Embodiment on Time Perception - Towards VR for Time-Based Therapy
Unruh, F., Landeck, M., Oberdörfer, S., Lugrin, J.-L., & Latoschik, M. E. (2021) · Frontiers in Virtual Reality · doi:10.3389/frvir.2021.658509 · Cited by 33
“Virtual Reality (VR) therapy has been proven to be ef fi cient in treating a variety of speci fi c psychological disorders, e.g., speci fi c anxieties or post-traumatic stress disorders (Wallach et al., 2009; Gonçalves et al., 2012; Lindner, 2020).”
BackgroundPhubbing and its impact on the individual's psychological well-being
Garrido, E. C., Delgado, S. C., & Esteban, P. G. (2024) · Acta Psychologica · doi:10.1016/j.actpsy.2024.104388 · Cited by 43
Kahlon, S., Lindner, P., & Nordgreen, T. (2023) · Frontiers in Virtual Reality · doi:10.3389/frvir.2023.1240778 · Cited by 38
Self-citationAlsem, S. C., van Dijk, A., Verhulp, E. E., Dekkers, T. J., & de Castro, B. O. (2023) · Child Development · doi:10.1111/cdev.13966 · Cited by 29
Could Avatar Therapy Enhance Mental Health in Chronic Patients? A Systematic Review
Franco, M., Monfort-Vinuesa, C., Mesa, A. P., & Rincón, E. (2021) · Electronics · doi:10.3390/electronics10182212 · Cited by 23
“Despite the growth in virtual reality technology, therapies based on virtual reality in the clinical setting have not experienced the massive accessibility that recreational activities have seen, with mental health profes‐ sionals still having relatively low access to such devices [35].”
BackgroundMeta-Review on Brain-Computer Interface (BCI) in the Metaverse
HamlAbadi, K. G., Laamarti, F., & Saddik, A. E. (2024) · ACM Transactions on Multimedia Computing Communications and Applications · doi:10.1145/3696109 · Cited by 23
“The patient can simulate lifestyle changes to improve health management [7, 18, 63].”
InfluentialImpact assessment of implementing virtual reality in the Egyptian construction industry
Bakhoum, E. S., Younis, A. A., Aboulata, H. K., & Bekhit, A. R. (2023) · Ain Shams Engineering Journal · doi:10.1016/j.asej.2023.102184 · Cited by 20
Ong, T., Barrera, J. F., Sunkara, C., Soni, H., Ivanova, J., Cummins, M. R., Schuler, K. R., Wilczewski, H., Welch, B. M., & Bunnell, B. E. (2024) · Frontiers in Virtual Reality · doi:10.3389/frvir.2024.1332874 · Cited by 19
Mental health clients’ perspectives on telehealth-based virtual reality therapy
Ong, T., Ivanova, J., Soni, H., Barrera, J. F., Cummins, M. R., Welch, B. M., & Bunnell, B. E. (2025) · Frontiers in Virtual Reality · doi:10.3389/frvir.2025.1595326 · Cited by 21
Crone, C., & Kallen, R. W. (2024) · Computers in Human Behavior Reports · doi:10.1016/j.chbr.2024.100422 · Cited by 25
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Ørskov, P. T., Lichtenstein, M. B., Ernst, M. T., Fasterholdt, I., Matthiesen, A. F., Scirea, M., Bouchard, S., & Andersen, T. E. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.991755 · Cited by 21
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“VR is a sophisticated technology which has become more popular and has been used in several fields such as health (Asadzadeh, Samad-Soltani, Salahzadeh, RezaeiHachesu, 2021; Lindner, 2021; Peláez-Vélez, GactoSánchez & Martínez-Carrasco, 2023), employment (Ho, Wu & Yen, 2023 2023), education until sports (Hoyos, Yusti…”
MethodPopa, C. O., Sava, F. A., Muresan, S., Schenk, A., Cojocaru, C. M., Muntean, L. M., & Olah, P. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.1008981 · Cited by 14
“…to the existing empirical evidence, CBT approaches are flexible and highly adaptable psychological interventions that knew a rapid development towards an integrative orientation that, beyond the traditional delivery, also embraced digital, Internet-based and VR-augmented programs (Lindner, 2021).”
BackgroundReview: Evidence-Based Psychosocial Treatments for Childhood Irritability and Aggressive Behavior
Kalvin, C. B., Zhong, J., Rutten, M. R., Ibrahim, K., & Sukhodolsky, D. G. (2024) · JAACAP Open · doi:10.1016/j.jaacop.2024.01.009 · Cited by 26
“Incorporating virtual reality in psychotherapy is a burgeoning direction of psychotherapy research, 107 and given high interest in technology among children, adding virtual reality to talk therapy has a potential to enhance engagement of youth in treatment.”
Virtual reality in adolescent mental health management under the new media communication environment
Xu, D., Liu, Y., Zeng, Y., & Liu, D. (2025) · Humanities and Social Sciences Communications · doi:10.1057/s41599-025-04528-1 · Cited by 14
“Lindner (2021) investigated the impact of VR on cognitive behavior therapy (CBT) for depression in adolescents.”
Lindner, P., Dafgård, P., Miloff, A., Andersson, G., Reuterskiöld, L., Hamilton, W., & Carlbring, P. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.645273 · Cited by 16
Self-citationSharma, A., Sharma, N., & Chahal, A. (2024) · Pain Management Nursing · doi:10.1016/j.pmn.2024.04.015 · Cited by 15
Multi-view Layout Design for VR Concert Experience
Kim, M., Lee, Y., & Lee, J. (2022) · ACM International Conference on Multimedia (ACM MM) · doi:10.1145/3503161.3548347 · Cited by 13
“• Consideration of VR motion sickness: Several researchers have mentioned that the movement of the head and the direction of the axis of movement in a VR HMD environment affect motion sickness [10, 17, 19].”
BackgroundLin, Z., Yang, Z., & Yuan, J. (2024) · Heritage Science · doi:10.1186/s40494-024-01520-x · Cited by 11
Martins, S., & Vairinhos, M. (2023) · Virtual Worlds · doi:10.3390/virtualworlds2040018 · Cited by 6
“The digital medium not only allows for realistic exposure to fears but also provides unique opportunities for presenting phobic stimuli and facilitating controlled confronta-tions with these triggers, which may be impractical or impossible in real-world scenarios [7].”
BackgroundDescribing the Experiences of Students with ADHD Learning Science Content with Emerging Technologies
Hite, R. L., Childers, G. M., Jones, M. G., Corin, E. N., & Pereyra, M. (2021) · Journal of science education for students with disabilities · doi:10.14448/jsesd.13.0012 · Cited by 14
Technology-based cognitive behavioral therapy interventions
Newby, J. M., Upton, E., Mason, E., & Black, M. (2024) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2024.02.004 · Cited by 11
Affective States and Virtual Reality to Improve Gait Rehabilitation: A Preliminary Study
Rodríguez, J., Del-Valle-Soto, C., & Gonzalez-Sanchez, J. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19159523 · Cited by 12
Yaw, Q. P., Loh, Y. L., Lee, R., Ang, W. W., Lau, Y., & Wong, S. H. (2025) · Virtual Reality · doi:10.1007/s10055-025-01134-z · Cited by 10
“The VR devices can capture real-time and automated data during simulations for therapists (Lindner 2021; Mantovani et al. 2020).”
Systematic review of virtual reality's uses on vocabulary learning in higher education
Alhawsawi, S., & Alzaid, F. (2025) · Smart Learning Environments · doi:10.1186/s40561-025-00414-0 · Cited by 8
“The release of mobile VR devices like Samsung Gear VR and Oculus Go signaled the shift towards freestanding headsets, influencing the industry towards more affordable and accessible VR solutions (Lindner, 2021).”
Changing Biased Interpretations in CBT: A Brief History and Overview
Woud, M. L., & Hofmann, S. G. (2023) · CBT: science into practice · doi:10.1007/978-3-031-23650-1_12 · Cited by 11
Xianpin, Z. (2022) · Computational Intelligence and Neuroscience · doi:10.1155/2022/7260894 · Cited by 8
“…data with joint point category and position annotation, and finally obtains a model that can predict the position and category of human joint points [17]. existing deep learning models mainly include convolutional neural networks (CNNs), recurrent neural networks (RNNs), restricted Boltzmann…”
Shchory, S., Nitzan, K., Harpaz, G., & Doron, R. (2024) · Virtual Reality · doi:10.1007/s10055-023-00925-6 · Cited by 13
“This technology is distinguished from other medias by its ability to produce an immersive experience, characterized by a powerful sense of presence in the situation, a feature that disconnects its users from their current surroundings and reality at once (Riva et al. 2015; Lindner 2021).”
Kiuchi, K., Umehara, H., Irizawa, K., Kang, X., Nakataki, M., Yoshida, M., Numata, S., & Matsumoto, K. (2024) · Healthcare · doi:10.3390/healthcare12131287 · Cited by 10
“Second, psychotherapy based on virtual reality (VR) has been implemented [12].”
BackgroundTacca, C., Kerr, B. A., McLamb, C., Ridgway, K. L., & Friis, E. A. (2024) · Frontiers in Virtual Reality · doi:10.3389/frvir.2024.1281017 · Cited by 9
MeetingBenji: Tackling Cynophobia with Virtual Reality, Gamification, and Biofeedback
Alves, I., & Esteves, A. (2024) · ACM Symposium on Virtual Reality Software and Technology (VRST) · doi:10.1145/3641825.3687747 · Cited by 6
“Additionally, the need for regular clinic visits is leading to low commitment in the execution of the proposed tasks [5, 27].”
Ernst, M. T., Bouchard, S., Andersen, T. E., Ørskov, P. T., Tarp, K., & Lichtenstein, M. B. (2024) · JMIR Formative Research · doi:10.2196/55679 · Cited by 9
“Compared to traditional exposure methods, VR exposure holds several clinical advantages [22,23], such as increased control over situational elements, the opportunity to conduct the treatment in the comfort and security of a therapeutic room, increased motivation, or the opportunity to engage in…”
BackgroundChang, C., & Chien, W.-C. (2024) · Lecture notes in computer science · doi:10.1007/978-3-031-60405-8_20 · Cited by 7
Arrom-Llabrés, M., Mendoza-Medialdea, M. T., & Gutiérrez-Maldonado, J. (2025) · Applied Sciences · doi:10.3390/app15063334 · Cited by 5
“This “safer” feeling has been previously linked to greater patient commitment to VR therapy [38], lowering the chances of dropouts.”
Systematic Literature Review of Machine Learning in Virtual Reality and Augmented Reality
Sindu, I. G. P., Hartati, R. S., Sudarma, M., & Gunantara, N. (2023) · Jurnal Nasional Pendidikan Teknik Informatika (JANAPATI) · doi:10.23887/janapati.v12i1.60126 · Cited by 14
“The main goal of VR is to provide a highly immersive experience that makes you feel like you are actually in a digital environment [2].”
BackgroundImpact of Metaverse in the Near ‘Future’
Gupta, P., Bhadani, K., Bandyopadhyay, A., Banik, D., & Swain, S. (2023) · International Conference on Intelligent Engineering and Management (ICIEM) · doi:10.1109/iciem59379.2023.10166025 · Cited by 6
“Since 2017, major strides in the integration of Virtual Reality and Cognitive Behavioral Therapy have been made, focusing on how to tailor the experience to suit each individual patient [7].”
BackgroundVirtual emotions and Criminal Law
González-Tapia, M. I. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1260425 · Cited by 9
“VR is widely used for training and to promote mental health and personal well-being ( Cf. Lindner, 2021), although there is still no consensus regarding its long-term effectiveness and consequences.”
MethodInfluentialKahlon, S., Gjestad, R., Lindner, P., & Nordgreen, T. (2023) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2023.2281243 · Cited by 8
“Virtual Reality Exposure Therapy (VRET) can create a virtual environment that makes exposure situations readily available for the patients, as well as the therapist (Lindner, 2020).”
BackgroundSelf-citationFradette, M.-J., Azrak, J., Cousineau, F., Désilets, M., & Dumais, A. (2025) · BioMedInformatics · doi:10.3390/biomedinformatics5030048 · Cited by 7
“Building on these advances, the integration of real-time physiological monitoring directly into VRET shows considerable potential [32].”
Using iVR to deliver optimal psychotherapy experience—current perspectives on VRET for acrophobia
Varšová, K. K., & Juřík, V. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1491622 · Cited by 6
Virtual Reality in the treatment of depression; what therapeutic strategies does VR target?
Freher, N. K., van Bennekom, M. J., Bexkens, A., Veling, W., & Bockting, C. (2025) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2025.100912 · Cited by 6
What if Virtual Reality could be used as a Tool in Positive Psychotherapy in Brazil?
Kunst, M. H., Teixeira, J. M., Peres, F. F. F., & Maurício, C. R. M. (2024) · Symposium on Virtual and Augmented Reality (SVR) · doi:10.1145/3691573.3691609 · Cited by 4
“After The use of narratives makes VR experience more interactive and influences the way people see themselves and deal with their problems [18].”
PhobeeVR – Design and Development of a Virtual Reality Serious Game for People with Phobias
Ramalhoto, M., Martins, S., & Vairinhos, M. (2024) · SeGAH ... IEEE ... International Conference on Serious Games and Applications for Health/IEEE International Conference on Serious Games and Applications for Health · doi:10.1109/segah61285.2024.10639582 · Cited by 4
“The immersive and digital nature of VR enables the recreation of exposure situations, providing a realistic experience in a safe, controlled, and customizable setting [12], [13].”
BackgroundVirtual Reality Exposure Therapy
Turman, M. L., Olden, M., Emrich, M., & Difede, J. (2024) · CBT: science into practice · doi:10.1007/978-3-031-72720-7_4 · Cited by 5
Bell, I. H., Li, C., Thompson, A., Ellinghaus, C., O’Sullivan, S., Reynolds, K. A., Wadley, G., Liu, Y., Bendall, S., Gleeson, J., et al. (2025) · JMIR Mental Health · doi:10.2196/70160 · Cited by 3
“The past decade has seen a rapid increase in the number of studies exploring the use of VR for the treatment of mental disorders [2,16].”
Bettahi, L., Remacle, A., Schyns, M., Etienne, E., Etienne, A.-M., & Leclercq, A. (2026) · Frontiers in Virtual Reality · doi:10.3389/frvir.2026.1755571 · Cited by 3
IJdema, T., Laceulle, O. M., Dibbets, P., & Korrelboom, K. (2023) · Computers in Human Behavior Reports · doi:10.1016/j.chbr.2023.100311 · Cited by 3
Lewis-Fung, S. E., Tchao, D., Gray, H. G., Nguyen, E., Pardini, S., Harris, L. R., Calabia, D., & Appel, L. (2023) · Frontiers in Virtual Reality · doi:10.3389/frvir.2023.1209535 · Cited by 3
Use of Virtual Reality (VR) and AI in Therapeutic Settings
Singha, R., & Singha, S. (2025) · Advances in psychology, mental health, and behavioral studies (APMHBS) book series · doi:10.4018/979-8-3693-9341-3.ch015 · Cited by 3
Exploring Peak Experiences through Multi-Sensory Extended Reality
Thaker, S., Heitmayer, M., & Hanley, T. (2025) · ACM International Conference on Interactive Media Experiences · doi:10.1145/3706370.3731932 · Cited by 3
“Visuals can contribute to raising the intensity of an experience, which may in turn have therapeutic outcomes as we increasingly see in VR-based treatment protocols [31].”
Virtanen, L., Kaihlanen, A., Isola, A.-M., Laukka, E., & Heponiemi, T. (2021) · Sosiaalilääketieteellinen Aikakauslehti · doi:10.23990/sa.107405 · Cited by 24
Van, M., Wong, J. O. Y., Soni, A., Huynh, B., Arora, S., Mann, J. I., Wallsworth, C., Wong, L., Mortenson, W. B., Lim, A., et al. (2026) · Frontiers in Dementia · doi:10.3389/frdem.2026.1735564 · Cited by 1
“…more effectively than television because of its ability to allow first-person perspective observation while incorporating social cues and spatially adapted multisensory experiences that create a physical sense of presence within the scenario (Dang et al., 2018; Lindner, 2021; Yoo and Ohu, 2024).”
Weng, A. K.-W., Chang, H., & Lai, K. (2023) · IEEE International Conference on Consumer Electronics - Berlin (ICCE-Berlin) · doi:10.1109/icce-berlin58801.2023.10375685 · Cited by 2
“These virtual characters can remind patients of the therapeutic context and convey psychoeducational information while adding a positive emotional element, which can alleviate symptoms of acrophobia and arachnophobia [48-50].”
BackgroundOmoboye, M., Eneh, N. E., & Titor-Addingi, M. C. (2024) · World Journal of Advanced Research and Reviews · doi:10.30574/wjarr.2024.21.2.0635 · Cited by 2
Gagliardi, M., & Markowski, M. (2024) · Computers in Human Behavior Reports · doi:10.1016/j.chbr.2024.100440 · Cited by 2
Research on the Application of Virtual Reality in Mass Communication
Jin, X. (2022) · Advances in Social Science, Education and Humanities Research/Advances in social science, education and humanities research · doi:10.2991/assehr.k.220105.124 · Cited by 2
Measuring Anxiety Levels with Head Motion Patterns in Severe Depression PopulationPreprint
Boutaleb, F., Pierson, E., Doudeau, N., Nineuil, C., Amad, A., & Daoudi, M. (2025) · arXiv (Cornell University) · doi:10.48550/arxiv.2502.08813 · Cited by 2
“Head movements are significant nonverbal indicators for behavioral analysis and are well studied, as they are easy to track in virtual reality environments [25] or dyadic interactions [31].”
Sviridova, M. K., & Ershova, R. V. (2025) · Психолог · doi:10.25136/2409-8701.2025.4.75119 · Cited by 1
Digital Mental Health Treatments for Depression
Ramos, G., Karyotaki, E., Mohr, D. C., & Schueller, S. M. (2025) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2025.08.023 · Cited by 1
Ilioudi, M., Steingrímsson, S., Wallström, S., Thunström, A. O., Lindner, P., Ioannou, M., Falk, Ö., & Ali, L. (2025) · JMIR Formative Research · doi:10.2196/75961 · Cited by 1
“Despite decades of research support for its clinical application, it has only recently begun to be incorporated into real-world health care [1].”
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Chiappa, G. D., Atzeni, M., & Rashidin, M. S. (2026) · Italian Journal of Marketing · doi:10.1007/s43039-026-00129-1 · Cited by 1
“VR offers an immersive and interactive digital experience designed to replicate real or imagined environments (Lindner, 2021), and it has found applications across a variety of sectors, including agriculture, education, retail, tourism, and sports (Hamad & Bochen, 2022).”
Can You Feel What I Feel? Leveraging aesthetics in visual and spatial audio VR experience
Gloor, R., Corness, G., Marshack, R., & Paolucci, A. (2023) · Electronic workshops in computing · doi:10.14236/ewic/eva2023.21 · Cited by 1
A Systematic Literature Review for Proposal of Therapeutic Possibilities of AR Beauty Apps
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Doğan, U., Sarıcaoğlu, H., Sinem, A. C. A. R., Türkçapar, M. H., Sağkal, A. S., Büyüköksüz, E., Erözkan, A., Zeybek, S. U., Üzmez, H., Dağılgan, E. B., et al. (2025) · Current Psychology · doi:10.1007/s12144-025-07376-z · Cited by 1
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Taylor, L. C., Ranaldi, H., Amirova, A., Zhang, L., Ahmed, A., & Dibb, B. (2021) · doi:10.2196/preprints.34407
Improve your skills with virtual reality
Alsem, S. C. (2023) · Utrecht University Repository (Utrecht University) · doi:10.33540/1649
Targeting avoidant behaviors in social anxiety and agoraphobia using 360 degree immersive videosPreprint
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Cárdenas‐López, G., Durón-Figueroa, R., & Quero, S. (2023) · Frontiers in Virtual Reality · doi:10.3389/frvir.2023.1158427
“This approach could be more accessible and acceptable, as users could benefit from these programs fromhome, considering that VR-based programs are typically carried out in the office (Wiederhold & Riva, 2019; Linder, 2021).”
BackgroundWeng, A. K.-W., Chang, H., & Lai, K. (2023) · IEEE International Conference on Consumer Electronics - Berlin (ICCE-Berlin) · doi:10.1109/icce-berlin58801.2023.10375634 · Cited by 3
“These virtual characters can remind patients of the therapeutic context and convey psychoeducational information while adding a positive emotional element, which can alleviate symptoms of acrophobia and arachnophobia [48-50].”
BackgroundEditorial: Digital tools for relaxation and stress management: use, effectiveness and implementation
Bernaerts, S., & Lindner, P. (2024) · Frontiers in Digital Health · doi:10.3389/fdgth.2024.1366065
Self-citationNegative Emotions From Virtual Reality Usage: A Preliminary Exploratory Study Using Online Forums
Fang, E., Sivaramakrishnan, A., & Chen, K. (2024) · Proceedings of the Human Factors and Ergonomics Society Annual Meeting · doi:10.1177/10711813241275079
Virtual Reality in Clinical Mental Health
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Exploring a Virtual Reality Two-Chair Counseling Technique for Middle-Aged Men
Kwak, Y.-J., Son, J.-V., Kim, S.-M., & Kim, E. (2025) · Journal of Digital Contents Society · doi:10.9728/dcs.2025.26.2.525
Ilioudi, M., Steingrímsson, S., Wallström, S., Thunström, A. O., Lindner, P., Ioannou, M., Falk, Ö., & Ali, L. (2025) · doi:10.2196/preprints.75961
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“Virtual Reality (VR) can also help synthesize the preferred environment for treatment and conduct exposure therapy [48, 88].”
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Saba, P., Qi, H., Ye, Z., & Chen, I. (2025) · International Journal of Cognitive Behavioral Therapy · doi:10.1007/s41811-025-00256-1
“…behavioral therapy (CBT) is considered the leading therapy, and more problem-solving and its sessions are widely used to control media-driven anger and anger-related problems in a mechanistic way (Lindner and Better, 2020; Lindenberg et al., 2022; Reilly & Shopshire, 2019; Saba et al., 2023).”
Choi, M., Hwang, H., Seong, G., Lee, D., & Jung, Y. (2025) · 신경정신의학 · doi:10.4306/jknpa.2025.64.2.84
Metadata
- Authors
- Lindner, P.
- Affiliations
- Region Stockholm (SE)
- Corresponding author
- Lindner, Philip
- ORCID
- Lindner, Philip
- Venue
- International Journal of Cognitive Therapy
- Published
- 2020-10-20
- Volume
- 14
- Issue
- 1
- Pages
- 23-46
- ISSN
- 1937-1209 (ISSN-L)
- 1937-1217
- OpenAlex
- W3093847664
- Semantic Scholar
- f6bc7da21bcb63e0a542b5762a0a47d2df138d1b
- Cited by
- 120
- References
- 136
- Citations by year
- 2026: 19 · 2025: 28 · 2024: 30 · 2023: 24 · 2022: 7 · 2021: 11 · 2020: 1
- FWCI
- 7.83
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- International Journal of Cognitive Therapy (publishedVersion, cc-by)
- Funders
- Karolinska Institutet
- Topics
- Physical Sciences › Computer Science › Human-Computer Interaction › Virtual Reality Applications and Impacts
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- virtual reality, cognitive behavioral therapy, immersive technologies, embodiment, gamification, immersive storytelling, psychotherapy
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