Have you ever turned down a vacation because you don’t like flying? Denied a road trip because driving is scary? Heck, maybe you despise going into your basement due to those pesky, freaky spiders! Perhaps you’re like me and threw a book through a bedroom door because a centipede was walking across it (true story, I had to buy a new door and everything)! Fear has a nasty habit of running our lives, but virtual reality exposure therapy is flipping that script.

To make things even more tricky, overcoming fears is hard because to overcome them, you have to face them head on and, often, alone. It’s not like you can take your therapist on a plane, right? Well, that used to be true but now… cue the baller music… Virtual Reality enters the chat!  

Virtual Reality (VR) has been around for a hot minute at this point, but only in recent years has it been a truly viable piece of technology. When most people think of VR, they often think of video games or cheesy experiences that you can have at the Mall of America but at Ellie Mental Health, we have a different perspective. We are using virtual reality therapy as a professional therapeutic tool to help people take back control of otherwise fearful experiences.

What is VR Therapy?

Virtual reality (VR) therapy is a mental health treatment that uses immersive virtual environments to help people process emotions, confront fears, and build coping skills in a controlled setting. Think of it as exposure therapy meets cutting-edge tech—clients can practice real-world situations in a safe, guided way. It’s been used for everything from phobias and PTSD to mindfulness and stress management. As technology evolves, VR is becoming an increasingly accessible and powerful tool in mental health care.

How VR Therapy Works

VR therapy works by immersing clients in a virtual environment tailored to their therapeutic needs. Using a VR headset and handheld controllers, individuals can engage in guided scenarios designed to help them process emotions, confront fears, or practice coping strategies. A therapist customizes the experience, adjusting difficulty levels and providing support in real-time. Because everything happens in a controlled setting, clients can work through challenges at their own pace, with the reassurance that they can pause or step back at any time.

For example, someone with a fear of public speaking might start by standing in a virtual empty room, gradually progressing to speaking in front of a small virtual audience. Over time, the therapist might increase the challenge by adding distractions or a larger crowd, helping the client build confidence and resilience. This step-by-step approach aligns closely with exposure therapy, a well-established method for treating anxiety and phobias. The key difference is that VR therapy offers a safe, repeatable, and fully customizable environment—making exposure more accessible and less intimidating than real-world practice.

Virtual Reality as Therapy for Mental Health Treatment

VR therapy is sometimes called “fear therapy” because of its ability to help people gradually face and overcome anxiety-provoking situations in a safe, controlled way. By immersing clients in realistic yet customizable environments, it’s especially effective for conditions like phobias, PTSD, and social anxiety. But its usefulness goes beyond fear! VR is also being used for mindfulness, stress management, and even pain reduction in therapy. The next sections explore how VR therapy is transforming mental health treatment across different areas.

VR for PTSD

Virtual Reality Exposure Therapy is helpful for PTSD and healing from past traumas. By immersing clients in controlled virtual environments that simulate aspects of their traumatic experiences, VR therapy allows them to gradually confront distressing memories in a safe, guided way. It follows the same principles as traditional exposure therapy but adds an interactive, immersive element that can make the process feel more manageable and engaging.

Research backs up its effectiveness. One study found that VRET significantly reduced PTSD symptoms, with some participants no longer meeting the criteria for diagnosis after treatment. Another 2024 study showed that combining VR exposure with brain stimulation led to even greater improvements, especially for military veterans, and had higher efficacy rates than traditional exposure therapy.

VR for Phobias

Whether it’s a fear of flying, heights, spiders, or public speaking, VR lets clients interact with their specific phobia in a virtual setting while their therapist guides them through the process. Because it’s customizable and repeatable, clients can ease into exposure at their own pace without the pressure of real-world consequences.

And the research backs it up. This article reviewed studies that compared VR therapy and traditional exposure therapy, and it found that VR therapy is just as effective for treating phobias, with some studies suggesting it might even have extra benefits. Another study found that people with social phobia saw significant, lasting improvements after VR therapy. As VR keeps evolving, it’s making exposure therapy more accessible—and maybe even a little less intimidating.

VR for Anxiety Disorders

Virtual reality isn’t just effective for phobias and trauma. Recent studies also show VR’s effectiveness with anxiety. A meta-analysis published in the Journal of Medical Internet Research found that VR found significant improvements in symptoms for people with severe anxiety disorders, obsessive-compulsive disorder, and post-traumatic stress disorder.

Additionally, a systematic review indicated that self-guided VR interventions effectively reduced symptoms of social anxiety disorder, public speaking anxiety, and specific phobias, with positive user experiences and low attrition rates. These findings suggest that VR therapy offers an effective approach to anxiety treatment.

VR for Depression

As therapists are using VR therapy more and more with clients, we are seeing its effectiveness across different diagnoses, including depression. VR therapy immerses individuals in interactive environments that promote mood improvement and coping strategies. Through guided virtual experiences, patients can practice mindfulness, reframe negative thoughts, and engage in activities that boost motivation.

Research supports its effectiveness. One particular study from 2019 found that VR interventions can help reduce depressive symptoms by translating CBT techniques (like psychoeducation and cognitive restructuring) into virtual reality experiences.

The Benefits of Virtual Reality Therapy

1. Controlled Environment
2. Controlled Exposure
3. Personalized Treatment

1. Controlled Environment

As previously discussed, VR therapy offers a level of control that traditional exposure therapy can’t. In real-world settings, variables are unpredictable—VR allows therapists to adjust intensity, ensuring a gradual, personalized approach. This control allows for a more gradual, personalized approach.

Clients appreciate that they can start with lower-intensity exposures and work their way up at their own pace, reducing the risk of being retraumatized or overwhelmed. VR also ensures consistency—each session replicates the exact scenario needed, something that’s nearly impossible to guarantee in real life. This makes exposure therapy more accessible, flexible, and tailored to each person’s unique needs.

2. Controlled Exposure

VR therapy gives therapists and clients more control over the exposure process, making it a safer and more adaptable approach than traditional exposure therapy. In real-world settings, exposure can be unpredictable—clients might face unexpected triggers or overwhelming situations. With VR, therapists can tailor the experience, adjusting intensity and pacing to match the client’s comfort level.

This level of control allows for gradual, repeatable exposure without the risk of overstimulation. Clients can build confidence at their own pace, knowing they won’t be thrown into a situation they’re not ready for. It also ensures consistency, making progress easier to track and refine over time.

3. Personalized Treatment

With the controlled environment therapists are able to offer highly personalized treatment, adapting exposure to each client’s specific needs and progress. Therapists can adjust factors like intensity, duration, and specific triggers, ensuring a gradual and manageable approach. This flexibility helps clients build confidence at their own pace while minimizing distress, making treatment more effective and tailored to individual goals.

VR Therapy with Ellie Mental Health

Virtual Reality (VR) has been around for a hot minute at this point, but only in recent years has it been a truly viable piece of technology.

At Ellie Mental Health, we’re using virtual reality as a professional therapeutic tool to help people take back control of otherwise fearful experiences. 

In creating the VRT program at Ellie, we pulled over 30 peer-reviewed research papers from the last 5 years.

Our process is based on Systematic Desensitization and evidence-based Exposure Response Prevention methods. This includes creating what we call a SUDS (Subjective Units of Discomfort Scale) Ladder. Meaning, we determine a series of steps that are increasingly more distressing and work our way through it.

Intrigued? Virtual reality therapy is seriously amazing! Learn more about VRT with Ellie Mental Health.

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We’re starting to see tools pop up that use AI to make healthcare note-taking easier (huge win!), but we’re also seeing some concern around people using AI in place their therapists (*red flag*).

I’m a human therapist, and I was recently talking to a friend that uses AI for mental health help. He sees a therapist weekly, but he will occasionally use a therapy chatbot for questions and advice in between sessions. At first I was like, “HOLD up, this can’t be good.” The more I looked into the AI therapy options out there, the more intrigued I was by the pros and cons. This blog will outline those pros and cons of using AI in healthcare settings.

Where We’re Seeing AI Used in Healthcare

• Note-taking to help with insurance documentation
• Creating clinical summaries
• Creating treatment plans
• Streamlining billing processes
• AI virtual assistants can help people monitor symptoms and answer questions
• Chatbots offering coping skill ideas and guiding them to professional help

Concerns and Limitations with AI in Mental Health

There’s a lot that AI can do, and it’s continually expanding and changing, but we all know that AI chatbots are computers, not humans.

Lack of Relationship

A large part of the therapeutic process is building a true relationship—something that is not possible with an AI chatbot. A real therapist makes the conversation person-focused instead of popping out a general answer or list of things that other humans find helpful. A real therapist can gather things from your past, current and future and understand how you may need support especially during a time of crisis based on how you respond in the past (also, raises some privacy red flags, which we cover below).

AI Can’t Replace Human Empathy and Non-Verbal Cues

Humans can read your body language, be empathetic, and validate, and this isn’t something a chatbot can do (this is also a reason we’re not fans of text therapy here at Ellie Mental Health).

Since chatbots are not humans, they are not able to take into account all of the complexities of a human’s mental health and how delicate it can actually be.    

Because humans are complex, a mental health professional is more in tune with the problems that humans may be facing. AI has a bunch of data that is inputted, for example, if you say you are struggling with suicidal thoughts, they will create a generated answer that is shared generally and not specific to an individual. A real, human therapist isn’t going to give you a general answer and they are able to connect with you on a deeper level through the relationship that has been built.

In more extreme examples, there have been times where these AI chatbots have encouraged someone who is suicidal to take their life, told a recovering alcoholic to drink alcohol, or have given harmful eating advice to an AI chatbot specific to eating disorder (as mentioned in an article by National Geographic).

Receiving a Professional Diagnosis

According to Chaitali Sinha, senior VP of healthcare and clinical development at AI therapy app Wysa, the AI chatbots are unable to make diagnosis or prescribe medication because they do not have the same ethical and liability standards as licensed healthcare professionals. They may suggest that you meet criteria for depression, anxiety, or the sorts, however it is not a legit diagnosis.

Therapists can give you a real diagnosis, which can help you receive further services through insurance or medication through a prescriber. A diagnosis isn’t just a checklist of symptoms though, there are more nuanced things that go into a diagnostic assessment that are not yet able to be captured through an AI chatbot. A diagnostic assessment should tell a story, not just list off your problems in order to effectively offer a treatment path.

The Ethical Challenges of AI in Mental Health

Lack of Oversight

Are there ethical issues with AI therapy? To answer this question, we need to ask ourselves who defines what is ethical in mental health care…. And the answer is the state licensing boards. All therapists—regardless if they’re a psychologist or social worker or psychiatrist—have licensure boards that oversee their care. These boards monitor the therapists’ work, investigate issues of malpractice, and essentially decide who can and cannot see clients. Obviously, there are not licensing boards monitoring AI’s treatment and care. In fact, there is very little regulation of AI in the United States period.

Privacy Concerns

In any field, AI is based on data that is provided to them from people that use their systems. This means that as you use chatbots, you are training them. You are discussing the things that you may be struggling with, and based on your response, they are trying to figure out how to respond back. These solutions will be filtered in their system and used again when someone uses a similar key word, even though it might be an entirely different situation.

That being said, it is difficult to know if your private health information (PHI) is being protected if the chatbots are using it to train themselves for the next individual. This leads to a huge risk of having your private health information leaked, or even what information they could be gathering about you and then selling to third parties, something that mental health companies are prohibited from doing (and some companies like BetterHelp and Grow therapy have gotten in trouble for in recent years).

With a licensed mental health professional, you can guarantee confidentiality when it comes to your private health information unless there are very specific circumstances where there is risk of harming yourself, harming others, an elderly adult or a child is in danger, or if your records needed to be subpoenaed in court.

Pros and Cons of Using AI Tools for Mental Health Care

We’re not going to say that AI is all bad, but we’re also not big fans of it being used in place of therapy with a real human therapist, for various ethical and relational reasons.

Pros:

1. AI chatbots are more accessible for folks who are unable to afford therapy but need advice of an outside perspective or ideas.
2. If you’re afraid of judgment, talking to a chatbot might be helpful in getting through that fear.
3. Mental health concerns have been growing rapidly, and for someone who cannot get services, chatbots can give you reasonable advice around coping skills, communication skills, and other ideas for dealing with mental health struggles.
4. If you were recently diagnosed with a mental health disorder, a chatbot may be helpful in breaking down some of the symptoms and understanding more about this diagnosis (we get it– sometimes an AI summary can be helpful instead of spending long amounts of time reading through Reddit or Google).
5. AI can a helpful tool for providers dealing with administrative tasks like progress notes and treatment plans—allowing them to reduce the documentation burden and spend more time and energy on the actual treatment.

Cons:

1. There are errors in the system, and it is not individualized. They are just repeating back learned responses.
2. AI does not offer various other modalities like EMDR, ART, or Brainspotting. They’re limited in what they can help you with.
3. It may also increase the risk of your private health information being leaked.
4. Licensed professionals are held to certain ethical standards through their licensure and therefore have to uphold confidential rights when it comes to their clients. AI chatbots are not held to the same standards.

Final Thoughts

If you are struggling with the idea of talking to a human face-to-face, and after reading this blog are unsure of using AI chatbots, try virtual or telehealth therapy! You’d be speaking to a human, but you don’t need to leave your couch or go to an actual office (happy medium!).

Ellie Mental Health provides both in-person and virtual options with insurance options as well as out-of-pocket amounts. Check out the nearest location near you and call them to be scheduled as soon as possible!

Sources:

More people are turning to mental health AI chatbots. What could go wrong? (nationalgeographic.com)

What Is AI Therapy? | Built In

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