Anxiety DIsorder Treatment, Virtual Reality, VR Theraphy

What is Virtual Reality & How Does It Work for Anxiety Disorder Treatment?


October 26, 2021 | Reading Time: 3 Minutes

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What Is Virtual Reality in Psychotherapy?

Virtual reality (VR) is the use of computer-generated simulation of a three-dimensional environment to create an experience by interacting in a seemingly real way by using advanced engineering equipment such as sensors. VR has become a popular topic in psychological research studies because of its potential benefit for digitally treating a wide variety of disorders, including the most common: anxiety, trauma, schizophrenia, and depression. According to experts specializing in psychotherapy, VR therapy is one of the top digital interventions having a projected positive growth trajectory for anxiety disorder treatment in the coming decades.

There is much scientific evidence that VR and cognitive behavioral therapy can effectively treat a range of anxiety disorders, such as social anxiety, generalized anxiety, exam anxiety, general driving anxiety, and public speaking anxiety. A recent study called Virtual Reality for Supporting the Treatment of Depression and Anxiety: Scoping Review, published in the journal JMIR Mental Health reported yet more data about VR proving helpful in the treatment of anxiety. Lead author Nilufer Baghaei and colleagues reported their findings after having reviewed 369 articles published between 2017 and 2021. They discussed 34 clinical studies in their summary article.

Most of the selected studies combined cognitive-behavioral therapy with virtual reality environments and simulations. A simulation is an animated representation that mimics the function of an existing or planned system, like the day-to-day family interaction, challenging job situation, or traumatic event.

How Does VR Work?

Virtual reality offers individuals a safe and private method to explore a simulated world while working closely with therapists in real-time. For instance, according to the study published in JMIR Mental Health, anxious people were placed in virtual workplaces or job interviews, while those who disliked public speaking were put into virtual classrooms and conference rooms. By implementing interactive tools such as gloves embedded with sensors and using a variety of engineering techniques involving modeling and simulation, virtual reality creates a realistic, visual 3D environment whereby people can experience a modified reality. While VR modeling can be used in VR programs to create virtual scenes, VR simulation provides users a realistic 3D experience that they can use to experience emotions that can then be approached using new skills that they are learning in therapy. When conducted safely and reliably in a clinical setting or therapeutic interaction, behavior change can often result. A common VR intervention is VR exposure therapy (VRET). Researchers have shown that VRET can reduce anxiety in social and public speaking situations. Through a simulated environment, VR deliberately exposes participants to an object they fear or an experience that triggers anxiety.It works by exposing patients to a triggering simulated environment in a slow and repeated fashion common to systematic desensitization. Anxiety disorder treatment and depression treatment usually entails calming negative emotions. VR specializes in this area because it can help distract the client or patient’s brain from painful thoughts and other negative emotions. It is easier for them to cope if they can concentrate on something else. For instance, virtual gardening and pet interaction are two playful immersive activities that are highly effective when used in clinical settings.

In the study named Virtual Therapeutic Garden: A Promising Method Supporting the Treatment of Depressive Symptoms in Late-Life, a virtual therapeutic garden containing a set of symbols and metaphors is used. The approach includes the use of Ericksonian psychotherapeutic techniques. Symbolically, a weakened and grey garden becomes more colorful and lively with every session, representing a process of gaining strength and vigor. Each session begins with a mandala in the center of the virtual garden, which represents various traits and emotions that are integral to therapy processes, such as vitality, joy, optimism, imagination, inner wisdom, and trust.

Another study by Frontiers in Psychiatry and authored by Philip Lindner, William Hamilton, Alexander Miloff, and Per Carlbring examines how VR-unique experiences can be therapeutic, such as alternative embodiment and virtual pet interactions. Yet another study titled The Principles of Art Therapy in Virtual Reality discusses the potentials and challenges of VR in art therapy and outlines basic principles for its implementation. According to the study, art therapy is particularly suitable for VR therapy since the clients create a suitable therapeutic environment for their specific needs.

It is also possible to use virtual reality for health activities like games, exercises, biofeedback, and neurofeedback. The goal of biofeedback is to teach one to control some of the body’s functions, such as heart rate. Neurofeedback is a form of biofeedback and depends on the electroencephalogram (EEG), a test used to detect abnormalities in the brain’s electrical activity. Neurofeedback has been in use since the 1970s to treat epilepsy, anxiety, depression, insomnia, PTSD, post-concussive syndrome, and more recently, centralized pain. See’s previous article Telepresence, Virtual Reality, and Augmented Reality Applied to Clinical Care for more information regarding VR.

Using virtual reality can be a useful method for enhancing traditional forms of anxiety disorder treatment. A factor to consider is that virtual reality is not likely to be best used as a standalone treatment option. Rather, this approach to anxiety disorders can improve treatment outcomes when used with other treatment modalities. With virtual reality’s continued expansion and development, it is reasonable to assume that providers will opt for including in into their treatment mix when working with people who struggle with challenging anxiety disorders.

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