Treatment with Virtual Reality appears to work very well for people with psychosis. It works faster than the current treatment with cognitive behavioral therapy and is at least as effective. This is evident from research conducted by UMCG psychiatrist Wim Veling. 'I hope that this application of Virtual Reality will soon be available in all mental health care facilities.
Cognitive behavioral therapy is the most important psychological treatment for paranoid ideas in patients with psychotic disorders. In a study, Veling compared the effect of treatment with Virtual Reality-based therapy with current standard therapy. 'With Virtual Reality, we can better focus on reducing avoidance behavior and relearning safety. And that is crucial for the effect of the treatment. With Virtual Reality, we can better expose patients to their paranoid fears in a controlled manner.'
With the help of Virtual Reality, patients practised social situations that provoked paranoid ideas and anxiety in virtual social environments. For example, they could go shopping in a virtual supermarket or take a bus ride. Veling: 'Standing in line at the supermarket checkout is difficult when you are suspicious. People are looking at you, you have to talk to the cashier and you can't leave. In Virtual Reality, you can practise how to deal with such a situation, how to reduce avoidance and anxiety, and just do your shopping.' Therapists guided them to let go of their safety behaviors, test paranoid beliefs, and learn new behaviors. The exercises could be tailored precisely to the participant's needs and goals and could be repeated.
Wim Veling calls the results of the study promising. 'It appears that Virtual Reality therapy works very well for people with psychosis and reduces their extreme suspicion and anxiety. When we look at factors such as paranoia, depression, avoidance, self-confidence and anxiety, it may even work somewhat better than the current standard treatment. And with Virtual Reality, people need an average of 15% fewer sessions, which shows that the therapy works faster!
Veling is now working on implementing this Virtual Reality treatment into mental health care. 'We are actively looking for more efficient treatments in mental health care. This appears to be an efficient treatment that will enable us to help more people. People recover sooner and need fewer sessions.
Meanwhile, Veling is already looking further ahead. He is currently investigating whether AI can be used to partially automate treatment with Virtual Reality. 'We are looking into whether a psychologist is no longer needed for some sessions. If that works and if patients indicate that they have no problem with an automated session, then that will of course help to reduce waiting lists. I expect the first treatment results from this study in three years' time.
About this research:
The study was conducted in seven mental health centres in the Netherlands and Belgium. A total of 98 patients participated in the study. The study was made possible in part by the Hersenstichting (Brain Foundation).
Source:
Journal reference:
van der Stouwe E. C. D., et al. (2025) Virtual-reality cognitive behavior therapy versus cognitive behavior therapy for paranoid ideation: A pragmatic, single-blind, multicenter randomized clinical superiority trial. Psychological Medicine. doi.org/10.1017/S0033291725100949.