Virtual Reality Exposure Treatment in Phobias: a Systematic Review

Psychiatr Q. 2021 Dec;92(4):1685-1710. doi: 10.1007/s11126-021-09935-6. Epub 2021 Jun 26.


We compare the relative efficacy of virtual reality therapy exposure (VRET) versus in vivo therapy exposure among individuals suffering from phobias. A systematic search was completed up to 03 April 2020, using the following databases: ACM Digital Library, ResearchGate, IEEE, Science Direct, MIT PressJournals, Center for Direct Scientific Communication (CCSD) and Mary Ann Liebert Publishers. Five authors searched the databases using the following terms: Virtual Reality, Phobia, Mental health, Computing, Therapy, HMD, CAVE, Virtual ambient, in virtuo, Avoidance, Exposure, VRET, in vivo, Anxiety, Agoraphobia, Social Phobia, Stimuli, Cognitive-behaviour. All studies that evaluate the effect of in virtuo exposure towards phobia rehabilitation were selected. By reviewing the article, each author then applied the inclusion and exclusion criteria, and 30 articles were selected. Data extracted included the number of samples, amount of sessions, study variables that may affect the final outcome, therapy technology. The data provided was synthesized using a meta-analysis based on the results. The results demonstrated a positive outcome of Virtual Reality Exposure Treatment in the treatment of most phobias. In contrast, some of these treatments did not work for a few specific phobias in which the standard procedures were more effective. The findings suggest that for some specific phobias treatment, Virtual Reality Exposure Treatment does not reach the in vivo exposure level of immersion and presence. Further research is needed to perform studies with higher-dimension samples, since many papers report a low sample size and that is probably why many of them have inconclusive results.

Keywords: Cognitive-behavior therapy; Exposure therapy; Mental health computing; Meta-analysis; Social phobia; Specific phobias; VRET; Virtual reality.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Anxiety Disorders
  • Humans
  • Implosive Therapy*
  • Phobic Disorders* / therapy
  • Virtual Reality Exposure Therapy*
  • Virtual Reality*