Virtual Reality Exposure Therapy: Advancements in Treating Phobias in Digital Age- A Systematic Review

Abstract

What if confronting your deepest fears could happen inside a headset rather than a therapist’s office? Virtual Reality Exposure Therapy (VRET) offers a scalable, immersive alternative to traditional treatments for anxiety and phobia-related disorders by integrating psychological science with digital simulation technologies. This systematic review evaluates the clinical efficacy, technological progression, and implementation challenges of VRET, with a focus on its application to conditions such as acrophobia, social anxiety, and agoraphobia. The study contributes to the broader discourse on emerging technologies in multidisciplinary domains, particularly the convergence of mental health, computing, and behavioural science. Following PRISMA guidelines, a comprehensive search was conducted across PubMed, PsycINFO, Scopus, and Web of Science for empirical studies published between 2005 and 2025. Thirty-eight studies, primarily randomized controlled trials, met the inclusion criteria. Quantitative synthesis revealed significant reductions in symptom severity (Cohen’s d = 0.60-1.15), with VRET outcomes often comparable to or exceeding those of traditional exposure therapies. Additional benefits included high patient engagement, lower dropout rates, and enhanced treatment accessibility. However, the review also identified considerable variability in VR platform types, exposure protocols, and outcome measures. Methodological constraints such as small sample sizes, inconsistent follow-up durations, and insufficient blinding procedures limited generalizability. Ethical issues including data privacy, cybersickness, and potential algorithmic bias warrant further scrutiny. This review highlights VRET’s transformative role in digital mental health interventions and emphasizes the need for interdisciplinary collaboration. Future research should focus on AI-enabled personalization, standardized frameworks, and scalable, cost-effective delivery models to ensure equitable access.