Developing VR environments for trauma-focused CBT in clinical routine settings
Trauma-focused cognitive behavioural therapy is effective but hard to access. This open-label case-series study describes the development and initial clinical use of virtual reality environments specifically designed to support TF-CBT in routine care settings – not specialist labs. A concrete, clinician-oriented account of what it takes to make VR work in everyday trauma treatment.
Abstract
This open-label case-series study examined the feasibility of implementing VR Photoscan, a cost-effective Virtual Reality intervention, within a community-based mental health care setting in Northern Ireland. By integrating VR Photoscan into trauma-focused Cognitive Behavioural Therapy, the study explored its acceptability among clients and therapists, and identified practical considerations for future implementation.
Using a mixed-methods approach, five Post-Traumatic Stress Disorder diagnosed clients received Trauma Focused -Cognitive Behavioural Therapy, supplemented with VR Photoscan. Symptom changes were assessed using the Post-Traumatic Stress Disorder Checklist for DSM-5 (PCL-5) and the Clinical Outcomes in Routine Evaluation-10 (CORE-10). Additionally, semi-structured interviews were conducted with three consenting clients and the participating clinical team, comprised of a service manager, four psychological therapists, and a software company manager, to explore experiences and perspectives of using the VR Photoscan intervention within therapy sessions.
Results indicated a reduction in Post-Traumatic Stress Disorder symptoms and psychological distress in most clients, suggesting VR Photoscan can be feasibly integrated into trauma focused therapy for PTSD. While some clinical staff were initially hesitant, they later recognised the value of VR in providing immersive, controlled environments that supported core therapeutic processes.
This study offers preliminary evidence for the acceptability and practical integration of VR Photoscan within routine mental health care. Collaboration among therapists, clients, and developers was identified as a key factor in successful implementation. Given the small sample size, and lack of a control group, future research is needed to examine the comparative effectiveness of VR-assisted versus standard PTSD treatment, evaluate strategies for implementation across clinical settings, and explore conditions under which broader adoption may be feasible.
Keywords: virtual reality, trauma-focused CBT, PTSD, routine care, clinical implementation, case series
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Reference
Cushnan, J., Best, P., Van Daele, T., D’Arcy, J., Mc Cafferty, P., Roche, R., & Elliot, A. (in press). Developing virtual reality environments for trauma focused cognitive behavioural therapy in clinical routine settings: An open-label case-series study. Cognitive and Behavioral Practice. https://doi.org/10.1016/j.cbpra.2025.08.003