Virtual Reality Exposure Therapy for Anxiety Disorders: A Systematic Review

Introduction: Anxiety disorders are among the most prevalent mental disorders and are commonly maintained by avoidance of feared situations. Exposure therapy remains one of the most effective psychological treatments, but its implementation in routine practice may be limited by logistical and practical barriers. Virtual Reality Exposure Therapy (VRET) has emerged as an immersive and controlled form of exposure-based treatment. This systematic review aimed to evaluate the current evidence on the use of VRET in anxiety disorders. Methods: A systematic review was conducted following PRISMA guidelines. PubMed and EMBASE databases were searched, duplicate records were removed, and studies were screened by title and abstract. Eligible publications included systematic reviews and meta-analyses examining VRET in anxiety disorders. After the selection process, six review-level studies were included in the final analysis. The last search was conducted on 8 March 2026 Results: The included studies consistently showed that VRET was associated with significant reductions in anxiety symptoms. Broad meta-analyses indicated that VRET was superior to inactive control conditions and, in many cases, comparable to in vivo exposure. Reviews focused on social anxiety disorder also confirmed meaningful symptom improvement, although some inconsistency remained regarding long-term comparisons with conventional exposure-based treatment. The most recent large meta-analysis supported the effectiveness of VR-based interventions, while also highlighting substantial heterogeneity across studies. Conclusions: VRET appears to be a promising and clinically relevant intervention in anxiety disorders. Further high-quality randomized controlled trials are needed to clarify long-term efficacy, disorder-specific effects, and optimal implementation.