Table 2.

Review of CBT^a studies.

ID	Condition	CBT type	VRb toolkit	VR scenario and total participants	Summary of findings
Anderson et al [14]	Public speaking anxiety	CBT and VR	—c	Participants gave a speech in front of the increasing number group in a virtual conference room, classroom, and auditorium (n=28).	Participants showed statistically significant improvement on all self-report measures from pretreatment to follow-up.
Stamou et al [26]	Postnatal Depression	CBT inside VR	—	Participants were exposed to a series of virtual stressors, whereas at the same time, they were asked to tidy up the virtual house (n=6).	All participants reported feeling better, more relaxed and with improved mood, better self-esteem, and improved sleep and appetite.
Guitard et al [27]	Generalized anxiety disorder	CBT and VR	A 6-side CAVEd-like system and wireless motion tracking	Three standardized VEe of an emergency room (n=11), an apartment (n=15), and a student room (n=2)	The standardized VE induced significant anxiety. No difference was found between standardized VE and imagined scenario.
Geraets et al [28]	Generalized and social anxiety disorder	CBT inside VR	Head-mounted display (Sony HMZ-T1) and joystick	Virtual street, bus, cafe, and supermarket environments were available. Patients tested their beliefs and feedback was given on cognition and behavior (n=15).	Two patients dropped out of treatment. Social anxiety and quality of life improved at posttreatment. At follow-up, depressive symptoms decreased, and social anxiety was maintained.
Kovar I [37]	Social anxiety disorder	CBT inside VR	HTC Vive+ controllers	Public speaking, a telephone call from a random institution, criticism of their appearance, and a job interview or refusal (n=10)	Most significant improvement in the length of fluent speech. VRETf improved reaction speed by 204.8 seconds. No effect in job interview VE.
Zinzow et al [38]	Driving-related anxiety	CBT and VR	Drive Safety CDSg-250 driving simulator. Three 19-inch LCDh screen displays	Lane keeping straight, changing, and mirrors, speed control straight, pedals and stopping, functional object detection–basic, turning left and right (n=8)	Hyperarousal in driving situations declined by 69%, aggressive driving declined by 29%, and risky driving declined by 21%.
Tarrant et al [39]	Generalized anxiety disorder	CBT inside VR	SPSS software, Gear VR 19-channel EEGi, and Brain Masterj	A mindfulness meditation by Story Up VR (n=12)	The VR meditation significantly reduced subjectively reported anxiety.
Bouchard et al [50]	Social anxiety disorder	CBT inside VR (RCTk)	Virtually Better, eMagin z800 head-mounted display, and InterSense InertiaCube motion tracker	Eight VEs such as a meeting room, job interview, introducing oneself, and facing criticism situations (n=59)	Conducting CBT with in virtuo exposure was effective and more practical for therapists than CBT with in vivo exposure.
Jeong et al [54]	Social anxiety	CBT inside VR	Desktop or mobile version with monitor of eye movement, speaking time, and heart rate	Some VEs were classroom, auditorium, job interview, train, and cafe (n=115)	Short-term VR-based individual CBT of 9-10 sessions may be effective. Minimal benefit if extended.

^aCBT: cognitive behavioral therapy.

^bVR: virtual reality.

^cNot applicable.

^dCAVE: cave automatic virtual environment.

^eVE: virtual environment.

^fVRET: virtual reality exposure therapy.

^gCDS: Clinical Driving Simulator.

^hLCD: liquid crystal display.

ⁱEEG: electroencephalogram.

^jBrainMaster Technologies, Inc.

^kRCT: randomized controlled trial.