Virtual Reality Revolution: Strategies for treating mental and emotional disorders Eleonora Nava Department of Design Norwegian University of Science and Technology, NTNU Trondheim, Norway eleonorn@stud.ntnu.no Ashis Jalote-Parmar Department of Design Norwegian University of Science and Technology, NTNU Trondheim, Norway ashis.jalote.parmar@ntnu.no Abstract—Virtual Reality (VR) is increasingly gaining recognition in healthcare, especially as a treatment tool for psychological interventions. This paper reviews current advances in immersive VR-based therapies to explore different strategies designed to treat mental and emotional disorders with Virtual Reality Therapy (VRT). The study contributes to the VR community by exemplifying the application of various psychological treatment strategies in designing VR therapies, such as Cognitive-Behavioral, Distraction, Perspective-Taking and Exposure. For higher adoption of VR by clinicians, greater quality control of these strategies and well-defined user experiences are required, followed by clinical validation. Keywords—virtual reality therapies, psychological treatment, mental and emotional disorders, exposure, cognitive-behavioural, distraction, perspective-taking I. INTRODUCTION Over the past few decades, technological progress has changed the Healthcare Industry, and Virtual Reality (VR) has surfaced as one of the most exploited tools [1]. Healthcare is one of the significant early adopters of this technology, and, due to an increase in research, VR is expected further to revolutionize the healthcare industry in the coming years. One of the most explored applications of VR is in psychotherapy, where VR is used as a tool to deliver therapeutic support [2]. As defined by pioneer Jaron Lanier, VR is an advanced frontier of our era, helpful in understanding human cognition and perception [3]. VR provides a virtual environment that extends the real world to induce an immersive behavioural, cognitive, and emotional reaction equivalent to real-world situations. With the advent of widely affordable wearable technologies, this technology is making its way into therapy clinics, research laboratories and hospitals [4]. In addition, a steady wave of psychological research affirms the usefulness of VR for diagnosing and treating mental and emotional disorders, from social anxiety to chronic pain [5]. Therefore, there is still a lack of guidance and classification on the various types of psychotherapeutic approaches. The ability to design customized patient-specific environments is a significant contribution of VR in this field. Each person's emotional, cognitive, behavioural, and spiritual needs and spheres are in fact, different. Designing future interventions requires an understanding of different psychotherapies and their role in treatment and adoption. This article aims to investigate and classify different strategies and psychotherapeutic orientations applied to VR to treat mental and emotional disorders. It examines the application of VR technology to illustrate examples of implementations among deployed projects and ongoing research. II. METHOD A systematic review was conducted of peer-reviewed articles published in the last five years related to VR-based psychotherapeutic therapies, both in research projects and clinical practice. Keywords such as 'Emotional Disorders', 'Mental Disorders' and 'Virtual Reality Therapy' were used in PubMed, Frontiers and ScienceDirect databases. The search revealed a total of 64 articles; among them, 42 articles, classified as seen in Fig. 1, were considered, consisting of systematic scientific literature reviews, comparative experiments and deployed projects. The analysis revealed four main VR therapy strategies, further reviewed in the article. Fig. 1. Classification of reviewed articles. III. VIRTUAL REALITY THERAPY (VRT) Virtual Reality Therapy (VRT) is a treatment that uses a virtual world created by VR. The system creates the illusion of a real-life experience, keeping the patient in a safe, controlled, secure environment. The benefit of using VRT for therapists is that they can transport their patients into a detailed simulation rich in contextual information while maintaining control over the variables. While the experience is engaging and credible for the patient, psychological reactions and brain activity are recorded and archived by a system analysing them. The patient's physiological parameters are measured to control arousal and understand stress and anxiety levels. Biofeedback signals are used to create stimuli and track progress over time [6]. Different strategies are applied in therapies, such as coping with one's fears and phobias, reframing anxieties, practising mindfulness, relaxation techniques and empathising to change one's point of view in immersive environments that enhance the experience. IV. CLASSIFICATION OF PSYCHOTHERAPY TECHNIQUES IN DESIGN OF VRT This section will present the different psychotherapeutic techniques that are applied in the design of VRT, that have emerged during the review research. These are classified into 2022 IEEE International Conference on Systems, Man, and Cybernetics (SMC) October 9-12, 2022, Prague, Czech Republic 978-1-6654-5257-1/22/$31.00 ©2022 IEEE 3370