Virtual Reality Exposure Therapy

Strong evidence supports several psychotherapies to treat posttraumatic stress disorder (PTSD). First-line cognitive behavioral therapies (CBTs) include cognitive processing therapy (CPT), cognitive therapy for PTSD, and exposure-based approaches such as prolonged exposure (PE) (International Society for Traumatic Stress Studies [ISTSS], 2018). In ISTSS’ most recent practice guidelines, virtual reality exposure therapy (VRET) for PTSD is noted to have emerging evidence of efficacy (ISTSS, 2018). Although VRET shares many of the foundational principles of PE, it is a distinct treatment that was developed independently. Early studies using VR technology for exposure to treat PTSD (e.g., Rothbaum et al., 2001; Difede & Hoffman, 2002) occurred before there was a standard of care for PTSD and before the PE manual was published (Foa et al., 2007), and thus do not follow the exact same protocol. Although it is possible to utilize the standard PE protocol within VR, the term “VRET” that is used throughout this chapter encapsulates a range of exposure-based PTSD treatments, some of which are closer to the standard PE protocol than others. VRET has garnered a strong empirical base spanning nearly three decades and is a promising therapy for PTSD. VRET is an important method for delivering exposure-based PTSD treatments that may be particularly useful for those unable or unwilling to effectively engage in alternate forms of delivery, such as standard PE.