In 1995, psychologist Barbara Rothbaum pioneered the use of VRET to treat acrophobia (fear of heights) at Emory University. Using rudimentary VR technology, her team created a simulated high-rise setting where patients could safely confront their fear of heights under controlled conditions. But  despite its promise, technology at the time made VRET very expensive due to the hardware, limited graphics and lack of mainstream availability.

As technology improved in the early 2000s, researchers expanded VRET applications beyond phobias. One of the most notable uses was in PTSD treatment, particularly for veterans. Simulated combat scenarios allowed soldiers to process trauma in a controlled environment, guided by trained therapists. Studies by the National Center for PTSD showed significant improvements in patient outcomes, proving that VR could be an effective supplement to traditional therapy, rather than a replacement.

Today, as technology has advanced greatly and VR sets have become more affordable, VR therapy has moved beyond clinical settings into mainstream wellness applications. Virtual “smash rooms” —  simulations where users can destroy objects in a risk-free environment — have gained popularity as an alternative use for stress relief as a way to process frustration and even anger. While real-life smash room exist today, VR versions offer a more accessible, mess-free alternative for users looking to release pent-up emotions. This shift from a strictly clinical applications to consumer-friendly mental health tools demonstrate not only how far has technology advanced, but also how VRET could potentially be reaching wider audiences in the future.

Despite significant advancements in VRET, experts agree that it is not a substitute for real-world exposure therapy but rather should be seen as a complementary tool. While virtual environments provide a safe and controlled setting for exposure, they cannot fully replicate the sensory, emotional and physiological response that could occur in real life-situations.

Mental health professionals emphasize that VRET works better when combined with cognitive behavioral therapy and real-life exposure to reinforce the progress built in virtual sessions. This integration ensures that patients transfer their learned coping skills into their everyday lives.

VR and VRET have undergone a remarkable transformation over the years. The rudimentary tech that powered the acrophobia treatments of the 1990s has given way to dizzyingly realistic video games that place users on planks 80 stories in the air. While still evolving, their accessibility continues to grow, offering new ways to address mental health challenges. With the latest advances in haptic feedback, AI-driven therapy and multisensory VR environments, the future of VRET promises an even greater integration into everyday stress management and psychological treatment.