A VR-based EMDR application that automates therapy delivery while maintaining clinical rigour and patient engagement for trauma treatment is presented, incorporating therapist-informed designs, naturalistic virtual environments, and game-inspired interaction mechanics to enhance usability and immersion.
Abstract
Eye Movement Desensitisation and Reprocessing (EMDR) is a proven psychotherapy for treating trauma, yet access is severely limited due to a shortage of trained therapists and long waiting times. This paper presents the development of a VR-based EMDR application that automates therapy delivery while maintaining clinical rigour and patient engagement for trauma treatment. The system incorporates therapist-informed designs, naturalistic virtual environments, and game-inspired interaction mechanics to enhance usability and immersion. The application integrates key elements of the EMDR protocol, featuring bilateral stimulation through an interactive metronome, intuitive free-hand interactions, and calming environments designed to support different phases of the treatment. A cloud-based data management system enables remote therapist support when needed. A five-day pilot study evaluating the feasibility and usability of specific phobia treatment was conducted. Quantitative results indicated improvement in phobia response, with four out of five participants achieving subclinical phobia levels on the Improving Access to Psychological Therapies Phobia Scale (IAPT toolkit 2008). Qualitative feedback highlighted the system’s accessibility, calming design, and potential to enhance user confidence in managing phobias. These findings underscore the potential of VR-based solutions for accessible and scalable psychotherapy.
Depression and anxiety affect up to 52% of hemodialysis patients, yet most cases remain undiagnosed and untreated. This paper presents the design and preliminary evaluation of an immersive virtual reality mindfulness application specifically designed for use during hemodialysis sessions, when patients remain physically immobilized for 3-4 hours, three to four times weekly, to transform this idle treatment time into therapeutic psychological intervention without imposing additional time burdens. The application integrates naturalistic Alpine environments, alpha-frequency binaural beats, guided meditation, and positive affirmations within a 30-minute experience accessible through head-tracking-only interaction to accommodate patients’ restricted movement during dialysis. Preliminary evaluation with eight healthy volunteers in a laptop setting demonstrated excellent usability (System Usability Scale: 91.88/100) and high immersion (EGameFlow: 5.75/7), with particularly strong performance on cognitive immersion dimensions therapeutically relevant for anxiety and depression management, including temporal distortion, sustained attention, and worry reduction. Qualitative feedback identified refinement priorities including narration pacing optimization and environmental visual enhancement. While this study establishes foundational usability and immersion benchmarks using laptop-based testing with nonclinical participants, clinical validation with actual hemodialysis patients using head-mounted displays remains necessary to assess therapeutic efficacy and implementation feasibility in dialysis care contexts.
Gwladys Rubayita, Bruno Alves de Paula, Júlia Tannús et al.· International Conference on...· 0 citations
The advancement of digital technology has driven innovation in mental health interventions, including Virtual Reality Therapy (VRT), a technology-based approach that enables patients to experience immersive and controlled three-dimensional environments. This literature review aims to examine the concepts and effectiveness of VRT in managing mental health disorders. The findings indicate that VRT is effective in reducing symptoms of anxiety, depression, post-traumatic stress disorder (PTSD), and substance use disorders. It is commonly integrated with exposure therapy and cognitive behavioral therapy (CBT), allowing gradual and controlled exposure to anxiety-provoking stimuli in a safe environment. In addition, VRT enhances patient engagement and improves accessibility of mental health services, including through smartphone-based applications. However, several limitations remain, particularly related to methodological variability and the lack of long-term evidence. Therefore, further research is needed to evaluate long-term outcomes and optimize its implementation in clinical practice. In conclusion, VRT represents a promising and innovative intervention that can serve as both an alternative and complementary approach in mental health care
A. Mufida, Aisyah Adinda Kurniawan, Diska Aprisa Lestari et al.· Lombok Medical Journal· 0 citations
Virtual Reality (VR) has become an increasingly relevant medium for psychological interventions because it can combine immersion, controlled stimuli, and therapist-guided reflection. However, VR systems explicitly grounded in Positive Psychology remain comparatively underexplored, particularly in supervised psychotherapy settings. This paper presents Positive Psychology VR, a Unity-based VR intervention composed of eight virtual environments designed around Positive Psychology constructs, including gratitude, mindfulness, savoring, personal strengths, positive reappraisal, emotional expression, and acts of kindness. We report an exploratory pilot study with 30 adults who participated in three weekly therapist-guided sessions using a Meta Quest 3 head-mounted display, followed by a three-month follow-up. Data were collected through participant characterization, open-ended session reports, psychologist observations, acceptability records, and follow-up feedback. Results indicate high acceptability, with all participants reporting that they would recommend the experience. No serious cybersickness events were reported. Qualitative findings suggest that the intervention supported self-awareness, reflection, emotional regulation, relaxation, and changes in perspective. Nature-inspired, meditation-oriented, and strengths-based environments were among the most frequently used and were often described as memorable anchors for later recall. At follow-up, most respondents reported perceived benefits that extended beyond the sessions, although individual variability was observed. These findings suggest that Positive Psychology-oriented VR can be feasibly integrated into professionally supervised psychotherapy as an adjunctive tool for reflection and emotional well-being. The study contributes design and evaluation insights for immersive therapeutic systems and highlights the need for larger, controlled, and longitudinal studies.
Marina Holanda Kunst, Eliane De Holanda Silva, Willams de Lima Costa et al.· Journal of the Brazilian Com...· 0 citations
BACKGROUND
Avatar therapy is a virtual reality-based intervention designed to reduce the distress and severity of persistent auditory verbal hallucinations (AVHs) in schizophrenia spectrum disorders. Despite promising initial evidence, methodological limitations and implementation barriers have prevented widespread adoption. This study evaluated the feasibility and preliminary effectiveness of an enhanced VR-Avatar therapy in a Hungarian cohort as part of an international multi-site trial.
METHODS
In a non-randomized, waitlist-controlled pre-post design study, 30 outpatients with schizophrenia spectrum disorders and persistent AVHs received seven sessions of individual VR-Avatar therapy following a 12-week waiting period. Assessments were conducted at baseline, pre-intervention, and post-intervention by blinded raters, using measures of symptom severity, comorbid symptoms, and well-being. Piecewise linear mixed-effects models examined changes in slopes between waitlist and therapy phases.
RESULTS
Regarding primary outcomes, VR-Avatar therapy was associated with significant reductions in AVH severity (PSYRATS Hallucinations: Δslope = -0.36, p = 0.02, partial η2 = 0.09, PANSS hallucination: Δslope = -0.04, p = 0.02, partial η2 = 0.17) The PANSS positive symptoms subscale, the third primary outcome, showed a marginal improvement (Δslope = -0.09, p = 0.05, partial η2 = 0.056). The secondary outcome (BAVQ-R) showed trends toward reduction in voice malevolence (Δslope = -0.12, p = 0.16) and omnipotence (Δslope = -0.11, p = 0.09). Among exploratory outcomes, trait anxiety improved significantly (STAI-Trait: Δslope = -0.47, p = 0.02, partial η2 = 0.17). Dropout was low (2.85%). Therapy produced heterogeneous responses, where 43.3% (N = 13) achieved ≥6-point PSYRATS-AH reduction. Older age significantly predicted stronger outcomes (p = 0.028).
CONCLUSION
VR-Avatar therapy demonstrated good feasibility and high acceptability in a Hungarian clinical setting, with preliminary evidence suggesting potential benefits in reducing the severity of AVH and related distress.
L. Egervári, G. Csukly, Lilla Gerlinger et al.· Acta Psychologica· 0 citations
Depression remains one of the leading causes of disability worldwide, and existing pharmacological and psychotherapeutic treatments leave a substantial proportion of affected individuals without adequate symptom relief. Virtual reality (VR) has emerged over the past decade as a candidate adjunctive or stand-alone therapeutic modality, offering immersive, controllable environments in which established psychotherapeutic techniques can be delivered with heightened experiential intensity. This critical review synthesises evidence from meta-analyses, randomised controlled trials, and scoping reviews published between 2013 and early 2026 on the effectiveness, mechanisms, safety, and implementation of VR-based interventions for depressive symptoms. The literature indicates that VR interventions produce moderate-to-large reductions in depressive symptoms relative to control conditions across adult, adolescent, and older-adult populations, with particularly consistent effects for embodiment-based self-compassion protocols, VR-adapted behavioural activation, and restorative nature-based environments. Effect sizes vary considerably according to intervention type, dose, and population, and heterogeneity across trials remains high. Adverse effects, chiefly cybersickness, are under-reported in a substantial proportion of published trials, raising concerns about the completeness of the safety evidence base. Cost, hardware accessibility, and the shortage of long-term follow-up data represent the principal barriers to widespread clinical translation. The review concludes that VR therapy constitutes a promising but still maturing intervention class, whose clinical utility depends on more rigorous trial design, standardised outcome reporting, and closer integration with established evidence-based psychotherapeutic frameworks.
Nonso Francis Ifezuoke, Kolloju Suchitha, Oyeniyi Tofunmi et al.· International Neuropsychiatr...· 0 citations
Results indicate that the configuration flow was perceived as easy to learn and use, with generally positive acceptance, and offer concrete design directions for researchers and developers building AI-assisted mental health tools, particularly for users blocked by cost, stigma, or geography.
Fabiha Islam, Shamim Sharbaf, Liang Zhan et al.· Proceedings of the Internati...· 0 citations
