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Blog - Therapy
Innovative Treatment: Virtual Reality Exposure Therapy For PTSD
By Dr. Melanie Smith, Advisory board member at PsyTech VR
March 21, 2025
PsyTechVR
Traumatic events, according to statistics, are common occurrences that have either been witnessed or experienced at least once by approximately 70 percent of the global population. It is a terrible ordeal that typically follows with the individuals having strong physical, emotional, and psychological distress which makes them unable to function normally in their day-to-day life. Now, while most individuals, with time and the right support, learn to cope with and then recover from their terrifying experiences, there are certain people whose distress levels only worsen with time, showing signs of PTSD.
Post-Traumatic Stress Disorder (PTSD), since its official recognition in 1980, has been known to affect millions of individuals worldwide. Although the traditional treatment options are generally effective, they sometimes fall short for individuals who are suffering from the most severe symptoms. In recent times, virtual reality technology has evolved as a highly effective tool in combating this challenging condition. As we continue in this article, we will be looking at how VR exposure therapy is being utilized in helping PTSD sufferers to reclaim control of their lives.
Post-Traumatic Stress Disorder (PTSD), since its official recognition in 1980, has been known to affect millions of individuals worldwide. Although the traditional treatment options are generally effective, they sometimes fall short for individuals who are suffering from the most severe symptoms. In recent times, virtual reality technology has evolved as a highly effective tool in combating this challenging condition. As we continue in this article, we will be looking at how VR exposure therapy is being utilized in helping PTSD sufferers to reclaim control of their lives.
What Is Virtual Reality Exposure Therapy?
Virtual reality exposure therapy (VRET) can be described as a form of psychotherapy that involves the use of VR technology to create 3D digital environments where individuals can safely confront and process their fears, anxieties or traumatic experiences. This therapeutic approach is used to primarily treat mental health conditions and it is designed to remove the limitations of traditional exposure therapy by allowing for safe, repeatable and regulated exposures to distress-stimulating scenarios. The virtual scenarios can be paused, modified, or exited at any time, providing the users with flexibility in managing the entire therapeutic process.
The principle of VRET is based on the understanding that the avoidance of feared situations only strengthens anxiety while gradual and controlled exposures, on the other hand, reduce stress responses over time. VRET applies this principle by fully immersing individuals into realistic virtual scenarios that mimic their traumatic experience to help them build the confidence they need to overcome their real-world fears.
What Is PTSD?
Post-traumatic stress disorder (PTSD), also known as ‘’shell shock’’ is a mental health condition that occurs in individuals as a result of witnessing or experiencing a very stressful or terrifying event(s). Examples of these events include terrorist acts, catastrophic accidents, natural disasters, sexual assaults, and other incidents that are considered physically and emotionally harmful or life-threatening. PTSD typically occurs months after a traumatic experience and can last for many years if untreated. It is characterized by the presence of persistent symptoms, which is often classified into 4 major categories:
Intrusive Thoughts
People with PTSD involuntarily relive the experience of their traumatic events when randomly triggered by certain sounds, sights, and even smells. These distressing memories often manifest themselves in the form of flashbacks and nightmares, and they are capable of disrupting an individual’s life.
Avoidance
Individuals with PTSD do everything in their power to never be reminded of their trauma experiences. A lot of them refrain from talking about it while some even go to extreme lengths to avoid specific places, people, and activities associated with the event. This avoidance, in most cases, results in social withdrawal and it makes it difficult for sufferers to build and maintain personal relationships.
Negative Mood And Thought Changes
PTSD is capable of making individuals develop negative emotions such as fear, anger, guilt, and shame. A common sign of PTSD is when an individual begins to cultivate an unhelpful mentality about themselves and even the world. This may result in them losing interest in activities they previously enjoyed and also engagement in self-destructive behaviors such as substance abuse.
Heightened Reactivity And Arousal
Individuals with PTSD have this on-edge feeling where they constantly believe they are in danger. This results in them always being alert or easily startled, which can bring about irritability, frequent anger outbursts, and difficulty concentrating or sleeping.
People are normally diagnosed with PTSD when their anxiety or fear-induced symptoms last for an extended period after the traumatic event, and it begins to significantly affect different aspects of their daily life.
Understanding Exposure Therapy For PTSD
Exposure therapy is a form of cognitive behavioral therapy where therapists gradually introduce individuals with PTSD to scenarios, activities or things that trigger the fear caused by their traumatic experiences. Instead of the signature practice of always avoiding their fears, exposure therapy helps individuals with PTSD safely confront their fears until the point they grow comfortable with them.
There are several ways through which mental health professionals introduce people with PTSD to fear-triggering situations. However, the safety of each exposure therapy type is dependent on several factors, some of which include the individual’s state, the mode of application, and how well the therapy type is tailored to meet the subject’s needs. Let’s go over the types of exposure therapy:
There are several ways through which mental health professionals introduce people with PTSD to fear-triggering situations. However, the safety of each exposure therapy type is dependent on several factors, some of which include the individual’s state, the mode of application, and how well the therapy type is tailored to meet the subject’s needs. Let’s go over the types of exposure therapy:
| Imaginal Exposure Therapy This type of exposure therapy involves a process where the individual with PTSD repeatedly visualizes or imagines traumatic events while describing them out loud to the therapist. During the sessions, the patients are guided by the therapists to remember everything they can about their traumatic experiences. This repeated process helps the brain gradually reframe the memories, making them less overwhelming with each exposure. |
| Interoceptive Exposure Therapy This approach of exposure therapy focuses on the bodily sensations associated with traumatic events such as racing heart, dizziness, and shortness of breath. By inducing these sensations, it brings the people back to the way they felt during their period of trauma. However, through guided and repeated exposures to the same sensations, the brain is taught the sensations are not as dangerous as they thought. |
| In Vivo Exposure Therapy This exposure therapy type is also referred to as ’Real life Exposure Therapy’. It involves a therapeutic process where therapists place their PTSD patients in actual situations that they fear or avoid due to trauma. For example, an individual that suffers from PTSD as a result of a car accident can start by visiting a parking lot and then progress to driving in the parking lot before moving on to short distances and highways. |
| Virtual Reality Exposure Therapy As previously mentioned, this type of exposure involves the use of VR technology to create virtual environments/scenarios where individuals with PTSD can be immersed to gradually confront their fears. This method provides the best access among all the types of exposure therapy, as it can recreate situations/events that are difficult or impossible to create in real life. It can be regulated, paused and even customized to meet the specific needs of each person with PTSD. VRET is integrated with bio-tracking monitors and also allows the option of being guided by therapists in real-time during sessions. |
The methods of exposure therapy for PTSD treatment are also categorized based on the timing. These approaches include:
| Gradual Exposure This involves a step-by-step method where, in terms of intensity, the individuals with PTSD are exposed to trauma-stimulating environments in an incremental process. This is the most researched and recommended method as it helps the PTSD individuals build tolerance and reduce anxiety at a steady pace. |
| Prolonged Exposure This is another important principle of mindfulness, and it involves acknowledging things as they are without trying to change them or desiring them to be different. Through acceptance, it then becomes easy to move on without holding on to any past experience and fully be in the moment. |
| Flooding This is regarded as one of the most extreme forms of exposure therapy. It involves the PTSD subject being immediately exposed to the most intense trauma-related memories or triggers without any gradual or incremental buildup. It is based on the notion that when an individual with PTSD faces the full intensity of their fear at once, their anxiety will be diminished. It is important to note that this approach is not generally recommended for individuas with PTSD as it carries a high risk of overwhelming distress or emotional shutdown. |
The length of time required for exposure therapy to yield positive outcomes in the treatment of PTSD varies amongst different individuals. This is majorly due to factors such as the complexity of the subject’s mental condition, the severity of fear or anxiety, and the willingness of the subject to fully commit to the therapeutic process.
How Is PTSD Traditionally Treated?
Ever since the emergence of PTSD as a mental health condition, several treatment options have been developed and refined over the years to better combat it. These options include:
Cognitive Therapy
This is a type of psychotherapy (talk therapy) where a clinician helps individuals with PTSD to identify the patterns of thinking that keep them stuck. These thinking patterns are referred to as cognitive patterns and they often include negative beliefs about the risk of the traumatic events occurring again. For PTSD, cognitive therapy is often used alongside exposure therapy to help achieve the best results.
By identifying these cognitive patterns, it becomes possible for therapists to help their patients build up tolerance and develop stress management skills that help them handle stressful events better than they used to.
By identifying these cognitive patterns, it becomes possible for therapists to help their patients build up tolerance and develop stress management skills that help them handle stressful events better than they used to.
Use Of Medications
The use of medications is another effective option for the treatment of the stress responses caused by PTSD. The use of antidepressants like SSRIs (Selective Serotonin Reuptake Inhibitors) for example, can help to reduce symptoms of anxiety, intrusive thoughts, and depression. Medications help to regulate mood in the brain by increasing serotonin levels in the brain, and in some cases, also assist with sleep disorders and concentration problems. It is, however, important to understand that the use of medication only helps to effectively manage PTSD symptoms and not cure the condition. This is why it is mostly used together with psychotherapy to guarantee effectiveness.
Supportive Interventions
This option involves optimizing the use of group therapy and peer support programs for treatment of PTSD. Group therapy helps to provide a safe space where individuals get to talk about their personal traumatic experiences and also learn from people who have faced similar struggles. This is especially useful in cases where the individual has cultivated self-destructive habits such as drinking or gambling.
Additionally, the inclusion of healthy practices such as regular exercises, mindfulness and stress management techniques into the routine of individuals with PTSD helps to complement other traditional treatments while enhancing their overall well-being.
How Does VR Work In Therapy?
Here is a step-by-step process that details exactly how virtual reality is used in exposure therapy.
1
Assessment And Planning:
The mental health professional starts the process by carrying out an evaluation of the patient in a bid to fully understand his/her condition and treatment goals. This assessment often includes determining the intensity of the fear induced into the subject as a result of trauma and having an understanding of the traumatic event itself. This stage also involves the preparation of the patient, where the professional explains the process of VRET, what to expect, and what they aim to achieve through gradual and repeated exposures.
The mental health professional starts the process by carrying out an evaluation of the patient in a bid to fully understand his/her condition and treatment goals. This assessment often includes determining the intensity of the fear induced into the subject as a result of trauma and having an understanding of the traumatic event itself. This stage also involves the preparation of the patient, where the professional explains the process of VRET, what to expect, and what they aim to achieve through gradual and repeated exposures.
2
Selection Of Virtual Environment And Customization:
With the knowledge procured from the evaluation, the professional proceeds to select a virtual scenario/environment that specifically matches the patient’s fear. VR therapy platforms generally offer several in-built virtual environments that mimic different traumatic experiences that can be easily selected. Common virtual scenarios used for people with PTSD include car accidents, natural disasters like flooding, and combat exposures for military veterans who are suffering from war-related PTSD. There are also VR systems such as PsyTechVR that allow for customization of factors like sound, lighting and interaction levels to provide a more personalized experience which feels realistic and aligns with the patient’s unique triggers.
With the knowledge procured from the evaluation, the professional proceeds to select a virtual scenario/environment that specifically matches the patient’s fear. VR therapy platforms generally offer several in-built virtual environments that mimic different traumatic experiences that can be easily selected. Common virtual scenarios used for people with PTSD include car accidents, natural disasters like flooding, and combat exposures for military veterans who are suffering from war-related PTSD. There are also VR systems such as PsyTechVR that allow for customization of factors like sound, lighting and interaction levels to provide a more personalized experience which feels realistic and aligns with the patient’s unique triggers.
After personalization, the therapist then proceeds to create a progressive exposure system. This system allows the patient to start out with relatively low-stress virtual scenarios and build their way up to very distressing ones.
3
Gradual Exposure:
The next stage involves the actual exposure to the selected virtual scenarios. The patient is first familiarized with the VR equipment, which includes the VR headset, VR controllers, feedback devices, and motion tracking sensors. Afterwards, the patient is exposed to the virtual scenarios with the therapist adjusting the settings based on the patient’s reaction.
The next stage involves the actual exposure to the selected virtual scenarios. The patient is first familiarized with the VR equipment, which includes the VR headset, VR controllers, feedback devices, and motion tracking sensors. Afterwards, the patient is exposed to the virtual scenarios with the therapist adjusting the settings based on the patient’s reaction.
4
Real-time Therapeutic Guidance:
During each VR session, the therapist actively guides the patient through the experience while helping them develop adaptive coping strategies and tolerance for the overall emotional experience. This includes cognitive behavioral techniques, mindfulness, etc. This feature also makes it possible for therapists to provide their patients with the feedback their patients need to stay engaged and motivated.
During each VR session, the therapist actively guides the patient through the experience while helping them develop adaptive coping strategies and tolerance for the overall emotional experience. This includes cognitive behavioral techniques, mindfulness, etc. This feature also makes it possible for therapists to provide their patients with the feedback their patients need to stay engaged and motivated.
5
Data Collection And Progress Tracking:
After repeated exposures, there are several VR therapy systems that allow for the collection of data to track the subject’s progress. This data, when analyzed, provides patients with the information they need to make informed decisions as regards how to enhance the effectiveness of their patient’s treatment.
After repeated exposures, there are several VR therapy systems that allow for the collection of data to track the subject’s progress. This data, when analyzed, provides patients with the information they need to make informed decisions as regards how to enhance the effectiveness of their patient’s treatment.
Benefits Of Using Virtual Reality In PTSD Treatment
The use of VR for PTSD treatments brings about several benefits, many of which serve as an advantage over the traditional treatment options. Let’s examine some of them in detail:
Personalized Treatment
The VR technology used in VRET allows for the customization of the exposures (generated environments) in order to ensure that it matches the user’s unique traumatic experience. This is especially beneficial in cases where the subject’s traumatic experience is difficult to re-create in real-life.
Unlike the generic exposures used in traditional exposure therapy, VR scenarios can be tailored to match the exact sights and sounds that trigger the subject’s PTSD, making the therapeutic experience more effective.
Furthermore, the VR personalization feature enables the operator to regulate the PTSD-triggering intensity of each virtual scenario. This makes it possible for the distressing exposures to be introduced to the subject in a gradual and controlled manner. For instance, virtual reality therapy sessions for veterans can start with a VR exposure of a military training ground and then progress to the battlefield as described by the subject themselves.
Furthermore, the VR personalization feature enables the operator to regulate the PTSD-triggering intensity of each virtual scenario. This makes it possible for the distressing exposures to be introduced to the subject in a gradual and controlled manner. For instance, virtual reality therapy sessions for veterans can start with a VR exposure of a military training ground and then progress to the battlefield as described by the subject themselves.
AI in VR therapy: tailored OCD exposure generation
PsyTechVR’s AI exposure creation tool generates personalized VR scenarios in just 30 seconds, tailored for conditions like OCD, phobias, addiction, and trauma.
Safe Environment
One of the major reasons why individuals with PTSD refrain from confronting their fears even in the traditional exposure therapy treatments, is that they are terrified of external dangers. Virtual reality therapy takes away that limitation by allowing digitally generated exposures that are completely separated from real world dangers.
Every condition in the virtual scenarios is modified to ensure the gradual exposure of the patient to distress-stimulating experiences. The therapists can also modify or immediately stop the exposure if it becomes too overwhelming.
Additionally, in VR therapy, the patients understand that they are being exposed to a digitally-simulated world and this reduces their anxiety while increasing their engagement and commitment to the therapeutic process.
Additionally, in VR therapy, the patients understand that they are being exposed to a digitally-simulated world and this reduces their anxiety while increasing their engagement and commitment to the therapeutic process.
AI in VR therapy: safe place / manifestation
MindGap AI is a powerful VR system allowing you to create personalized experiences tailored to your needs. With this tool, you can establish a VR space to help you manage stress and anxiety and achieve a sense of calm and relaxation. Innovative tool that empowers you to take control of your thoughts and emotions with just one click.
Reduction In Stigma And Accessibility
VR eliminates the embarrassment and stigma that is often associated with seeking treatment for PTSD. Prior to the emergence of VR therapy, many individuals with PTSD refuse to get the help they need due to fear of judgment or the appearance of looking weak.
VR solves this issue by enabling options for people to discreetly engage in exposure therapy at private clinics and even in the comfort of their homes.
On top of that, virtual reality therapy can be conducted remotely and modified for different languages and cultural contexts. This increases the reach of high-quality PTSD treatment to people in rural areas. It also removes barriers such as a lack of mental health professionals and physical disabilities, which are known to restrict people from getting help.
On top of that, virtual reality therapy can be conducted remotely and modified for different languages and cultural contexts. This increases the reach of high-quality PTSD treatment to people in rural areas. It also removes barriers such as a lack of mental health professionals and physical disabilities, which are known to restrict people from getting help.
How Effective Is VR-Based Exposure Therapy For PTSD?
Since its emergence, VR-based exposure therapy has gained significant recognition as a highly effective treatment option for PTSD. In a bid to discover just how effective VRET is, we will be exploring its impact on PTSD symptom severity. We would also be reviewing the comparative effectiveness of this treatment method against traditional therapy as well as insights from systematic reviews and meta-analyses.
Systematic Review And Meta-Analysis Of VR Therapy
Sci Rep. 2018 Jul 9;8(1):10323. doi: 10.1038/s41598-018-28113-6.
Statistically, several meta-analyses show that VR-based therapeutic interventions result in significant improvements in PTSD symptoms when compared to the groups who didn’t receive treatment in the studies.
A 2018 meta-analysis, for instance, discovered an overall effect size of approximately 0.6-0.8 across different studies.
Systematic reviews reflect that VR therapy is especially effective for treating PTSD symptoms caused by combat/war-related trauma. This refers to trauma experienced or witnessed by war veterans and first responders. The technology functions effectively by facilitating emotional engagement with traumatic memories while at the same time maintaining a sense of safety and control.
Systematic reviews reflect that VR therapy is especially effective for treating PTSD symptoms caused by combat/war-related trauma. This refers to trauma experienced or witnessed by war veterans and first responders. The technology functions effectively by facilitating emotional engagement with traumatic memories while at the same time maintaining a sense of safety and control.
Research Findings On PTSD Symptom Severity
J Clin Psychiatry 2001;62(8):617-622
There have been several clinical studies that confirm the efficiency of VRET in reducing PTSD symptoms. Individuals with PTSD who go through VR therapy are known to show significant improvements in symptoms such as hyperarousal, trauma avoidance, and re-experiencing. A notable example is the landmark study conducted on 10 male Vietnam veterans in 2001.
The objective of the study was to evaluate the effectiveness of VR exposure therapy in treating PTSD symptoms. After treatment, which included 8-16 VR therapy sessions with CBT across the span of several weeks, the veteran’s CAPS (clinician-administered PTSD Scale) scores were taken. It was then observed 6 months post-treatment that 8 of the combat veterans had experienced a reduction in their PTSD symptom severity ranging from 15%-67%.
The general effect sizes of PTSD symptom reduction when VRET is used typically range from moderate to large, with many patients showing clinical improvements several months and years post-treatment.
The general effect sizes of PTSD symptom reduction when VRET is used typically range from moderate to large, with many patients showing clinical improvements several months and years post-treatment.
Comparative Effectiveness Of VR versus Traditional Therapy
The effectiveness of VR-based exposure therapy in comparison with traditional therapy has been a widely discussed focus in mental health research. While several studies indicate that both approaches produce significant positive effects, VR-based therapy offers several unique advantages. For starters, VR-based exposure therapy encourages its participants to stay engaged and committed to the therapeutic process as a result of the gamified elements integrated into the virtual scenarios. VR-based therapy also promotes ease through its ability to digitally create and repeat events that are difficult to create in real-life, i.e. the battlefield or a burning house. There is also the real-time modification feature that allows therapists to make changes to the virtual scenarios even when in session. All of these features make VR-based therapy a preferred choice, especially in cases where the patient finds the traditional method too stressful and ineffective.
However, the traditional approach is not without its own merits. Unlike VR-based therapy, traditional therapy does not require the need for any technological equipment or expertise. It is also preferred by patients who prefer face-to-face interactions as opposed to virtual sessions.
The unique advantages of these 2 distinct approaches are the exact reason why it is often advised that they should not serve as a replacement for each other when treating PTSD. Rather, they should be used complementarily.
The unique advantages of these 2 distinct approaches are the exact reason why it is often advised that they should not serve as a replacement for each other when treating PTSD. Rather, they should be used complementarily.
Virtual Reality THERAPY AND PTSD
Who Can Benefit From Virtual Reality Treatment?
The general rule is that VR treatment works for individuals who are suffering from symptoms caused by their traumatic experience. This includes people that are struggling with traditional exposure therapy. There are several individuals who find it incredibly difficult to relive their traumatic events by imagination or face them in the real world. VR helps to mitigate this problem by providing a structured immersive and realistic environment where they can be helped to gradually confront their distressing memories under the guidance of a therapist.
A good example of people who fall into this category are veterans and military personnel. Most combat-related issues are difficult to recreate in traditional-based therapy (whether imaginary or in vivo). This is because the exposure environment requires elements like explosions, helicopter rides, and other battlefield conditions.
VR treatment is also a great fit for survivors of violent crimes, sexual assault or natural disasters. Aside from the fact that the exposure experiences can be difficult to recreate, VR therapy is more accessible and can be done remotely, eliminating the embarrassment and fear of judgement that limits certain individuals struggling with PTSD.
VR treatment is also a great fit for survivors of violent crimes, sexual assault or natural disasters. Aside from the fact that the exposure experiences can be difficult to recreate, VR therapy is more accessible and can be done remotely, eliminating the embarrassment and fear of judgement that limits certain individuals struggling with PTSD.
VR exposure therapy
Veterans With PTSD: A Case Study
Wood et al in 2007 conducted a clinical trial to verify the effectiveness of VRET as a PTSD treatment. The candidate was a 32-year-old Iraq veteran who had completed 12 years of active duty service and was diagnosed with PTSD. To assess the severity of the PTSD symptoms, the subject was evaluated using the Post-traumatic Stress Checklist-Military (PCL-M), the Beck Anxiety Inventory (BAI) and CES, alongside psychophysiological measures such as skin conductance, respiration rate and heart rate.
Afterward, the veteran was engaged in 10 VRET sessions, one session per week. Each session was set to last for 90 minutes and all assessments were made pre-treatment and even during the session. During the first 2 sessions, the veteran was acquainted with the VR therapy equipment and how the process works. The veteran also pointed out that the traumatic event and the physiological measurements were obtained. In subsequent sessions, each session was divided into 4 parts, which included a review of the previous session, meditation training, exposure to the virtual environments, and then a debriefing and discussion of the subject’s current symptoms and issues.
The veteran’s BAI scores indicated that his anxiety remained moderate throughout the 10 weeks of treatment. However, when the PCL-M score before and during the treatment was compared, it was shown that the veteran’s PTSD symptoms have significantly reduced. The physiological measurements taken after treatment also showed no arousal symptoms. Finally, the veteran’s heart rate was observed to be low posttreatment, which means the veteran was now able to decrease his arousal and allow for habituation to take place.
Afterward, the veteran was engaged in 10 VRET sessions, one session per week. Each session was set to last for 90 minutes and all assessments were made pre-treatment and even during the session. During the first 2 sessions, the veteran was acquainted with the VR therapy equipment and how the process works. The veteran also pointed out that the traumatic event and the physiological measurements were obtained. In subsequent sessions, each session was divided into 4 parts, which included a review of the previous session, meditation training, exposure to the virtual environments, and then a debriefing and discussion of the subject’s current symptoms and issues.
The veteran’s BAI scores indicated that his anxiety remained moderate throughout the 10 weeks of treatment. However, when the PCL-M score before and during the treatment was compared, it was shown that the veteran’s PTSD symptoms have significantly reduced. The physiological measurements taken after treatment also showed no arousal symptoms. Finally, the veteran’s heart rate was observed to be low posttreatment, which means the veteran was now able to decrease his arousal and allow for habituation to take place.
VR therapy and PTSD
"Vietnam PTSD Documentary" movie showcasing the use of VR exposure therapy for PTSD with Vietnam War veterans
Meta Quest 2 VR headset was a game changer when Meta released it in 2020
Adapting VR Therapy For Different Trauma Types
The use of virtual reality therapy is not only reserved for the use of veterans or military personnel with PTSD. The personalization capability of VR therapy systems makes it flexible to meet the therapeutic need of any trauma context. Let’s go over a few trauma contexts that you can modify VR therapy to suit:
Childhood Trauma
VR technology can be used to help people suffering from PTSD caused by childhood traumas. It achieves this by creating virtual nurturing environments where they can rebuild their emotional regulation skills and potentially their attachment-related issues in a safe space.
Natural Disasters
It is possible to use VR technology that digitally simulates events that lead to trauma-causing disasters like fires, hurricanes, and earthquakes. Exposures to these kinds of scenarios help individuals with PTSD to process their experiences in a healthy way and then reduce their anxiety in similar real-world situations.
Domestic Violence
For survivors of domestic violence, VR can be used to create virtual environments where individuals can practice boundary-setting, assertiveness, and emotion control. This helps the people to rebuild trust and also reduces their anxiety level.
Medical Trauma
For survivors of domestic violence, VR can be used to create virtual environments where individuals can practice boundary-setting, assertiveness, and emotion control. This helps the people to rebuild trust and also reduces their anxiety level.
Age And Demographics Considerations In PTSD Treatment
PTSD is a mental health condition that affects individuals across all age groups. However, the presentation of the symptoms of this condition and the appropriate treatment response varies in each age group type. Consequently, it is crucial to understand these variations in order to effectively customize VRET interventions.
PTSD Across Different Age Groups
In children/adolescents, PTSD typically manifests itself through symptoms such as behavioral changes, nightmares, and difficulty expressing trauma verbally. To ensure that the therapeutic sessions are effective amongst this age group, you can modify the virtual scenarios with the age-appropriate content while including gamified elements to improve engagement.
Young adults (18-35 years) who are likely to experience PTSD from assault, war or natural disasters. The VR interventions that will prove beneficial for this age group are immersive virtual scenarios that mimic real-world experiences.
For middle-aged adults (36-60 years), their PTSD symptoms are most likely amplified by extra stressors such as work, family, or life issues. The VR therapy interventions for this age group are recommended to include mindfulness and relaxation techniques to achieve the best results.
Older adults (above 60 years) mostly experience PTSD caused by resurfacing past traumas such as grief and wartime. The VR interventions for this age group are recommended to make use of a simpler interface, stimulating environments, and incorporate reminiscence therapy (i.e, guided storytelling) to help them process trauma.
Other demographic factors to consider include;
Young adults (18-35 years) who are likely to experience PTSD from assault, war or natural disasters. The VR interventions that will prove beneficial for this age group are immersive virtual scenarios that mimic real-world experiences.
For middle-aged adults (36-60 years), their PTSD symptoms are most likely amplified by extra stressors such as work, family, or life issues. The VR therapy interventions for this age group are recommended to include mindfulness and relaxation techniques to achieve the best results.
Older adults (above 60 years) mostly experience PTSD caused by resurfacing past traumas such as grief and wartime. The VR interventions for this age group are recommended to make use of a simpler interface, stimulating environments, and incorporate reminiscence therapy (i.e, guided storytelling) to help them process trauma.
Other demographic factors to consider include;
Gender Differences
In terms of development and presentation, PTSD affects women in different ways than men. The cause of women’s PTSD is mostly linked to interpersonal trauma such as sexual assault, domestic violence, and childhood violence, while men’s PTSD is often associated with combat, physical accidents, and workplace trauma.
Women’s PTSD is often characterized to be chronic, with their symptoms lasting for a longer period than that of men. The symptoms of women’s PTSD include anxiety, depression, emotional numbness, and social dissociation. For men, the PTSD symptoms are typically externalized and are exhibited in the form of anger, aggression, irritability, and substance abuse. This knowledge infers that women are likely to benefit more from emotion-focused exposure therapy while men may require more structured, goal-driven scenarios that encourage direct confrontation of their trauma.
Cultural And Socioeconomic Factors
Cultural and socioeconomic factors also play a very significant role in how PTSD develops and, more importantly, how it should be treated using VR therapy. Different cultures have distinct attitudes and notions towards trauma and mental health wellness. This alone influences whether an individual with PTSD would seek the treatment they need or avoid it altogether. For instance, some cultures stigmatize mental health struggles, making it difficult for those suffering from trauma-caused PTSD to openly discuss their trauma or seek professional help. Conversely, there are cultures that promote personal well-being, which encourage people with PTSD to be more accepting of VRET as a treatment for their condition. VRET can be adapted to accommodate these cultural differences to ensure that the treatment aligns with the patient’s background and belief system.
There are also language and communication differences that impact PTSD treatment. Certain cultures depend on nonverbal or indirect communication when discussing emotional pain. In these cases, the VRET sessions can incorporate symbolic or storytelling-based exposure therapy where the patients can be engaged with relevant narratives. Additionally, VRET also allows for multilingual support which helps in situations where language barriers hinder engagement for diverse populations.
There are also language and communication differences that impact PTSD treatment. Certain cultures depend on nonverbal or indirect communication when discussing emotional pain. In these cases, the VRET sessions can incorporate symbolic or storytelling-based exposure therapy where the patients can be engaged with relevant narratives. Additionally, VRET also allows for multilingual support which helps in situations where language barriers hinder engagement for diverse populations.
What Are The Key Components Of VR Exposure Therapy?
The effectiveness of virtual reality exposure therapy in PTSD treatment is as a result of the combination of certain important aspects. Let’s go over each one in detail:
Graded Exposure Techniques In Virtual Environments
Graded exposure is a fundamental principle that is applied to every VR therapeutic process. It involves the step-by-step exposure of patients to trauma-related stimuli, starting from low-intensity virtual scenarios to highly distressing ones. This systematic approach allows patients to process their traumatic experience at a healthy pace, rather than facing it all at once.
The virtually-generated environments play a crucial role in controlling these exposure levels through personalization. Every virtual environment can be modified in such a way that it ensures that patients can face their fears without being overwhelmed. The adjustable conditions include:
The virtually-generated environments play a crucial role in controlling these exposure levels through personalization. Every virtual environment can be modified in such a way that it ensures that patients can face their fears without being overwhelmed. The adjustable conditions include:
- The intensity of visuals and sound to control sensory overload
- Interaction with virtual elements (passive or active engagement)
- Gradual increase in exposure time
- Graded exposure helps to build resilience in individuals with PTSD and it is the cornerstone of VRET effectiveness.
Clinician-Administered PTSD Scale In VR Settings
To ensure accurate assessment and real-time monitoring of PTSD patients, VRET incorporates the use of standardized psychometric tools such as the Clinician-Administered PTSD Scale (CAPS). This is regarded as the universal standard for the diagnosis and assessment of PTSD symptoms. It is specifically used to help the operator/user measure PTSD symptom severity, track the progress of the patient, and also make informed modifications within the VR sessions.
The CAPS was originally developed by the U.S Department of Veterans Affairs (VA) National Center for PTSD. It works by putting patients through structured clinical interviews that are aimed to:
When integrated into VR settings, CAPS becomes more than just a questionnaire but a feature that allows mental health professionals to observe and record real-time emotional and physiological responses.
The CAPS was originally developed by the U.S Department of Veterans Affairs (VA) National Center for PTSD. It works by putting patients through structured clinical interviews that are aimed to:
- Evaluate the frequency and intensity of the patient’s PTSD symptoms (e.g, nightmares, flashbacks, hyperarousal, and avoidance)
- Assess the impact of the symptoms on the subject’s daily life. i.e, social withdrawal, emotional detachment, and sleep disturbances
- Identify the patient’s physiological and emotional reactions to trauma-related stimuli
When integrated into VR settings, CAPS becomes more than just a questionnaire but a feature that allows mental health professionals to observe and record real-time emotional and physiological responses.
Importance Of Immersive Experiences In Therapy
The immersive experience is one of the most defining strengths of virtual reality exposure therapy (VRET). Unlike the traditional exposure therapy that relies on imagination and real-world exposures, VRET places PTSD patients in a realistic, multisensory virtual scenario that mimics their traumatic event. Not only does this capability increase patient engagement and their ability to process emotion, it also improves the effectiveness of VR therapy. It increases the patient's sense of presence while allowing them to safely confront their fears.
VRET achieves immersion by combining sensory engagement with interaction and a sense of realism. The components used to make it possible include:
These components are modified to help PTSD patients bridge the gap between their memory and emotion, so they can face their traumatic memories head-on.
VRET achieves immersion by combining sensory engagement with interaction and a sense of realism. The components used to make it possible include:
- Visual and Auditory Stimulation, i.e., high-resolution 3D environment simulations and spatial audio effects like explosions
- Haptic Feedback And Sensory Integration: This includes devices such as haptic gloves, motion controllers, or vibration feedback.
These components are modified to help PTSD patients bridge the gap between their memory and emotion, so they can face their traumatic memories head-on.
What Are The Limitations And Challenges Of VR Therapy?
While VR therapy is a highly effective treatment option for PTSD, it is not without its own limitations. The efficiency of VR therapy relies on certain technological and practical factors, which can sometimes hinder its impact and accessibility.
Potential Side Effects And Risk Of VR Treatment For PTSD
- VR-Induced Motion Sickness (Cybersickness)This is a condition where individuals with PTSD experience physical discomfort and disorientation while undertaking VR exposure therapy. It typically occurs when there is a discontinuity between the visual motion experienced in the virtual scenario and the body’s lack of actual movement, resulting in sensory confusion. The symptoms of cybersickness include nausea, dizziness, sweating, and disorientation.
To reduce the chances of experiencing VR-induced motion sickness, it is recommended that you:- Use a high-quality VR headset with low latency and high refresh rates in order to reduce discomfort
- Ensure a gradual increment in session duration in order to help patients adapt to VR environments
- Take breaks in between VR therapy sessions to reduce the risk of disorientation
- Dissociation And Detachment From RealityVR therapy ensures an immersive experience which is beneficial as a result of the strong sense of presence it creates. However, in certain conditions, the line between virtual environments and reality gets blurred and this causes some individuals with PTSD to disconnect from their thoughts, feelings, and identity. People that experience this are known to:
- Feel like their environment is fake or dreamlike
- Have difficulty separating VR experiences from real memories
- Feel confused or disoriented when transitioning into the real-world
- Have memory gaps or difficulty recalling details of the therapy sessions
- Emotional OverloadSince VRET involves the exposure of patients to distress-stimulating scenarios, there is a good chance that an individual with PTSD can get emotionally overwhelmed during treatment. They may experience panic attacks, intense anxiety, and emotional reactions during exposure. In severe cases, the VR sessions may worsen the PTSD symptoms instead of reducing them.
To avoid this effect, it is essential that therapists:- Ensure graded exposure with well-regulated intensity levels to reduce the chances of emotional overwhelming
- Monitor patients closely during exposure to make real-time adjustments, if need be
- Train patients with coping techniques and helpful practices such as mindfulness before exposure
Patient Acceptance And Engagement With VR Therapy
While VR therapy provides a safe, regulated, and immersive approach to treating PTSD, its effectiveness is dependent on the patient’s willingness and acceptance of it. There are several factors that influence a patient’s comfort and perceived benefits regarding VRET. This includes the patient’s:
It is important to understand there are several individuals with PTSD who may be hesitant to embrace VR therapy due to skepticism or personal beliefs. Addressing these concerns requires reorientation through education and inclusion of personalized therapeutic support.
- Trust and perceived effectiveness of VR therapy
- Technological familiarity and comfort
- Physical and psychological discomfort experienced
- Personal preferences and preparedness for exposure therapy
It is important to understand there are several individuals with PTSD who may be hesitant to embrace VR therapy due to skepticism or personal beliefs. Addressing these concerns requires reorientation through education and inclusion of personalized therapeutic support.
VR and PTSD
PsyTechVR’s Contribution To PTSD Treatment
With Virtual Reality continuing to rise and revolutionize exposure therapy as we know it, PsyTechVR has emerged as a major solution for the treatment of PTSD. By leveraging VR’s immersive technology, PsyTechVR has created personalized exposure therapy experiences that help patients gradually face and process their traumatic events.
How PsyTechVR Enhances Virtual Reality Exposure For PTSD
PsyTechVR improves the effectiveness of VR therapy through the creation of highly realistic environments that can be tailored to each patient’s exact traumatic event. PsyTechVR’s virtual simulations operate at a level of realism such that they help to bridge the gap between the patient simply recalling their traumatic events and them actively processing these events in a safe environment. Another enhancement of VR therapy’s effectiveness for PTSD that can be attributed to PsyTechVR is the integration of biometric tracking and AI analysis into their system. PsyTechVR makes it possible for therapists to easily monitor their patients’ stress levels and physiological responses, such as heart rate and pupil dilation, in real-time.
Furthermore, PsyTechVR scales the effectiveness of VR therapy for PTSD treatment by enabling VR sessions to take place remotely. This allows for patients using their equipment to engage in exposure therapy from the comfort of their home while still being guided and monitored by their therapists. This feature is particularly beneficial for individuals with PTSD who struggle with in-person VR sessions or are limited by geographical distance.
Furthermore, PsyTechVR scales the effectiveness of VR therapy for PTSD treatment by enabling VR sessions to take place remotely. This allows for patients using their equipment to engage in exposure therapy from the comfort of their home while still being guided and monitored by their therapists. This feature is particularly beneficial for individuals with PTSD who struggle with in-person VR sessions or are limited by geographical distance.
PsyTechVR’s Role In Creating Customizable Trauma-Exposure Environments
PsyTechVR provides well-tailored VR exposures that realistically mimic their patients’ traumatic experiences through its adaptive environment design. This allows for therapists using the company’s software and equipment to modify different aspects of the generated environments in real-time. This includes elements such as lighting, sound, weather conditions, and even the presence of specific people and objects, that can potentially mirror the patient’s trauma experience.
Additionally, PsyTechVR includes the options of different interactive elements that can influence the patient’s engagement in the therapeutic process. This is based on the understanding that patients are not passive observers and just like in the real world, they can interact with different elements in their surroundings. By including these elements in their tailorable virtual scenarios, PsyTechVR helps their PTSD patients to regain a sense of control over their traumatic experiences.
Additionally, PsyTechVR includes the options of different interactive elements that can influence the patient’s engagement in the therapeutic process. This is based on the understanding that patients are not passive observers and just like in the real world, they can interact with different elements in their surroundings. By including these elements in their tailorable virtual scenarios, PsyTechVR helps their PTSD patients to regain a sense of control over their traumatic experiences.
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PsyTechVR: made by professionals,
for professionals
These psychotherapists and psychologists define the development of our product and methodology since 2020
- Dr. Albert "Skip" Rizzo
Leading expert in VR Therapy with 30+ years' experience.
VR scientist (ResearchGate)
Clinical psychologist. With 30+ years in VR research, Dr. Rizzo has developed groundbreaking VR tools for treating PTSD, TBI, autism - Dr. Udi OrenClinical psychologist and senior medical psychologist, PhDPast President at EMDR-EUROPE, Chief instructor of the EMDR method in Israel (Senior Trainer), President of Israel EMDR Association
- Dr. Gwilym RoddickPsychotherapist (DSW, LCSW), Founder of CBT of Central and South FloridaCBT/ERP/ACT expert, OCD Central and South Florida Board Member, ABCT committee member, Florida and New York based
- Dr. Lynn PanattoniClinical psychologist specializing in integrative and functional medicine, PhDLicensed clinical psychologist specializing in trauma, anxiety, and integrative mental health. Expert in CBT, mindfulness & lifestyle medicine
- Dr. Elizabeth McMahon
Clinical Psychologist since 1980, author of Virtual Reality Therapy for Anxiety" book
In memory of Dr. Elizabeth McMahon (1950-2024), whose vision and contributions continue to guide our mission - Dr. Gianni SerraClinical Psychologist and Psychotherapist, Certified Neuroscience specialistEvangelist of VR exposure therapy in Italy and member of the Italian Society of Cognitive Behavioral Psychotherapy
- Dr. Richard LambProfessor of Educational Psychology, Neurocognition Science Lab, University of GeorgiaPhD in science education and educational measurement. Dr. Lamb leverages neuroscience and VR to enhance STEM education
PsyTechVR:
by professionals,
for professionals
by professionals,
for professionals
These psychotherapists & psychologists define the roadmap and r&d of our company since 2020
Clinical Psychologist, Psychotherapist (CBT), Certified Neuroscience specialist
Dr. Gianni Serra
Evangelist of VR exposure therapy in Italy and member of the Italian Society of Cognitive Behavioral Psychotherapy
Dr. Albert "Skip" Rizzo
Clinical psychologist. With 30+ years in VR research, Dr. Rizzo has developed groundbreaking VR tools for treating PTSD, TBI, autism
Dr. Elizabeth McMahon
In memory of Dr. Elizabeth McMahon (1950-2024), whose vision and contributions continue to guide our mission
Clinical psychologist specializing in integrative and functional medicine, PhD
Dr. Lynn Panattoni
Licensed clinical psychologist specializing in PTSD, anxiety, and integrative mental health. Expert in CBT, mindfulness & lifestyle medicine
Psychotherapist (DSW, LCSW), Founder of CBT of Central and South Florida
Dr. Gwilym Roddick
CBT/ERP/ACT expert, OCD Central and South Florida Board Member, ABCT committee member, Florida and New York based
Clinical psychologist and senior medical psychologist, PhD
Dr. Udi Oren
Past President at EMDR-EUROPE, Chief instructor of the EMDR method in Israel, Chairman of Israel EMDR Association
Complete VR Therapy Package for $1599
Buying options
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Includes the latest Meta Quest 3s, 12-month access, regular updates, support, training, and marketing materials
VR Exposure Therapy Bundle
Special offer: 35% off Storewide
$
1,599
$
2,499
- Latest Meta Quest 3s (128GB) VR Headset with the installed VR app
- 12-Month Access to PsyTechVR Platforms
- Generative-AI to create exposure scenarios
- Dedicated Support Manager
- Comprehensive 4-Hour Training & Certificate
- Exclusive Marketing Materials for your website and social media
*VR headset will belong to you with full access to the VR app store
VR and PTSD
FAQ
How Does Virtual Reality Exposure Compare To Other PTSD Treatment In Terms Of Long-Term Efficacy?
VRET, according to several studies, has a superior efficiency when compared to other traditional PTSD treatments such as prolonged exposure therapy (PE) and CBT. Virtual reality exposure therapy helps patients to interact with their traumatic experiences more safely and easily by immersing them in regulated virtual scenarios that mimic their terrifying experiences. This approach helps to improve emotional processing and reduce the symptoms of PTSD in a more efficient and sustainable way.
How Can VR Exposure Be Tailored To Meet The Needs Of Individuals With Different Types Of Trauma?
Virtual reality exposure therapy is a highly effective tool that can be customized to treat PTSD conditions of different trauma contexts. With VRET, therapists can modify the settings of every virtual environment generated, making it optimizable for different trauma-related cases ranging from combat-related PTSD to natural disasters.
Are There Specific Patient Demographics ( e.g, age, gender) That Respond Better To VR Therapy For PTSD?
VR therapy is generally effective for individuals with PTSD across diverse demographics. However, there are certain groups of people who tend to have a more robust response to the treatment approach due to factors such as their age, familiarity with technology, and the nature of their trauma. For example, studies show that younger individuals between the ages of 18-45 years tend to adapt quickly to VR based therapy. This is primarily because younger people are more comfortable with digital environments than older generations.
Other demographic groups likely to respond better to VRET as a treatment option for PTSD include:
In Terms Of Occupation
Veterans, First Responders (firefighters, police officers, and paramedics), Healthcare Workers, and Survivors of Public Trauma.
In Terms Of Gender
Women are generally found to respond to VRET as a treatment approach for their PTSD better than men. This is because women’s PTSD symptoms are often internalized and socially related. VR therapy directly helps with that by providing the safe space they need to regain confidence in social settings.
Other demographic groups likely to respond better to VRET as a treatment option for PTSD include:
In Terms Of Occupation
Veterans, First Responders (firefighters, police officers, and paramedics), Healthcare Workers, and Survivors of Public Trauma.
In Terms Of Gender
Women are generally found to respond to VRET as a treatment approach for their PTSD better than men. This is because women’s PTSD symptoms are often internalized and socially related. VR therapy directly helps with that by providing the safe space they need to regain confidence in social settings.
Thanks for reading!
Dr. Melanie Smith
Advisory board member at PsyTechVR
Dr. Melanie Smith is a Certified Eating Disorders Specialist and Approved Consultant (CEDS-C) and is a Certified Therapist & Trainer of the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders (UP). Dr. Smith has been already working intensively in the area of helping patients with eating disorders for over 16 years and has proven her expertise working at the Renfrew Center - the nation's pioneer in the treatment of eating disorders since 1985. Dr. Smith's therapy focus includes ARFID (Avoidant Restrictive Food Intake Disorder), and various forms of related specific phobias which include emetophobia (specific phobia of vomiting), health-related anxiety, and coping with chronic illness, and Post-traumatic stress disorder (PTSD).
Virtual Reality Exposure Therapy (VRET) is another special treatment interest and has played a role in Dr. Smith's professional career over the last few years. Dr. Melanie Smith, together with Dr. Gwilym Roddick, is actively involved in the research and development of OCD and PTSD-related virtual exposure programs, forming the advisory board of PsyTechVR. Dr. Smith plays an active role in the research component of psychological VR product development but also develops training courses for future VR therapists integrating her vast experience of clinical supervision and clinical training gained over the the past decades.
Dr. Smith is passionate about the implementation of evidence-based treatments, clinical supervision, and clinical training and has presented numerous lectures, Continuing Education (CE) workshops, and keynote presentations at academic and professional conferences in the US and overseas. Dr. Melanie Smith has published publications in peer-reviewed journals and is the co-author of the peer-reviewed treatment manual and patient workbook, The Renfrew Unified Treatment Model for Eating Disorders and Comorbidity published by Oxford University Press.
Virtual Reality Exposure Therapy (VRET) is another special treatment interest and has played a role in Dr. Smith's professional career over the last few years. Dr. Melanie Smith, together with Dr. Gwilym Roddick, is actively involved in the research and development of OCD and PTSD-related virtual exposure programs, forming the advisory board of PsyTechVR. Dr. Smith plays an active role in the research component of psychological VR product development but also develops training courses for future VR therapists integrating her vast experience of clinical supervision and clinical training gained over the the past decades.
Dr. Smith is passionate about the implementation of evidence-based treatments, clinical supervision, and clinical training and has presented numerous lectures, Continuing Education (CE) workshops, and keynote presentations at academic and professional conferences in the US and overseas. Dr. Melanie Smith has published publications in peer-reviewed journals and is the co-author of the peer-reviewed treatment manual and patient workbook, The Renfrew Unified Treatment Model for Eating Disorders and Comorbidity published by Oxford University Press.
Dr. Melanie Smith is a therapist specializing in Cognitive Behavioral Therapy and related evidence-based treatments, she claims a Master’s degree in Counseling Psychology and a Ph.D. in Counselor Education & Supervision (Capella University)
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