Using VRET with Youth: Is It the Right Choice?

Virtual Reality Exposure Therapy (VRET) is making waves in the treatment of phobias and anxiety disorders — but is it suitable for children and adolescents?

While research and clinical use are still growing, early signs are promising. Youth often find VR environments engaging and less intimidating than traditional exposure methods. Youth are digital natives. They’re used to immersive environments. And for many, the idea of facing fears through VR is far less intimidating than doing it in the real world.

And for clinicians, VRET offers a practical way to deliver targeted exposure — even when time, logistics, or emotional readiness present a barrier

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So how does it work in practice? And when is it the right fit for younger clients?

Meet Lily

Lily is a 14-year-old who hasn't been to school in three months. She developed a fear of vomiting after a bad stomach bug, and now panics any time she feels the slightest bit nauseous. The fear doesn’t stop at her own symptoms — she’s terrified that someone else might get sick near her. Classrooms feel unsafe. School hallways are overwhelming. Even stepping onto school grounds is too much.

Lily’s therapist begins VRET sessions using a simple classroom simulation. At first, Lily just sits in the virtual room, practicing calming strategies. Then, gradually, her therapist introduces layers of exposure: the sound of coughing, the presence of other students, walking past a school bathroom. Each scenario is adjusted to Lily’s pace, repeated as needed, and always done with support.

Within a few weeks, she’s not only back on school grounds — she’s attending half-days and building her confidence session by session.

Why VRET Works So Well with Youth

Traditional exposure therapy can be tough for young people. Imagining feared situations doesn’t always come easily, and real-world exposures — like going to an airport or climbing a tall building — aren’t always practical, especially when school and family schedules come into play.

With VRET, exposure becomes more accessible, more engaging, and less overwhelming. It feels like a game — but the therapeutic gains are very real. Young clients can take control of the environment, pause when needed, and gradually build tolerance in a way that feels empowering rather than scary.

And for youth who already spend time in immersive environments — from gaming to VR classrooms — this therapeutic format feels natural, even fun.

Real Benefits, Backed by Research

Studies are beginning to show what clinicians are already seeing: VRET can be highly effective for children and adolescents.

For example, a pilot study found that just a single session of VR exposure targeting public speaking significantly reduced anxiety in adolescents — and these improvements were maintained at a three-month follow-up [1]. Another study found that virtual exposure to school and social situations led to meaningful reductions in anxiety symptoms [2]. Notably, youth often report finding VR exposure more interesting and engaging than traditional in vivo methods, making them more willing to participate [3].

What’s especially promising is that all of these studies used animated virtual environments. At oVRcome, our scenarios are filmed in real-world locations, offering a level of realism and immersion that more closely mimics actual fear triggers. This allows for stronger emotional engagement — and, potentially, even better therapeutic outcomes.

School-Based Options and Parental Support

For many young clients, school is where anxiety shows up — and also where help is most needed. Whether it's fear of vomiting, public speaking, social scrutiny, or just being away from home, VRET allows clinicians to simulate these exact triggers without needing to physically leave the therapy space.

This is particularly valuable in school-based mental health services. All that’s needed is a smartphone and a headset. Exposure can happen onsite, during school hours, without requiring transport or special arrangements. That means fewer barriers to accessing care — and more continuity between treatment and real-world situations.

Parents and caregivers also benefit. They can be involved in the process, understand the hierarchy being followed, and feel reassured knowing that their child is working through fears in a structured and supported way.

A Customizable, Flexible Addition to CBT

VRET doesn’t replace therapy — it enhances it. Therapists remain in the room, guiding exposures, supporting regulation, and tailoring experiences to each client’s needs. The oVRcome platform, for example, allows clinicians to select environments, adjust intensity levels, and integrate skills like breathing or grounding between exposures.

And because it’s built on CBT principles, it fits easily into existing treatment plans. Exposure can be combined with cognitive restructuring, psychoeducation, or emotion coaching — making it not just immersive, but evidence-based.

A Braver Path Forward

For young clients like Lily, VRET offers something simple but powerful: a chance to face their fears in a way that feels safe. Each time they complete a session — whether it’s walking through a virtual school hallway or stepping into an elevator — they’re proving to themselves that they can handle it.

That confidence ripples outward. It shows up in how they engage at school, how they manage physical symptoms, and how they speak about their own progress.

As clinicians, we want to empower young people — to help them feel brave, capable, and in control. VRET gives us one more way to do exactly that. Sounds right for your practice? Head over to our clinician page to register!

References

[1] Kahlon, S., Lindner, P., & Nordgreen, T. (2019). Virtual reality exposure therapy for adolescents with fear of public speaking: a non-randomized feasibility and pilot study. Child and adolescent psychiatry and mental health, 13, 1-10.

[2] Beele, G., Liesong, P., Bojanowski, S., Hildebrand, K., Weingart, M., Asbrand, J., ... & Uhlhaas, P. J. (2024). Virtual Reality Exposure Therapy for Reducing School Anxiety in Adolescents: Pilot Study. JMIR Mental Health, 11, e56235.

[3] Whiteside, S. P., Brennan, E., Biggs, B. K., Vickers, K., Hathaway, J., Seifert, S. J., ... & Hofschulte, D. R. (2020). The feasibility of verbal and virtual reality exposure for youth with academic performance worry. Journal of anxiety disorders, 76, 102298.