Outcomes associated with virtual reality in psychological interventions: where are we now?
Open accessAbstract
The impending commercial release of affordable VR systems is likely to accelerate both the opportunity and demand for VR applications that specifically target psychological conditions. The aim of this study was to conduct a meta-analysis of outcomes associated with VR psychological interventions and to examine the methodological rigour used in these interventions. Literature search was conducted via Ovid, ProQuest Psychology Journals and ScienceDirect (Psychology) databases. Interventions were required to: be published between 1980 to 2014; use a randomised controlled trial design; be published in a scholarly journal; focused primarily on psychological/behavioural intervention; include validated measures; include reported means and standard deviations of outcome measures; and include one group with clinical/subclinical disorders, syndromes or distressing behaviours. Thirty eligible studies were identified. Random effects meta-analysis found an overall moderate effect size for VR interventions. Individual meta-analyses found an overall large effect size against non-intervention wait-lists and an overall moderate effect size against active interventions. No correlation was found between treatment outcomes and methodological rigour. Limitations may include limited study numbers, the use of a single coder, a need for more in-depth analyses of variation in form VR intervention, and omission of presence as a moderating factor. The current review supports VR interventions as efficacious, promising forms of psychological treatment. Use of reporting guidelines such as the CONSORT and CONSORT-EHEALTH statements should promote greater emphasis on methodological rigour, providing a firm foundation for the further development of clinical VR applications.
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Only three systematic reviews with meta-analyses examined the efficacy of VR interventions in randomized controlled trials, and they present certain shortcomings.
“While many narrative reviews and commentaries focused on VR interventions, only three systematic reviews with meta-analyses examined their efficacy in randomized controlled trials/RCTs4,6,7 and they present certain shortcomings.”
From The effectiveness of virtual reality based interventions for symptoms of anxiety and depression: A meta-analysis (2018) · cites this paper as [7]
Only one meta-analysis considered heterogeneity between effect sizes, but did so only descriptively, without providing a quantification.
“Only one meta-analysis7 considered heterogeneity between effect sizes (ESs), but did so only descriptively, without providing a quantification.”
From The effectiveness of virtual reality based interventions for symptoms of anxiety and depression: A meta-analysis (2018) · cites this paper as [7]
Assessment of quality in prior meta-analyses relied on mixed and potentially inadequate tools that included items not linked to any type of trial bias.
“Assessment of quality6,7 relied on mixed and potentially inadequate tools that included items not linked to any type of trial bias (e.g., treatment fidelity)9, thereby potentially confounding the relationship between study quality and treatment effects.”
From The effectiveness of virtual reality based interventions for symptoms of anxiety and depression: A meta-analysis (2018) · cites this paper as [7]
Only one meta-analysis considered publication bias, with conflicting results between the assessment methods used.
“Only one meta-analysis7 considered publication bias, with conflicting results between the assessment methods used (Egger’s test and fail-safe N).”
From The effectiveness of virtual reality based interventions for symptoms of anxiety and depression: A meta-analysis (2018) · cites this paper as [7]
A significant amount of research has yielded evidence on the efficacy of mixed realities, particularly virtual reality, for several clinical conditions.
“From the 90s on, a significant amount of research has yielded evidence on the efficacy of MR, particularly VR, for several clinical conditions (Opriş et al., 2012; Turner and Casey, 2014).”
From New Technologies for the Understanding, Assessment, and Intervention of Emotion Regulation (2019) · cites this paper as Turner and Casey, 2014
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- Authors
- Turner, W. A., & Casey, L. M.
- Affiliations
- Griffith University (AU)
- Corresponding author
- Turner, Wesley A.
- ORCID
- Turner, Wesley A.
- Venue
- Clinical Psychology Review
- Publisher
- Elsevier BV
- Published
- 2014-12
- Volume
- 34
- Issue
- 8
- Pages
- 634-644
- ISSN
- 0272-7358 (ISSN-L)
- OpenAlex
- W2079610064
- Cited by
- 116
- References
- 72
- Citations by year
- 2026: 7 · 2025: 10 · 2024: 7 · 2023: 9 · 2022: 3 · 2021: 14 · 2020: 10 · 2019: 17 · 2018: 11 · 2017: 9 · 2016: 9 · 2015: 10
- FWCI
- 2.46
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- Clinical Psychology Review (publishedVersion)
- PubMed (publishedVersion)
- Griffith Research Online (submittedVersion, cc-by-nc-nd)
- 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, psychological intervention, treatment efficacy, methodological quality, randomized controlled trials, presence, reporting guidelines, behavior change
- MeSH terms
- Anxiety Disorders, Mental Disorders, Humans, Treatment Outcome, Virtual Reality Exposure Therapy
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