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The Use of Virtual Reality Technology in the Treatment of Anxiety and Other Psychiatric Disorders
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LEARNING OBJECTIVES: After participating in this activity, learners should be better able to:• Evaluate the literature regarding the effectiveness of incorporating virtual reality (VR) in the treatment of psychiatric disorders• Assess the use of exposure-based intervention for anxiety disorders ABSTRACT: Virtual reality (VR) allows users to experience a sense of presence in a computer-generated, three-dimensional environment. Sensory information is delivered through a head-mounted display and specialized interface devices. These devices track head movements so that the movements and images change in a natural way with head motion, allowing for a sense of immersion. VR, which allows for controlled delivery of sensory stimulation via the therapist, is a convenient and cost-effective treatment. This review focuses on the available literature regarding the effectiveness of incorporating VR within the treatment of various psychiatric disorders, with particular attention to exposure-based intervention for anxiety disorders. A systematic literature search was conducted in order to identify studies implementing VR-based treatment for anxiety or other psychiatric disorders. This article reviews the history of the development of VR-based technology and its use within psychiatric treatment, the empirical evidence for VR-based treatment, and the benefits for using VR for psychiatric research and treatment. It also presents recommendations for how to incorporate VR into psychiatric care and discusses future directions for VR-based treatment and clinical research.
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“Experiencing presence when immersed in VR has been reported to be an important factor for the implementation of effective interventions in VR (Maples-Keller et al., 2017).”
From iSenseVR: bringing VR exposure therapy outside the laboratory (2019) · cites this paper as Maples-Keller et al., 2017
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“VR exposure therapy allows the controlled delivery of sensory stimulation (Maples-Keller et al., 2017).”
From iSenseVR: bringing VR exposure therapy outside the laboratory (2019) · cites this paper as Maples-Keller et al., 2017
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“For instance, virtual reality (VR) technology, accessed through head-mounted displays, provides an immersive experience similar to real-life situations and has been used in controlled environments [7].”
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“However, when traditional graded exposure becomes complex to set up due to difficulties to control specific environment cues, VR offers opportunities for highly controllable settings empowering sensory exposure with the presence of the therapist, which would not be possible otherwise (Maples-Keller et al., 2017).”
From iSenseVR: bringing VR exposure therapy outside the laboratory (2019) · cites this paper as Maples-Keller et al., 2017
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Coja, D. M., Talaghir, L.-G., Georgescu, L., & Codreanu, C. M. (2023) · Balneo and PRM Research Journal · doi:10.12680/balneo.2023.629 · Cited by 6
“Reinforcing the feasibility of virtual reality (VR) as a viable approach for pain reduction was demonstrated through the systematic literature review conducted by Mesa-Gresa [31].”
MethodErnst, 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
“Finally, 4 participants (4, 24, 17, and 27) pointed out technological limitations affecting their perception of realism in the environments.”
BackgroundMethodInfluentialLafortune, D., Lapointe, V. A., Dubé, S., & Bonneau, J. (2024) · The Journal of Sexual Medicine · doi:10.1093/jsxmed/qdae154 · Cited by 7
İbek, E., & Çınar, D. (2024) · European Journal of Oncology Nursing · doi:10.1016/j.ejon.2024.102750 · Cited by 6
Lebamovski, P., & Gospodinova, E. P. (2025) · Applied System Innovation · doi:10.3390/asi8010016 · Cited by 6
Empathy Games for Depression Using Virtual Reality: A Literature Review and A Study Design
Li, Y., Luo, H., & Zhang, C. (2021) · Hawaii International Conference on System Sciences (HICSS) · doi:10.24251/hicss.2021.488 · Cited by 6
Co-watching 360-Films in Nursing Homes
Lundström, A., Ghebremikael, S., & Fernaeus, Y. (2021) · Lecture notes in computer science · doi:10.1007/978-3-030-85623-6_30 · Cited by 6
Sexual Dysfunction in Parkinson’s Disease
Bronner, G., & Gurevich, T. (2022) · Cambridge University Press eBooks · doi:10.1017/9781009039291.015 · Cited by 6
Chen, L., & Zhu, H. (2022) · Computational Intelligence and Neuroscience · doi:10.1155/2022/4128981 · Cited by 9
On the Multimodal Resolution of a Search Sequence in Virtual Reality
Klowait, N. O. (2023) · Human Behavior and Emerging Technologies · doi:10.1155/2023/8417012 · Cited by 6
Role-playing recovery in social virtual worlds: Adult use of child avatars as PTSD therapy
Davis, D., & Alexanian, S. (2023) · Computer Methods and Programs in Biomedicine Update · doi:10.1016/j.cmpbup.2023.100129 · Cited by 6
Engineering a Showcase of Virtual Reality Exposure Therapy
Muller, A., Truman, S., von Mammen, S., & Brukamp, K. (2019) · International Conference on Virtual Worlds and Games for Serious Applications (VS-Games) · doi:10.1109/vs-games.2019.8864536 · Cited by 6
“Lack of accessibility and adaptability of fear-inducing stimuli is this therapy’s major disadvantage—consider the fear of flying and the therapist’s lack of control over an actual airplane [5].”
BackgroundChen, F. (2021) · Journal of Physics Conference Series · doi:10.1088/1742-6596/1744/4/042220 · Cited by 6
“Therefore, it has derived the problems of long training cycle of virtual reality teaching staff, poor training quality, and susceptibility to equipment and location restrictions [1-2].”
BackgroundOptimization of building model based on 5G virtual reality technology in computer vision software
Zhuang, Z. (2021) · Mathematical Biosciences & Engineering · doi:10.3934/mbe.2021393 · Cited by 6
Bruce, T. A., Rebair, A., & Holmquist, L. E. (2022) · Nordic Conference on Human-Computer Interaction · doi:10.1145/3546155.3547725 · Cited by 6
“report on the uses of VR technology with schizophrenia, psychosis and anxiety, describing it as a tool that can have ‘lasting effects that generalize to the real world’ [40], Best et al.”
BackgroundGendia, A., Zyada, A., Nasir, M. T., Elfar, M., Sakr, M., Rehman, M. U., Cota, A., & Clark, J. (2022) · Cureus · doi:10.7759/cureus.29608 · Cited by 6
“The rationale for using VR to improve anxiety preoperatively is by immersing patients in a fully simulated relaxing environment with the objective of placing them in a more empowered state to deal with the triggers of their anxiety [21].”
BackgroundBrady, N., Lewis, J., McCreesh, K. M., Dejaco, B., & McVeigh, J. G. (2021) · HRB Open Research · doi:10.12688/hrbopenres.13239.1 · Cited by 8
Virtual Reality as an Innovative Tool for Youth Mental Health
Blondell, V. J., & Thomson, N. D. (2025) · Encyclopedia · doi:10.3390/encyclopedia5040215 · Cited by 6
“This has the potential to interfere with the data collection process in research contexts and treatment efficacy in clinical contexts [99], particularly with younger adolescent populations who may be more aroused by distractions present in the surrounding field of vision [100].”
Lu, S.-Y., & Li, Q. (2025) · International Journal of Human-Computer Interaction · doi:10.1080/10447318.2025.2518331 · Cited by 5
“VR has also showed promise in lowering stress and improving cognitive skills, notably in neuro rehabilitation settings (Andrunyk et al., 2023; De Giorgi et al., 2023; Du et al., 2024; Maples-Keller et al., 2017).”
AI affective computing and behavioral health
Farsadaki, V., & Griffy‐Brown, C. (2026) · Frontiers in Computer Science · doi:10.3389/fcomp.2025.1692728 · Cited by 9
Sokół-Szawłowska, M., & Poleszczyk, A. (2018) · Postępy Psychiatrii i Neurologii · doi:10.5114/ppn.2018.77031 · Cited by 5
“For the purpose of the therapy, TMS consists in a series of stimuli – dotyczy zastosowania tej metody w fobiach specyficznych czy w zespole stresu pourazowego [30].”
MethodDigital Media Art Design System Based on Virtual Reality Technology
Guo, L., & Zhang, L. (2022) · Lecture notes on data engineering and communications technologies · doi:10.1007/978-3-031-05237-8_82 · Cited by 5
Xin, J., Yan, G., & Song, Q. (2022) · Scientific Programming · doi:10.1155/2022/7507497 · Cited by 5
Choi, S., Kim, J., & Kim, S. (2023) · Journal of Rational-Emotive & Cognitive-Behavior Therapy · doi:10.1007/s10942-023-00533-y · Cited by 6
“…of VR sessions and telemedicine as cognitive-behavioral therapy treatments for various disorders and addictions has been explored for decades (Maples-Keller et al., 2017; Riva et al., 2001), and now the usage of such applications is expected to grow exponentially (Korea Ministry of Food and…”
Self-citationVirtual reality technology for learning detailed design in landscape architecture
Ha, J., Alrayyan, K., & Alam, M. M. L. (2024) · Discover Education · doi:10.1007/s44217-024-00123-9 · Cited by 5
“Sensory information is transmitted through a head-mounted display (HMD) equipped with a head movement tracking system, which provides seamless real-time visual representation, thereby allowing for a sense of full immersion [11, 12] and a feel of presence [13, 14].”
Wong, K. P., Wu, S., Lin, H., Poon, K., Zhang, B., & Qin, J. (2025) · Healthcare · doi:10.3390/healthcare13080895 · Cited by 6
Zhang, T. (2020) · American Journal of Biomedical Science & Research · doi:10.34297/ajbsr.2020.07.001156 · Cited by 5
“However, it is still uncertain if a VR-based cognitive behavioral therapy would be more effective than conventional methods [26].”
BackgroundApplication of VR virtual reality in film and television post-production
Chen, D., & Yang, F. (2020) · IOP Conference Series Materials Science and Engineering · doi:10.1088/1757-899x/750/1/012163 · Cited by 5
“In addition to film post-production and 3D effects of games in the film and television industry, there are also some commonly used applications, such as virtual test makeup and dress-up applications on some shopping apps[12].”
Virtual Reality in Social Work Education
Olson-Morrison, D. (2020) · Advances in higher education and professional development book series · doi:10.4018/978-1-7998-4960-5.ch011 · Cited by 5
Krish, G., Immerman, I., & Kinjo, S. (2021) · Journal of Perioperative Practice · doi:10.1177/1750458920984048 · Cited by 5
Metadata
- Authors
- Maples-Keller, J. L., Bunnell, B. E., Kim, S.-J., & Rothbaum, B. O.
- Affiliations
- Emory University (US)
- Venue
- Harvard Review of Psychiatry
- Published
- 2017-05
- Volume
- 25
- Issue
- 3
- Pages
- 103-113
- ISSN
- 1067-3229 (ISSN-L)
- 1465-7309
- PMC
- PMC5421394
- OpenAlex
- W2611287876
- Cited by
- 862
- References
- 108
- Citations by year
- 2026: 111 · 2025: 147 · 2024: 115 · 2023: 93 · 2022: 113 · 2021: 117 · 2020: 85 · 2019: 51 · 2018: 24 · 2017: 5
- FWCI
- 4.40
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Harvard Review of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Genentech
- National Institute of Mental Health (R01MH094757, R01MH070880)
- 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 › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- virtual reality, anxiety disorders, mental illness, exposure therapy, virtual reality exposure therapy, immersive virtual reality, head-mounted displays, treatment effectiveness, psychiatric treatment
- MeSH terms
- Anxiety Disorders, Humans, Randomized Controlled Trials as Topic, Treatment Outcome, Virtual Reality Exposure Therapy
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