Virtual Reality Therapy: Using Technology To Help You

Medically reviewed by Julie Dodson, MA
Updated May 31, 2024by BetterHelp Editorial Team
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Technology advances in counseling have allowed licensed therapists to utilize virtual reality technology to help clients overcome fear, anxiety, phobias, post-traumatic stress disorder (PTSD), and other psychiatric disorders and mental health conditions in a controlled environment. Virtual reality-based interventions, guided by a licensed professional counselor, offer a valuable tool for addressing mental health concerns. Although virtual reality therapy could have side effects, ongoing research and early studies provide insight into the possibilities and benefits of VR-based treatment.

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Gain insight into the technological advances of modern therapy

Virtual reality exposure therapy 

Virtual reality (VR) therapy is an exposure-based therapy that can allow you to enter a virtual world designed to increase your exposure to stimuli that elicit a fear response in a safe environment. This type of therapy aims to use repeated exposure in VR environments to reduce patient fears over time. VR-based therapy may help with pain management, life stress, memory improvement, specific phobias, and reducing symptoms of social anxiety. 

In VR exposure therapy, guided by a licensed counselor, you can participate in exposure and response prevention (ERP) counseling through a virtual world. ERP therapy, an effective treatment for anxiety symptoms and disorders like obsessive-compulsive disorder (OCD), involves exposure to stimuli that raise your anxiety levels, eventually allowing them to plateau over time as you begin to perceive your fears in a non-threatening manner. 

Virtual reality definition

To understand VR as a mental health treatment, you may want to learn more about VR systems.

VR refers to a virtual world that can be created through technology. When you use VR equipment, you can enter virtual environments that seem real. VR equipment typically includes a virtual reality headset that covers the eyes and sometimes the ears. This headset provides you with a box screen that makes it appear as though you are entirely inside the digital environment.

VR game developers work to make the graphics and appearance of items in the VR space appear natural. This effect may be caused by perspective, lighting, and 3D media. Although you may understand that the virtual environment is not real, you could react subconsciously as though it is. Outside of the potential fun of video games, VR can help you practice exposure to stimuli through ERP and prolonged exposure therapy. 

How does virtual reality counseling work?

Virtual reality exposure counseling employs a digital world created by VR technology to help you engage in social interactions or situations from which you can learn and achieve desired affective outcomes. If the goal is to overcome a fear, you might be exposed to the stimuli you fear through your VR system, with the level of fear-based triggers increasing over several sessions. The dynamic interaction between you and the virtual environment differentiates actual exposure treatment from internet reality, as you cannot touch or physically interact with anything you see in the session, even if it seems as though you are in the real world.  

During an initial VR appointment in a clinical practice, you might speak to your therapist before, during, and after the VR session to discuss what you are seeing, allowing for emotional processing. In exposure therapy, a therapist may track your level of significant distress on a scale of 1-10 or 10-100 in intervals of a few minutes. As your anxiety reduces in reaction to one stimulus, you may view another.

With VR counseling, patients can practice exposure in the same room as their therapist, making it a viable tool for mental health care with potentially live results. A systematic review of studies examining VR counseling demonstrated that virtual reality exposure is more effective than in vivo exposure for those with phobias of heights or flying.

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Uses of virtual reality in counseling

VR has been used as a behavioral medicine and cognitive counseling for several conditions and symptoms, including:

  • Fear of flying
  • Fear of public speaking
  • Fear of spiders
  • School phobia in children
  • Chronic pain and burn pain 
  • Distress related to painful medical procedures
  • PTSD
  • Reducing drug-related cues in people with substance use disorders
  • Depression
  • Anxiety
  • Eating disorders
  • Strokes

Technical aspects of virtual reality counseling

As VR relies on technology, the degree of its effectiveness may depend on the equipment and programs used, as well as the clinical adoption of these advancements. As the technology for VR therapy advances, the results from it might improve. And because VR can be effective for physical therapy treatments as well, your VR therapy provider could be trained as a physical therapist, a mental health professional, or both. 

Equipment used in virtual reality therapy

Various VR programs are available, each suited to treat different conditions or concerns. CAVE is an advanced VR environment presented to clients sitting in a cube-like room. The projectors for the CAVE respond to the client's movements and allow them to be immersed in the VR experience.

The US military has funded further research into VR as a PTSD treatment to treat combat veterans experiencing PTSD and help improve VR equipment.

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Drawbacks and limitations to virtual reality counseling 

Early results of VR counseling have been positive, depending on the inclusion criteria of the research conducted. However, there are potential drawbacks, such as its cost-effectiveness, as the cost of the equipment and programs can be expensive. This expense may mean VR treatment is less available. However, as headsets become more popular, the cost could be reduced.

Additionally, this type of treatment can cause a symptom called virtual reality sickness, which is a type of motion sickness. VR sickness might cause vertigo, nervousness, or dizziness. These symptoms can occur immediately upon headset use or up to 30 minutes or more after a session. If you feel sick while using the headset, let your provider know. 

Role of the counselor 

VR treatment involves more than sitting behind a display or wearing a VR headset. A counselor or other medical professional may speak with the client before and after a VR session to put the experience into perspective and help the client integrate it into their life. Therapists may also undergo VR training to improve their exposure therapy treatments.

Client Information 

When you visit a therapist for virtual reality exposure therapy, the therapist may begin the therapeutic process by speaking with you to determine your symptoms, any diagnoses, health history, and more. They might also ask about the specific fears that you hope to treat. 

You may have one or more sessions before you utilize the digital environment via VR technology. After you complete a short VR session, your therapist may work with you using cognitive behavioral treatment or another modality. 

VR techniques 

The primary techniques for VR mental health treatment are virtual reality exposure therapy (VRET) for anxiety disorders and a type of cognitive-behavioral treatment that uses VR as a tool. The computer-generated online environment can also be used as an educational experience. 

CAVE treatment 

The CAVE environment provides an immersive mode of VR treatment. While using the CAVE, your experience is controlled by the VR programming and your reactions to it. However, if you use non-immersive equipment like a desktop display, you may be exposed to outside stimuli that detract from the experience. 

Non-immersive techniques 

Non-immersive VR techniques may have limited success because of their inability to completely engage the client in the digital environment. Immersive techniques can make it easier for the client to experience the virtual environment as if it were an actual situation. For example, augmented reality psychotherapy, which adds stimuli to your existing environment without an immersive element, could achieve similar results, although future research is needed.

VR exposure treatment

VRET is the type of exposure therapy used to give the client experience with frightening stimuli. This therapy aims to expose clients to stimuli in a non-threatening environment so the mind and body can learn not to feel hyperalert when exposed to the same stimuli in real life.

People might use exposure for symptoms of obsessive-compulsive disorder (OCD), phobias, or anxiety disorders. Your therapist might check in with you during the practice to ensure you feel safe and find the process effective. 

Virtual reality to aid in CBT

VR and cognitive behavioral therapy (CBT) can be used together to help clients overcome fears through exposure and replace unhelpful thoughts with more beneficial ones. For example, a child with a phobia of school could be put in a VR environment with the stimuli they associate with negative experiences at school. 

After the VR session, their therapist might use CBT to help them identify new ways to think about those experiences and feelings. Because the session happens in the digital world rather than at school, the therapist can be present with the child, able to observe their reactions and help them make cognitive changes at the exact moment of exposure to the stressful stimuli.

Is VR counseling right for you?

VR counseling may benefit you if you have fears, phobias, pain, or other concerns that are heightened when you're exposed to certain stimuli. Additionally, JMIR mental health research suggests that it could be used to treat anxiety and depression as well. Discuss your concerns with a therapist beforehand to see if you are a suitable candidate for VRT. This treatment method combines aspects of occupational therapy and psychoanalysis to help you overcome fears and solve life's problems.

VR and exposure therapy can incur significant expenses for many people. Consider your options before choosing any method of care. You can also try in-person or online exposure therapy without the VR headset. A therapist can help you determine if this type of counseling would benefit you.  

Other forms of virtual counseling for mental health 

Many people benefit from VR. However, if VR counseling is inaccessible to you due to financial barriers or availability, you can try other forms of virtual counseling, such as online counseling. Through online counseling, you will meet with a therapist via phone, video, or live chat sessions on a device with an internet connection. After your session, you may be able to message your therapist with further questions. 

Studies show that online counseling is more cost-effective and beneficial for treating symptoms of obsessive-compulsive disorder than many forms of in-person counseling. You may also benefit from this modality for symptoms related to anxiety or depression, as well as a variety of other concerns. If you're interested in getting started, consider a platform like BetterHelp to learn more about how online counseling could support you. 

Takeaway

Virtual reality therapy is a modern form of technology-based counseling delivered through a controlled virtual environment. Although the procedure may be costly, it can benefit people with a variety of different mental health disorders and symptoms, particularly anxiety disorders. If you're interested in trying VR counseling or receiving further support through talk therapy, consider reaching out to a counselor for further guidance.

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