Cognitive behavioural therapy in virtual reality treatments across mental health conditions: a systematic review

Abstract

Background. Virtual reality (VR) has been effectively used in the treatment of many mental health disorders. However, significant gaps exist in the literature. There is no treatment framework for researchers to use when developing new VR treatments. One recommended treatment across a range of diagnoses, which may be suitable for use in VR treatments, is Cognitive Behavioural Therapy (CBT). The aim of this systematic review is to investigate CBT treatment methods that utilize VR to treat mental health disorders. Objectives. To investigate how CBT has been used in VR to treat mental health disorders and to report on the treatment characteristics (number of sessions, duration, and frequency) that are linked to effective and ineffective trials. Methods. Studies were included if patients had a mental health diagnosis and their treatment included immersive VR technology and CBT principles. Data were extracted in relation to treatment characteristics and outcomes, and analysed using narrative synthesis. Results. Ninety-three studies were analysed. Exposure-based VR treatments were mainly used to treat anxiety-related disorders. Treatments generally consisted of eight sessions, once a week for approximately one hour. VR treatments were commonly equal to or more effective than ‘traditional’ face-to-face methods. No specific treatment characteristics were linked to this effectiveness. Conclusion. The number, frequency and duration of the VR treatment sessions identified in this review, could be used as a treatment framework by researchers and clinicians. This could potentially save researchers time and money when developing new interventions.