Virtual Reality Technology in Cognitive Behavioral Therapy Across Multiple Psychiatric Conditions: A Narrative Literature Review

Abstract

Purpose: Modern psychotherapy increasingly incorporates technology to support patients with mental disorders. Virtual reality (VR) enables realistic, controlled simulations, offering structured, time-limited interventions focused on present problems, which are highly valuable in clinical practice. Cognitive-behavioral therapy (CBT), one of the most widely used psychotherapeutic approaches, can be effectively enhanced by VR. This review aims to summarize the potential of VR as a support tool for CBT and to evaluate its effectiveness across selected mental disorders.

Methods: A narrative review of the literature published over the last 15 years was conducted. Searches were performed in five major databases: PubMed/MEDLINE, PsycINFO, Scopus, Web of Science, and the Cochrane Library. Peer-reviewed studies involving VR as an integral component of CBT were included. The review focused on anxiety disorders, depression, eating disorders, addictions, and autism spectrum disorders (ASD).

Results: Immersive VR appears to enhance the effectiveness of CBT across multiple mental disorders. In anxiety disorders, VR-based exposure closely replicates real-life situations and represents the most extensively studied application; meta-analytic evidence (eg, Wu et al, 11 studies, 626 participants) indicates that VR-assisted CBT is effective and comparable to traditional CBT. In depression, VR facilitates behavioral activation and positive experiential learning. In eating disorders, VR supports body image modification, including realistic correction in bulimia and anorexia and altered gratification processes in obesity. VR also enables controlled exposure to substance-related cues in addiction treatment and supports training in emotional regulation and social skills in individuals with ASD.

Conclusion: The available literature indicates that the strongest and most consistent evidence for VR-assisted cognitive-behavioral therapy concerns anxiety disorders, which represent the primary focus of existing research. In contrast, evidence for the use of VR in other mental disorders remains more limited, heterogeneous, and often based on smaller or more individualized interventions. This imbalance in the evidence base constitutes a key limitation of the current field and should be considered when interpreting the overall effectiveness and generalizability of VR-assisted CBT. Further high-quality research and continued technological development are required to strengthen the evidence for VR applications across a broader range of mental disorders.

Keywords: CBT; VR; VRCBT; cognitive-behavioral therapy; literature review; psychotherapy; virtual reality.