Effectiveness and Clinical Use of Virtual Reality in Cognitive Behavioral Psychotherapy: A Focused Narrative Review of Randomized Controlled Trials

Virtual Reality (VR) can provide a more convenient and wider accessibility of Cognitive Behavioral Therapy (CBT) by allowing feared situations to be produced and repeated in a virtual reality space. VR-based CBT may be helpful to treat anxiety disorders and psychosis, as well as to address the avoidance and anxiety involved in some cases of Obsessive-Compulsive Disorder (OCD). This focused narrative review aims to summarize evidence available in public sources by 2026, and address the use of VR to treat anxiety disorders, psychosis, and OCD, as well as related conditions. Given the high social and economic burden related to psychosis and the role of avoidance, the preliminary results of a few randomized control trials (RCTs) using VR-based CBT indicate a potential to reduce symptoms and improve quality of life. A key challenge in psychotherapy is translating the practice simulated in a safe environment to the real world. Research is still needed to address this challenge. The goal of this review is to analyze RCTs and summarize the value of VR and psychotherapy integration by including results of qualitative and economic studies.