Last reviewed: November 2026. This guide is for general information and is not medical advice. If you are struggling with your mental health, please speak with a qualified professional.
Mental health is where virtual reality (VR) has some of its strongest research support. Nearly all of it concerns one approach: using VR to deliver exposure-based therapy inside a structured treatment program.
Key takeaways
- Anxiety disorders and phobias: across 30 randomized trials, VR exposure therapy performed about as well as real-life exposure.
- More severe conditions: a later analysis found VR-based therapy as effective as standard cognitive behavioral therapy for severe anxiety disorders, OCD and PTSD.
- Psychosis: a 346-person trial found an automated VR program reduced avoidance of everyday situations, with a small overall effect.
- Important limit: these results are for therapy programs with professional support, not for consumer apps used alone.
In this guide
Why VR suits exposure therapy
Exposure therapy helps a person face a feared situation gradually, in a controlled way, until the fear lessens. Arranging that in real life can be slow, costly or impossible: a therapist cannot easily produce a flight, a thunderstorm or a crowded train on demand.
VR can. The therapist chooses the scene, controls how intense it is, and can repeat it as often as needed, all from the clinic. That practical advantage is why exposure therapy became the main mental health use of VR.
Anxiety, phobias and PTSD
A 2019 meta-analysis combined 30 randomized trials with 1,057 participants. Fourteen trials covered specific phobias, eight social anxiety or performance anxiety, five PTSD and three panic disorder. VR exposure therapy clearly outperformed waiting-list controls, and showed no significant difference from real-life exposure.
Because many of those trials involved phobias, a 2022 meta-analysis looked only at more severe conditions: severe anxiety disorders, obsessive-compulsive disorder and PTSD. Across 16 trials with 817 participants, VR-based cognitive behavioral therapy was more effective than a waiting list and as effective as standard therapy.
One caution from the 2019 analysis: larger trials tended to show smaller effects. That pattern often means early, small studies overstated the benefit.
Psychosis and automated therapy
Many people with psychosis avoid everyday situations, such as shops or buses, because of intense anxiety. The gameChange trial, run across nine NHS trusts in England, tested an automated VR program for this problem. A virtual coach guides the patient through simulated everyday scenes over six weekly sessions of about 30 minutes, with a mental health worker present.
The trial randomly assigned 346 patients to the VR program plus usual care, or to usual care alone. The VR group showed significant reductions in avoidance and distress. The average effect was small, and the benefit was greatest for patients with the most severe avoidance, such as those unable to leave home alone.
The wider significance is the delivery model. Because the therapy content is automated, it can be supported by staff who are not specialist therapists, which could make psychological treatment available to more people.
Limits and cautions
- Apps are not therapy. The trials above tested structured programs with professional involvement. They do not show that a relaxation or exposure app used alone treats a mental health condition.
- Exposure can be distressing. It is meant to be done at a planned pace with support. Self-directed exposure to trauma-related content is not recommended.
- Evidence is uneven. Support is strongest for anxiety-related conditions and much thinner for others, such as depression.
- Physical side effects: some people experience motion sickness or eye strain in a headset.
Questions to ask
- Is VR being offered as part of a therapy program, and who will support me through it?
- What evidence is there for VR with my specific condition?
- What happens if a session becomes too distressing?
For the wider picture, see our guide to virtual reality in healthcare.
Common questions
Does VR therapy work for anxiety and phobias?
Across 30 randomized trials, VR exposure therapy performed about as well as real-life exposure.
Can VR be used to treat PTSD and OCD?
A later analysis found VR-based therapy as effective as standard cognitive behavioral therapy for severe anxiety disorders, OCD and PTSD.
Can I use a VR app instead of therapy?
The trial results are for therapy programs with professional support, not for consumer apps used alone.
Sources
- Carl E, et al. Virtual reality exposure therapy for anxiety and related disorders: a meta-analysis of randomized controlled trials. Journal of Anxiety Disorders, 2019.
- The effectiveness of virtual reality exposure-based cognitive behavioral therapy for severe anxiety disorders, obsessive-compulsive disorder, and posttraumatic stress disorder: meta-analysis. Journal of Medical Internet Research, 2022.
- gameChange Trial Group. Automated virtual reality therapy to treat agoraphobic avoidance and distress in patients with psychosis (gameChange). The Lancet Psychiatry, 2022.
- University of Oxford. gameChange: improving lives through VR therapy.
