Systematic scoping review of virtual reality exposure-based therapy for anxiety-related disorders since the commercial release of head-mounted display virtual reality
File(s)
Published version
Author(s)
Caltabiano, Anna
Akin, Adile Dicle
Martina, Di Simplicio
Nejra, van Zalk
Type
Journal Article
Abstract
Objective: This systematic scoping review mapped the empirical literature on Virtual Reality Exposure-Based Therapy (VRET) delivered via commercially available
head-mounted displays for adult anxiety-related disorders, to characterize study targets, methods, and gaps. Methods: A comprehensive database search yielded 1097 records. Publications were excluded if anxiety was not a measured outcome; if exposure was paired with other techniques (e.g., relaxation or additional therapies) in a way that prevented evaluation of exposure as a stand-alone component; or if virtual reality was delivered via methods other than head-mounted displays. Thirty studies met inclusion criteria and were charted for synthesis. Results: The 30 included studies examined phobias (n = 11), Obsessive-Compulsive Disorder (n = 4), public speaking anxiety and social anxiety (n = 13), and other anxiety presentations (n = 2; social physique anxiety; MRI anxiety). Most studies reported pre- to post-intervention reductions in anxiety symptoms, but study designs and outcome measures varied substantially. Acceptability and engagement were generally favorable when assessed, but measurement approaches were inconsistent and adverse effects were not uniformly reported. Methodological heterogeneity
and limited replication constrained cross-study comparability. Conclusions: The current evidence base indicates growing application of HMD-based VRET across multiple anxiety-related targets and suggests potential clinical benefit in many studies; however, heterogeneity and small samples limit the strength of inferences regarding comparative outcomes. Future research would benefit from standardized reporting of intervention parameters and equipment, consistent measurement of acceptability, and adequately powered comparative designs with longer follow-up to clarify where HMD-based VRET is most feasible and beneficial.
head-mounted displays for adult anxiety-related disorders, to characterize study targets, methods, and gaps. Methods: A comprehensive database search yielded 1097 records. Publications were excluded if anxiety was not a measured outcome; if exposure was paired with other techniques (e.g., relaxation or additional therapies) in a way that prevented evaluation of exposure as a stand-alone component; or if virtual reality was delivered via methods other than head-mounted displays. Thirty studies met inclusion criteria and were charted for synthesis. Results: The 30 included studies examined phobias (n = 11), Obsessive-Compulsive Disorder (n = 4), public speaking anxiety and social anxiety (n = 13), and other anxiety presentations (n = 2; social physique anxiety; MRI anxiety). Most studies reported pre- to post-intervention reductions in anxiety symptoms, but study designs and outcome measures varied substantially. Acceptability and engagement were generally favorable when assessed, but measurement approaches were inconsistent and adverse effects were not uniformly reported. Methodological heterogeneity
and limited replication constrained cross-study comparability. Conclusions: The current evidence base indicates growing application of HMD-based VRET across multiple anxiety-related targets and suggests potential clinical benefit in many studies; however, heterogeneity and small samples limit the strength of inferences regarding comparative outcomes. Future research would benefit from standardized reporting of intervention parameters and equipment, consistent measurement of acceptability, and adequately powered comparative designs with longer follow-up to clarify where HMD-based VRET is most feasible and beneficial.
Date Issued
2026-06-01
Date Acceptance
2026-02-21
Citation
Virtual Reality, 2026, 30 (2)
ISSN
1434-9957
Publisher
Springer
Journal / Book Title
Virtual Reality
Volume
30
Issue
2
Copyright Statement
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
License URL
Identifier
10.1007/s10055-026-01350-1
Subjects
Virtual reality
Anxiety
Exposure
Review
VR
Publication Status
Published
Article Number
ARTN 86
Date Publish Online
2026-03-17