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Virtual reality therapy

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Virtual reality therapy is the use of virtual reality (VR), and to a smaller extent augmented reality (AR), to deliver or support a medical or psychological treatment. Its best-studied form is virtual reality exposure therapy (VRET), in which a patient with an anxiety disorder is exposed to a computer-generated version of the feared situation instead of the real one or an imagined one.[1][2] Other uses include distraction from pain during medical procedures, home-based behavioral programs for chronic pain, automated cognitive therapy led by a virtual coach, motor rehabilitation after stroke and vision therapy for children with amblyopia.[3][4][5][6][7]

Controlled clinical studies began in the mid-1990s, when researchers at the Georgia Institute of Technology and Emory University treated fear of heights with a head-mounted display and tracked virtual environments.[8][9] A 2019 meta-analysis of 30 randomized controlled trials found that exposure delivered in VR worked about as well as exposure in real situations.[10] In November 2021 the U.S. Food and Drug Administration (FDA) authorized EaseVRx, later sold as RelieVRx, a prescription VR program for chronic lower back pain, and created a new device type for VR behavioral therapy for pain relief.[11][12]

Reviewed 4 October 2026. Checked the study, meta-analysis, FDA, CMS and NICE claims against PubMed records, PMC full texts, FDA De Novo and 510(k) documents, the FDA AR/VR device list and the cited institutional pages. About review dates.

Approaches

In a 2017 systematic review, Daniel Freeman, Mel Slater and colleagues described the basic idea: with VR, patients "can repeatedly experience their problematic situations and be taught, via evidence-based psychological treatments, how to overcome difficulties." They found 285 empirical studies of VR in mental health, 154 of them about treatment. Anxiety was by far the most researched condition (192 studies), followed by schizophrenia (44), substance-related disorders (22) and eating disorders (18). The review also noted that "VR" was often applied to technology that was neither interactive nor immersive.[3] Treatments built on VR fall into several groups.

Main forms of virtual reality therapy
Approach How VR is used Example
Exposure therapy The patient faces a graded series of virtual versions of a feared object or situation until anxiety falls Virtual bridges, balconies and a glass elevator for fear of heights[8]
Distraction analgesia An engaging virtual world draws attention away from a painful procedure SnowWorld for burn wound care[13]
Skills-based behavioral therapy A home program teaches relaxation, breathing, attention-shifting and other cognitive behavioral techniques EaseVRx / RelieVRx for chronic lower back pain[11]
Automated cognitive therapy A virtual coach guides the patient through the treatment program automatically Oxford VR fear-of-heights program; gameChange for agoraphobic avoidance in psychosis[5][14]
Motor rehabilitation Interactive virtual tasks and video games add practice time in physical rehabilitation Upper limb and balance training after stroke[6]
Vision therapy Different video images are shown to each eye to encourage use of the weaker eye Luminopia One for amblyopia[7]

Exposure therapy in VR keeps the logic of conventional graded exposure. Patients start with the least threatening situation and work up a hierarchy of more frightening ones. Real-world (in vivo) exposure for fear of heights requires repeated trips to a bridge, a tall building or a canyon, which costs time and money; Rothbaum expected VR to make the treatment more convenient and less expensive.[8][15] The Emory and Georgia Tech researchers described the user's "sense of presence" as essential to successful VR therapy.[8]

Pain distraction rests on a different mechanism. The University of Washington group that built SnowWorld argues that pain perception has a strong psychological component and needs conscious attention, and that "being drawn into another world drains a lot of attentional resources, leaving less attention available to process pain signals."[13]

History

Fear of heights at Georgia Tech and Emory

Larry F. Hodges, associate director of the Graphics, Visualization and Usability Center at Georgia Tech, and Barbara O. Rothbaum of the Emory University School of Medicine ran a study that Emory's magazine said was thought to be the first controlled study of VR as a treatment for a psychological disorder. The project was funded by the Emory/Georgia Tech Biomedical Research Consortium.[8] They screened 478 Georgia Tech students and enrolled 20 with acrophobia; 12 were assigned to VR treatment and 8 to a waiting list.[8][9]

Participants wore a head-mounted display, and an electromagnetic sensor tracked the head and right hand. They chose among three environments: a gorge crossed by bridges 7, 50 and 80 meters high (the highest a rope bridge with widely spaced slats), four balconies of a tall building at ground level and at 2, 10 and 20 stories, and a glass elevator similar to one in an Atlanta hotel. Real handrails were placed where the virtual balcony and elevator railings appeared, so users could hold on to something they also saw in VR. Sessions of 35 to 45 minutes took place once a week for eight weeks. Rothbaum estimated that the equipment cost $150,000 to $200,000.[8] The results appeared in the July 1995 issue of IEEE's Computer magazine and in the American Journal of Psychiatry. Ten of the treated students and seven waiting-list students completed the study; the treated group improved significantly on measures of anxiety, avoidance, attitudes and distress, while the comparison group did not change.[9][15]

Phobias, flying and PTSD

At the University of Washington, A. S. Carlin, Hunter Hoffman and S. Weghorst reported in 1997 the case of a 37-year-old woman with a severe fear of spiders. Over twelve weekly one-hour sessions she was exposed to virtual spiders, and in a mixed reality condition she also touched real objects that she saw as spiders in VR, a technique the authors called tactile augmentation. Her fear of spiders fell.[16] A controlled study by A. Garcia-Palacios, Hoffman, Carlin, Thomas Furness and C. Botella followed in 2002. With 23 participants, 83% of the VR group showed clinically significant improvement after an average of four one-hour sessions, compared with none on the waiting list, and no patient dropped out.[17]

Rothbaum, Hodges and colleagues next tested fear of flying. In a 2000 trial, 49 patients were randomly assigned to VR exposure in a virtual airplane, standard exposure in a real airplane at the airport, or a waiting list. Both active treatments beat the waiting list and did not differ from each other; six months later, 93% of the VR group and 93% of the standard exposure group had flown.[18]

Post-traumatic stress disorder (PTSD) followed. A 2001 open trial treated 10 male Vietnam combat veterans with a virtual Huey helicopter flying over Vietnam and a jungle clearing.[19] At the University of Southern California Institute for Creative Technologies (ICT), the BRAVEMIND project led by Albert "Skip" Rizzo, Arno Hartholt and Sharon Mozgai has run since 2005. It renders Afghan and Iraqi city, village, mountain and desert road environments, and later versions added content for military sexual trauma. ICT says it has been distributed to more than 170 clinical sites.[20] Rizzo and colleagues also described the earlier Virtual Iraq/Afghanistan system, with city and desert road convoy scenarios; in an open trial of Virtual Iraq, 16 of 20 treatment completers no longer met PTSD checklist criteria after treatment.[21] The article Psychological trauma covers the PTSD trials in more detail.

Pain distraction and SnowWorld

According to the University of Washington laboratory, Hunter Hoffman and David Patterson began using immersive VR for pain control in 1996.[13] Their first case report, in the journal Pain in 2000, described two adolescent burn patients who spent part of their wound care in VR and part playing a video game. For the first patient's first session, sensory and affective pain ratings, anxiety and time spent thinking about pain all dropped sharply in VR compared with the game.[22] The virtual world in that study was SpiderWorld, a kitchen in which patients could pick up objects and touch a virtual spider.[13] A controlled study the same year with 12 adult burn patients during physical therapy found that all of them reported less pain in VR; time spent thinking about pain fell from 60 to 14 mm on a 100-mm scale.[23]

SnowWorld, an icy canyon in which patients throw snowballs at snowmen, penguins and woolly mammoths, was completed in 2003 and was, according to its developers, the first immersive virtual world designed for reducing pain. The team also built water-friendly fiber-optic VR goggles so patients could use VR while being treated in a hydrotherapy tank.[13] In a 2004 functional MRI study using thermal pain stimulation, VR reduced both pain ratings and pain-related brain activity in all five regions examined: the anterior cingulate cortex, primary and secondary somatosensory cortex, insula and thalamus.[24] A later pilot study at a U.S. regional burn center enrolled 48 children aged 6 to 17 with burns over more than 10% of their body; their mean worst pain during wound cleaning in intensive care was 8.52 without VR and 5.10 while playing SnowWorld.[25]

Augmented reality exposure

In 2005 Cristina Botella of Universitat Jaume I and colleagues from Universitat de València and Universidad Politécnica de València published what they described as the first case study using AR to treat a specific phobia. Their system superimposed virtual cockroaches on the real world during a one-session exposure treatment that followed Öst's guidelines. Afterward the participant could approach, interact with and kill live cockroaches, and the gains held at a one-month follow-up.[26] The authors argued that AR might be cheaper than VR because the real surroundings do not need to be modeled.[26]

Consumer headsets and automated treatment

In 2018 Freeman's group at the University of Oxford and the company Oxford VR reported a randomized trial of fully automated treatment for fear of heights, delivered with consumer VR equipment. An avatar coach, animated with motion and voice capture of an actor, guided the sessions, and the hardware was an HTC Vive headset connected to a gaming PC. One hundred adults were randomized; the VR group received about six 30-minute sessions over two weeks. At the end of treatment the VR group's fear of heights had fallen far more than the usual-care group's (Cohen's d = 2.0), the benefit held at four weeks, and no adverse events were reported. The trial was funded by Oxford VR and the National Institute for Health Research.[5]

The same group's gameChange trial, across nine National Health Service trusts in England, randomized 346 patients with psychosis who had difficulty going outside because of anxiety. About six sessions of automated VR therapy over six weeks, delivered with an HTC Vive Pro headset and a laptop and added to usual care, produced small but significant reductions in agoraphobic avoidance (d = -0.18) and distress (d = -0.26) at six weeks. Patients with the most severe avoidance benefited most. Freeman is a founder of Oxford VR, which paid a licensing fee for the gameChange software and was to commercialize the therapy.[14] In December 2022 Oxford VR merged with BehaVR, and Freeman joined the leadership team of the combined company.[27]

Selected milestones
Year Event
1995 Rothbaum, Hodges and colleagues publish a controlled trial of VR graded exposure for fear of heights[9]
1996 Hoffman and Patterson begin using immersive VR for pain control at the University of Washington[13]
1997 Case report of VR exposure with tactile augmentation for spider phobia[16]
2000 Controlled trial of VR exposure for fear of flying; first case report of VR distraction during burn wound care[18][22]
2001 Open trial of VR exposure for Vietnam veterans with PTSD[19]
2003 Original SnowWorld completed[13]
2005 ICT's BRAVEMIND project begins; first case study of AR exposure for a specific phobia[20][26]
2018 Randomized trial of automated VR therapy with a virtual coach for fear of heights[5]
2021 FDA authorizes Luminopia One (amblyopia) and EaseVRx (chronic lower back pain)[4]
2022 gameChange trial results published[14]
2023 CMS creates HCPCS code E1905 for a VR cognitive behavioral therapy device; NICE allows gameChangeVR in the NHS with further evidence generation[12][28]

Regulation and reimbursement

United States

The FDA authorized EaseVRx, made by AppliedVR, on 16 November 2021 through the De Novo pathway, after granting it Breakthrough Device designation. It is a prescription system for home use by adults with chronic lower back pain. The kit consists of a VR headset, a controller and a "Breathing Amplifier" that directs the user's breath toward the headset microphone during deep-breathing exercises. The program has 56 sessions of 2 to 16 minutes, used daily over eight weeks, and draws on cognitive behavioral therapy (CBT) and other behavioral methods, including deep relaxation, attention-shifting, interoceptive awareness and distraction.[11] The FDA's decision summary lists the headset as the Goertek-made Pico G2 4K and notes that safety and effectiveness had not been shown in patients with moderate to severe depression.[29]

The trial behind the authorization, a double-blind study of 179 people conducted remotely during the COVID-19 pandemic, compared EaseVRx with a sham program of 2D nature video shown in a headset.[30] According to the FDA, 66% of EaseVRx users reported more than a 30% reduction in pain at the end of treatment, against 41% of controls, and 46% reported more than a 50% reduction, against 26%. No serious adverse events occurred; about 20.8% of participants reported discomfort with the headset and 9.7% motion sickness and nausea.[11] Several of the trial's authors were AppliedVR employees, consultants or advisors.[30]

The authorization created a new Class II device type, "virtual reality behavioral therapy device for pain relief" (21 CFR 890.5800, product code QRA), so that later devices of the same type can be cleared through the 510(k) process.[11][29] The FDA's list of AR and VR medical devices shows several clearances under that code since then.[4]

FDA authorizations of VR therapy devices (selected)
Decision date Submission Device Company Indication
20 October 2021 DEN210005 Luminopia One Luminopia Software for commercially available headsets to improve visual acuity in children aged 4 to 7 with amblyopia, used one hour a day, six days a week, for 12 weeks[4][7]
16 November 2021 DEN210014 EaseVRx AppliedVR Chronic lower back pain in adults[4][29]
25 September 2023 K230825 Smileyscope System (Therapy Mode) Smileyscope Pain and acute procedural anxiety in children aged 4 to 11 during needle procedures[4][31]
31 October 2023 K230814 VRNT CognifiSense Chronic lower back pain in adults[4][32]
4 December 2024 K243417 RelieVRx AppliedVR Same indication as EaseVRx, moved to the Pico G3 headset with a new home screen and IPD adjustment during onboarding[4][33]

At the time of its authorization, Luminopia One was authorized for use only with the Samsung Gear headset. Children watch TV shows and movies in which the image sent to each eye is modified to encourage use of the weaker eye. Its randomized trial enrolled 117 children.[7]

In March 2023 the Centers for Medicare and Medicaid Services (CMS) created HCPCS Level II code E1905, "Virtual reality cognitive behavioral therapy device (CBT), including pre-programmed therapy software", after an application by AppliedVR. CMS placed the device in the durable medical equipment benefit category, explaining: "The medical software and the device on which it is housed are so integral to each other that we consider them to be one whole device, not software and a separate device." An AppliedVR case study published by the Medical Device Innovation Consortium in 2024 describes RelieVRx as "formerly known as EaseVRx" and says the device is rented to patients for the course of therapy.[12][34]

The FDA's overview page lists pain management, mental health, neurological disorders and rehabilitation among the treatment areas for AR and VR devices, and gives a VR system for treating PTSD in army veterans as an example. It also lists risks such as neck pain from headset weight, dizziness, fatigue and effects on vision.[4]

United Kingdom

In an early value assessment published on 15 November 2023, the National Institute for Health and Care Excellence (NICE) said gameChangeVR "can be used in the NHS while more evidence is generated" to treat severe agoraphobic avoidance in people with psychosis aged 16 and over, with support from a mental health professional. It asked for more research before using gameChangeVR for mild to moderate avoidance or using XR Therapeutics' product for agoraphobia. The company must collect further evidence over a period of up to three years.[28]

Research and evidence

Meta-analyses have repeatedly found exposure therapy in VR to be more effective than waiting-list controls and roughly as effective as conventional exposure.[1][10]

Selected meta-analyses and systematic reviews
Year Authors Scope Main finding
2008 Powers and Emmelkamp[1] 13 studies, 397 participants, anxiety disorders Large effect versus control conditions (d = 1.11); small effect favoring VR over in vivo exposure (d = 0.35)
2012 Opriş et al.[35] 23 studies, 608 participants Similar efficacy to established treatments without VR; no difference in dropout between VR and in vivo exposure
2015 Morina et al.[2] 14 trials of specific phobias with behavioral tests Gains carried over to real-life behavioral tests; no significant difference from in vivo exposure
2019 Carl et al.[10] 30 randomized trials, 1,057 participants g = 0.90 versus waiting list and 0.78 versus psychological placebo; no significant difference from in vivo exposure (g = -0.07)
2024 Teh et al.[36] 92 randomized trials, 7,133 participants, pain during medical procedures Pain scores reduced across procedures (SMD -0.78), with high statistical heterogeneity
2025 Tan et al.[37] 17 randomized trials, social anxiety disorder Better than waiting list; similar to other interventions
2025 Laver et al. (Cochrane)[6] 190 trials, 7,188 participants, stroke rehabilitation Slight benefit over alternative therapy for upper limb function (SMD 0.20, low certainty); larger benefit when added to usual care (SMD 0.42, moderate certainty)
2026 Chang et al.[38] 26 randomized trials, 1,649 clinically diagnosed patients Reduced phobia (g = -0.98), anxiety (g = -0.61) and PTSD symptoms (g = -0.51)

The evidence has known weaknesses. Freeman and colleagues judged the methodological quality of the first 20 years of studies to be generally low.[3] Carl and colleagues found that larger trials reported smaller effects when VR was compared with control conditions.[10] The 2025 Cochrane review rated most stroke rehabilitation evidence as low or moderate certainty, because most trials were small and poorly reported; only 19% enrolled more than 50 participants.[6] Several prominent trials were run or funded by the companies developing the treatments, which the authors disclosed.[5][30]

Side effects in trials have generally been mild. Across the 59 stroke trials that monitored adverse events, the Cochrane authors found few, and those were relatively mild.[6] In the EaseVRx trial the most common complaints were headset discomfort and motion sickness.[11]

See also

References

  1. ↑ 1.0 1.1 1.2 M. B. Powers, P. M. Emmelkamp (2008). "Virtual reality exposure therapy for anxiety disorders: A meta-analysis". Journal of Anxiety Disorders, vol. 22, no. 3, pp. 561-569. doi:10.1016/j.janxdis.2007.04.006. https://doi.org/10.1016/j.janxdis.2007.04.006. Retrieved 2026-10-04.
  2. ↑ 2.0 2.1 N. Morina, H. Ijntema, K. Meyerbröker, P. M. Emmelkamp (2015-11). "Can virtual reality exposure therapy gains be generalized to real-life? A meta-analysis of studies applying behavioral assessments". Behaviour Research and Therapy, vol. 74, pp. 18-24. doi:10.1016/j.brat.2015.08.010. https://doi.org/10.1016/j.brat.2015.08.010. Retrieved 2026-10-04.
  3. ↑ 3.0 3.1 3.2 D. Freeman, S. Reeve, A. Robinson, A. Ehlers, D. Clark, B. Spanlang, M. Slater (2017-10). "Virtual reality in the assessment, understanding, and treatment of mental health disorders". Psychological Medicine, vol. 47, no. 14, pp. 2393-2400. doi:10.1017/S003329171700040X. https://doi.org/10.1017/S003329171700040X. Retrieved 2026-10-04.
  4. ↑ 4.0 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 "Augmented Reality and Virtual Reality in Medical Devices". U.S. Food and Drug Administration. U.S. Department of Health and Human Services. https://www.fda.gov/medical-devices/digital-health-center-excellence/augmented-reality-and-virtual-reality-medical-devices. Retrieved 2026-10-04.
  5. ↑ 5.0 5.1 5.2 5.3 5.4 D. Freeman, P. Haselton, J. Freeman, B. Spanlang, S. Kishore, E. Albery, M. Denne, P. Brown, M. Slater, A. Nickless (2018-08). "Automated psychological therapy using immersive virtual reality for treatment of fear of heights: a single-blind, parallel-group, randomised controlled trial". The Lancet Psychiatry, vol. 5, no. 8, pp. 625-632. doi:10.1016/S2215-0366(18)30226-8. https://doi.org/10.1016/S2215-0366(18)30226-8. Retrieved 2026-10-04.
  6. ↑ 6.0 6.1 6.2 6.3 6.4 K. E. Laver, B. Lange, S. George, J. E. Deutsch, G. Saposnik, M. Chapman, M. Crotty (2025-06-20). "Virtual reality for stroke rehabilitation". Cochrane Database of Systematic Reviews, issue 6, CD008349. doi:10.1002/14651858.CD008349.pub5. https://doi.org/10.1002/14651858.CD008349.pub5. Retrieved 2026-10-04.
  7. ↑ 7.0 7.1 7.2 7.3 "De Novo Classification Request for Luminopia One (DEN210005)". U.S. Food and Drug Administration. https://www.accessdata.fda.gov/cdrh_docs/reviews/DEN210005.pdf. Retrieved 2026-10-04.
  8. ↑ 8.0 8.1 8.2 8.3 8.4 8.5 8.6 Andrew W. M. Beierle. "High Anxiety: Emory and Georgia Tech researchers discover virtual reality provides a very real treatment for a crippling phobia". Emory Magazine. Emory University. https://web.archive.org/web/20060922064156/http://www.emory.edu/EMORY_MAGAZINE/winter96/virtreality.html. Retrieved 2026-10-04.
  9. ↑ 9.0 9.1 9.2 9.3 B. O. Rothbaum, L. F. Hodges, R. Kooper, D. Opdyke, J. S. Williford, M. North (1995-04). "Effectiveness of computer-generated (virtual reality) graded exposure in the treatment of acrophobia". American Journal of Psychiatry, vol. 152, no. 4, pp. 626-628. doi:10.1176/ajp.152.4.626. https://doi.org/10.1176/ajp.152.4.626. Retrieved 2026-10-04.
  10. ↑ 10.0 10.1 10.2 10.3 E. Carl, A. T. Stein, A. Levihn-Coon, J. R. Pogue, B. Rothbaum, P. Emmelkamp, G. J. G. Asmundson, P. Carlbring, M. B. Powers (2019-01). "Virtual reality exposure therapy for anxiety and related disorders: A meta-analysis of randomized controlled trials". Journal of Anxiety Disorders, vol. 61, pp. 27-36. doi:10.1016/j.janxdis.2018.08.003. https://doi.org/10.1016/j.janxdis.2018.08.003. Retrieved 2026-10-04.
  11. ↑ 11.0 11.1 11.2 11.3 11.4 11.5 "FDA Authorizes Marketing of Virtual Reality System for Chronic Pain Reduction". U.S. Food and Drug Administration. 2021-11-16. https://web.archive.org/web/20250505201039/https://www.fda.gov/news-events/press-announcements/fda-authorizes-marketing-virtual-reality-system-chronic-pain-reduction. Retrieved 2026-10-04.
  12. ↑ 12.0 12.1 12.2 Liesl M. Oldstone, Emily Judge (2024-01-29). "Case Study: Innovative Reimbursement Strategy for Digital Therapeutics". Medical Device Innovation Consortium. AppliedVR. https://mdic.org/wp-content/uploads/2024/02/AppliedVR-Case-Study_FINAL.pdf. Retrieved 2026-10-04.
  13. ↑ 13.0 13.1 13.2 13.3 13.4 13.5 13.6 "Virtual Reality Pain Reduction". Human Interface Technology Laboratory, University of Washington. https://www.hitl.washington.edu/projects/vrpain/. Retrieved 2026-10-04.
  14. ↑ 14.0 14.1 14.2 D. Freeman, S. Lambe, T. Kabir, A. Petit, L. Rosebrock, et al. (2022-05). "Automated virtual reality therapy to treat agoraphobic avoidance and distress in patients with psychosis (gameChange): a multicentre, parallel-group, single-blind, randomised, controlled trial in England with mediation and moderation analyses". The Lancet Psychiatry, vol. 9, no. 5, pp. 375-388. doi:10.1016/S2215-0366(22)00060-8. https://doi.org/10.1016/S2215-0366(22)00060-8. Retrieved 2026-10-04.
  15. ↑ 15.0 15.1 L. F. Hodges, R. Kooper, T. C. Meyer, B. O. Rothbaum, D. Opdyke, J. J. de Graaff, J. S. Williford, M. M. North (1995-07). "Virtual environments for treating the fear of heights". Computer (IEEE), vol. 28, no. 7, pp. 27-34. doi:10.1109/2.391038. https://doi.org/10.1109/2.391038. Retrieved 2026-10-04.
  16. ↑ 16.0 16.1 A. S. Carlin, H. G. Hoffman, S. Weghorst (1997-02). "Virtual reality and tactile augmentation in the treatment of spider phobia: a case report". Behaviour Research and Therapy, vol. 35, no. 2, pp. 153-158. doi:10.1016/s0005-7967(96)00085-x. https://doi.org/10.1016/s0005-7967(96)00085-x. Retrieved 2026-10-04.
  17. ↑ A. Garcia-Palacios, H. Hoffman, A. Carlin, T. A. Furness III, C. Botella (2002-09). "Virtual reality in the treatment of spider phobia: a controlled study". Behaviour Research and Therapy, vol. 40, no. 9, pp. 983-993. doi:10.1016/s0005-7967(01)00068-7. https://doi.org/10.1016/s0005-7967(01)00068-7. Retrieved 2026-10-04.
  18. ↑ 18.0 18.1 B. O. Rothbaum, L. Hodges, S. Smith, J. H. Lee, L. Price (2000-12). "A controlled study of virtual reality exposure therapy for the fear of flying". Journal of Consulting and Clinical Psychology, vol. 68, no. 6, pp. 1020-1026. doi:10.1037/0022-006X.68.6.1020. https://doi.org/10.1037/0022-006X.68.6.1020. Retrieved 2026-10-04.
  19. ↑ 19.0 19.1 B. O. Rothbaum, L. F. Hodges, D. Ready, K. Graap, R. D. Alarcon (2001-08). "Virtual reality exposure therapy for Vietnam veterans with posttraumatic stress disorder". The Journal of Clinical Psychiatry, vol. 62, no. 8, pp. 617-622. doi:10.4088/jcp.v62n0808. https://doi.org/10.4088/jcp.v62n0808. Retrieved 2026-10-04.
  20. ↑ 20.0 20.1 "BRAVEMIND". USC Institute for Creative Technologies. University of Southern California. https://ict.usc.edu/research/projects/bravemind-virtual-reality-exposure-therapy/. Retrieved 2026-10-04.
  21. ↑ A. S. Rizzo, J. Difede, B. O. Rothbaum, G. Reger, J. Spitalnick, J. Cukor, R. McLay (2010-10). "Development and early evaluation of the Virtual Iraq/Afghanistan exposure therapy system for combat-related PTSD". Annals of the New York Academy of Sciences, vol. 1208, pp. 114-125. doi:10.1111/j.1749-6632.2010.05755.x. https://doi.org/10.1111/j.1749-6632.2010.05755.x. Retrieved 2026-10-04.
  22. ↑ 22.0 22.1 H. G. Hoffman, J. N. Doctor, D. R. Patterson, G. J. Carrougher, T. A. Furness III (2000-03). "Virtual reality as an adjunctive pain control during burn wound care in adolescent patients". Pain, vol. 85, no. 1-2, pp. 305-309. doi:10.1016/s0304-3959(99)00275-4. https://doi.org/10.1016/s0304-3959(99)00275-4. Retrieved 2026-10-04.
  23. ↑ H. G. Hoffman, D. R. Patterson, G. J. Carrougher (2000-09). "Use of virtual reality for adjunctive treatment of adult burn pain during physical therapy: a controlled study". The Clinical Journal of Pain, vol. 16, no. 3, pp. 244-250. doi:10.1097/00002508-200009000-00010. https://doi.org/10.1097/00002508-200009000-00010. Retrieved 2026-10-04.
  24. ↑ H. G. Hoffman, T. L. Richards, B. Coda, A. R. Bills, D. Blough, A. L. Richards, S. R. Sharar (2004-06-07). "Modulation of thermal pain-related brain activity with virtual reality: evidence from fMRI". NeuroReport, vol. 15, no. 8, pp. 1245-1248. doi:10.1097/01.wnr.0000127826.73576.91. https://doi.org/10.1097/01.wnr.0000127826.73576.91. Retrieved 2026-10-04.
  25. ↑ H. G. Hoffman, R. A. Rodriguez, M. Gonzalez, M. Bernardy, R. Peña, W. Beck, D. R. Patterson, W. J. Meyer III (2019-08-08). "Immersive Virtual Reality as an Adjunctive Non-opioid Analgesic for Pre-dominantly Latin American Children With Large Severe Burn Wounds During Burn Wound Cleaning in the Intensive Care Unit: A Pilot Study". Frontiers in Human Neuroscience, vol. 13, article 262. doi:10.3389/fnhum.2019.00262. https://doi.org/10.3389/fnhum.2019.00262. Retrieved 2026-10-04.
  26. ↑ 26.0 26.1 26.2 C. M. Botella, M. C. Juan, R. M. Baños, M. Alcañiz, V. Guillén, B. Rey (2005-04). "Mixing realities? An application of augmented reality for the treatment of cockroach phobia". CyberPsychology and Behavior, vol. 8, no. 2, pp. 162-171. doi:10.1089/cpb.2005.8.162. https://doi.org/10.1089/cpb.2005.8.162. Retrieved 2026-10-04.
  27. ↑ Marissa Plescia (2022-12-16). "BehaVR and OxfordVR Merge, Secure $13M in Funding". MedCity News. https://medcitynews.com/2022/12/behavr-and-oxfordvr-merge-secure-13m-in-funding/. Retrieved 2026-10-04.
  28. ↑ 28.0 28.1 "Virtual reality technologies for treating agoraphobia or agoraphobic avoidance: early value assessment (HTG701) - Recommendations". National Institute for Health and Care Excellence. 2023-11-15. https://www.nice.org.uk/guidance/htg701/chapter/1-Recommendations. Retrieved 2026-10-04.
  29. ↑ 29.0 29.1 29.2 "De Novo Classification Request for EaseVRx (DEN210014)". U.S. Food and Drug Administration. https://www.accessdata.fda.gov/cdrh_docs/reviews/DEN210014.pdf. Retrieved 2026-10-04.
  30. ↑ 30.0 30.1 30.2 L. M. Garcia, B. J. Birckhead, P. Krishnamurthy, J. Sackman, I. G. Mackey, R. G. Louis, V. Salmasi, T. Maddox, B. D. Darnall (2021-02-22). "An 8-Week Self-Administered At-Home Behavioral Skills-Based Virtual Reality Program for Chronic Low Back Pain: Double-Blind, Randomized, Placebo-Controlled Trial Conducted During COVID-19". Journal of Medical Internet Research, vol. 23, no. 2, e26292. doi:10.2196/26292. https://doi.org/10.2196/26292. Retrieved 2026-10-04.
  31. ↑ "510(k) clearance K230825: Smileyscope System (Therapy Mode)". U.S. Food and Drug Administration. https://www.accessdata.fda.gov/cdrh_docs/pdf23/K230825.pdf. Retrieved 2026-10-04.
  32. ↑ "510(k) clearance K230814: VRNT". U.S. Food and Drug Administration. https://www.accessdata.fda.gov/cdrh_docs/pdf23/K230814.pdf. Retrieved 2026-10-04.
  33. ↑ "510(k) clearance K243417: RelieVRx". U.S. Food and Drug Administration. 2024-12-04. https://www.accessdata.fda.gov/cdrh_docs/pdf24/K243417.pdf. Retrieved 2026-10-04.
  34. ↑ "AppliedVR Becomes First Virtual Reality Provider to Receive HCPCS Level II Code from Centers for Medicare and Medicaid Services as Durable Medical Equipment". PR Newswire. AppliedVR. 2023-03-21. https://www.prnewswire.com/news-releases/appliedvr-becomes-first-virtual-reality-provider-to-receive-hcpcs-level-ii-code-from-centers-for-medicare-and-medicaid-services-as-durable-medical-equipment-301773521.html. Retrieved 2026-10-04.
  35. ↑ D. Opriş, S. Pintea, A. García-Palacios, C. Botella, Ş. Szamosközi, D. David (2012-02). "Virtual reality exposure therapy in anxiety disorders: a quantitative meta-analysis". Depression and Anxiety, vol. 29, no. 2, pp. 85-93. doi:10.1002/da.20910. https://doi.org/10.1002/da.20910. Retrieved 2026-10-04.
  36. ↑ J. J. Teh, D. J. Pascoe, S. Hafeji, R. Parchure, A. Koczoski, M. P. Rimmer, K. S. Khan, B. H. Al Wattar (2024-02-14). "Efficacy of virtual reality for pain relief in medical procedures: a systematic review and meta-analysis". BMC Medicine, vol. 22, article 64. doi:10.1186/s12916-024-03266-6. https://doi.org/10.1186/s12916-024-03266-6. Retrieved 2026-10-04.
  37. ↑ Y. L. Tan, V. Y. X. Chang, W. H. D. Ang, W. W. Ang, Y. Lau (2025-03). "Virtual reality exposure therapy for social anxiety disorders: a meta-analysis and meta-regression of randomized controlled trials". Anxiety, Stress and Coping, vol. 38, no. 2, pp. 141-160. doi:10.1080/10615806.2024.2392195. https://doi.org/10.1080/10615806.2024.2392195. Retrieved 2026-10-04.
  38. ↑ Y. C. Chang, H. Arifin, T. M. Hung, C. L. Lin, J. Y. Ye, et al. (2026-03-27). "Innovative virtual reality exposure therapy for anxiety and posttraumatic stress disorder: a meta-analysis of randomised controlled trials". Journal of Global Health, vol. 16, 04090. doi:10.7189/jogh.16.04090. https://doi.org/10.7189/jogh.16.04090. Retrieved 2026-10-04.
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