How Virtual Reality Exposure Therapy (VRET) Treats PTSD

This form of exposure therapy is pricey but produces results

Annual Gaming Industry Conference E3 Takes Place In Los Angeles. Credit: Christian Petersen / Staff / Getty Images

Virtual reality exposure therapy (VRET) is being examined as another way to help people recover from PTSD. VRET is a type of exposure therapy that has increasingly been used to treat a variety of anxiety disorders, including specific phobias. Before learning how VRET treats PTSD symptoms, however, it's important to have a handle on what exposure therapy is.

Exposure Therapy

Exposure therapy is considered to be a behavioral treatment for PTSD.

Exposure therapy targets behaviors that people engage in (most often avoidance) in response to situations or thoughts and memories that are viewed as frightening or anxiety-provoking. For example, a rape survivor may begin to avoid relationships or going out on dates for fear that she will be attacked again.

If not addressed, avoidance behavior can become more extreme and interfere with a person's quality of life. Avoidance can also make PTSD symptoms stick around longer or even become worse. As a person avoids certain situations, thoughts or emotions, they don't have the opportunity to learn that these situations may not be quite as dangerous or threatening as they seem. Avoidance also interferes with a person working through their thoughts, memories and emotions.

The goal of exposure therapy then is to help reduce a person's fear and anxiety, with the ultimate goal of eliminating avoidance behavior and increasing quality of life.

This is done by actively confronting the things that a person fears most. By confronting feared situations, thoughts and emotions, a person can learn that anxiety and fear will lessen on their own.

Now, for exposure therapy to be effective, it is very important that a person confronts a situation that closely maps onto what they fear most.

However, this may not always be possible for the person with PTSD. For example, a veteran who developed PTSD as a result of combat exposure would not be able to confront a combat situation again. It would unsafe to do so. This is where virtual reality technology comes in.

Using Virtual Reality for Exposure

In VRET, an individual is immersed in a computer-generated virtual environment, either through the use of a head-mounted display device or entry into a computer-automated room where images are present all around. This environment can be programmed to help the person directly confront feared situations or locations that may not be safe to encounter in real life.

There is some evidence which shows that VRET may be useful for treating several different anxiety disorders and anxiety-related problems, including claustrophobiafear of drivingacrophobia (or a fear of heights), fear of flying, arachnophobia (or a fear of spiders) and social anxiety. In addition, a couple of studies have been done that test how useful VRET may be for PTSD.

To date, VRET for PTSD has primarily been examined in Vietnam War combat veterans. Therefore, the virtual environment in which a person is immersed has included imagery that a soldier may come into contact with during combat, such as helicopters and jungles. These studies found that, following VRET, soldiers experienced a reduction in their PTSD symptoms.

Some studies have also examined whether VRET may be effective in reducing PTSD symptoms among soldiers from the Iraq and Afghanistan Wars. Similar to what was found among Vietnam veterans, it appears as though VRET can reduce PTSD symptoms in such vets.

Finding a Therapist Who Uses VRET

VRET is an expensive technology. Therefore, not many clinicians currently use this procedure. Until VRET is more widely available, it is important to know that exposure therapy (without virtual reality) remains a very effective way of reducing PTSD symptoms, and there are many therapists who do exposure therapy. 


Cahill, S.P., & Foa, E.B. (2005). Anxiety disorders: Cognitive-behavioral therapy section of Anxiety disorders. In B.J. Sadock, & V.A. Sadock (Eds.), Kaplan and Sadock's Comprehensive Textbook of Psychiatry, 8th ed., vol. 1 (pp. 1788–1799). Philadelphia: Lippincott Williams and Wilkins.

Keane, T.M., & Barlow, D.H. (2002). Posttraumatic stress disorder. In D.H. Barlow (Ed.), Anxiety and its disorders, 2nd edition (pp. 418-453). New York, NY: The Guilford Press.

Krijn, M., Emmelkamp, P.M.G., Olafsson, R.P., & Biemond, R. (2004). Virtual reality exposure therapy of anxiety disorders: A review. Clinical Psychology Review, 24, 259-281.

Rothbaum, B.O., Hodges, L., Alarcon, R,. Ready, D., Shahar, F., Graap, K., Pair, J., Hebert, P., Gotz, D., Wills, B., & Baltzell, D. (1999). Virtual reality exposure therapy for PTSD Vietnam veterans: A case study. Journal of Traumatic Stress, 12, 263-271.

Rothbaum, B.O., Hodges, L.F., Ready, D., Graap, K., & Alarcon, R.D. (2001). Virtual reality exposure therapy for Vietnam veterans with posttraumatic stress disorder. Journal of Clinical Psychiatry, 62, 617-622.

Continue Reading