Self-Guided Virtual Reality Therapy for Anxiety: A Systematic Review

Abstract: Virtual reality (VR) technology can be used to treat anxiety symptoms and disorders. However, most VR interventions for anxiety have been therapist guided rather than self-guided. This systematic review aimed to examine the effectiveness and user experience (i.e., usability, acceptability, safety, and attrition rates) of self-guided VR therapy interventions in people with any anxiety condition as well as provide future research directions. Peer-reviewed journal articles reporting on self-guided VR interventions for anxiety were sought from the Cochrane Library, IEEE Explore Digital Library, PsycINFO, PubMED, Scopus, and Web of Science databases. Study data from the eligible articles were extracted, tabulated, and addressed with a narrative synthesis. A total of 21 articles met the inclusion criteria. The findings revealed that self-guided VR interventions for anxiety can provide an effective treatment of social anxiety disorder, public speaking anxiety, and specific phobias. User experiences outcomes of safety, usability, and acceptability were generally positive and the average attrition rate was low. However, there was a lack of standardised assessments to measure user experiences. Self-guided VR for anxiety can provide an engaging approach for effectively and safely treating common anxiety conditions. Nevertheless, more experimental studies are required to examine their use in underrepresented anxiety populations, their long-term treatment effects beyond 12 months, and compare their effectiveness against other self-help interventions for anxiety (e.g., internet interventions and bibliotherapy).