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March 10, 2025Journal of Behavioral and Cognitive TherapyOpen Access

Examining the comparative effectiveness of virtual reality and in-vivo exposure therapy on social anxiety and specific phobia: A systematic review & meta-analysis

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Authors

DKDamla KuleliPTPhilip John TysonNDNyle Davies

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Overview

Meta-analysis reveals equivalent symptom reduction between virtual reality and in-vivo exposure in adults with phobias or social anxiety, suggesting digital therapy is a viable alternative.

Key Points

  • To evaluate and compare the therapeutic effectiveness of virtual reality exposure therapy against in-vivo exposure therapy in adults diagnosed with social anxiety disorder or specific phobias.
  • Systematically searched PubMed, PsycNet, ProQuest, and ScienceDirect for randomized controlled trials examining adults diagnosed with social anxiety or specific phobia via DSM-IV, DSM-5, or ICD-10 criteria.
  • Required eligible trials to compare head-mounted display virtual reality exposure therapy, in-vivo exposure therapy, and an additional control condition using pre- and post-assessment measures.
  • Conducted a random-effects meta-analysis to evaluate and compare effect size estimates on symptom reduction between the two active exposure modalities.
  • Both virtual reality exposure therapy and in-vivo exposure therapy produced moderate effect sizes in reducing symptoms of social phobia and anxiety.
  • Virtual reality exposure therapy achieved positive clinical outcomes comparable to in-vivo exposure therapy.
  • The limited scope of existing literature precluded determining whether virtual reality or in-vivo exposure is the optimal therapeutic intervention.

Cite This Study

Kuleli et al. (2025) studied this question.

synapsesocial.com/papers/6a15804c79ff98d0de4eb8ffhttps://doi.org/10.1016/j.jbct.2025.100524
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1The Simulation Game—Virtual Reality Therapy for the Treatment of Social Anxiety Disorder: A Systematic Review2021 · 63 citations
  2. 2Virtual reality exposure therapy for social anxiety disorder: A randomized controlled trial.2013 · 357 citations
  3. 3A Meta-Analysis of the Efficacy of Virtual Reality and In Vivo Exposure Therapy as Psychological Interventions for Public Speaking Anxiety2021 · 66 citations
  4. 4Measuring inconsistency in meta-analyses2003 · 64,238 citations
  5. 5The effectiveness of virtual reality based interventions for symptoms of anxiety and depression: A meta-analysis2018 · 289 citations