Virtual reality is a technology used to synthetically reproduce real or imaginary environments. In this sense, the immersion enjoyed by the mental health user will lead them to expose themselves to stimuli in complete safety.

This type of exposure gave birth to the 4th wave of cognitive-behavioral therapies: therapies through exposure to virtual reality.

The first scientifically validated protocol dates from 1992. However, until the 2000s, virtual reality was relatively little known and used. Thanks to technological progress and the interest of researchers and clinicians, it is today in an increasing phase of democratization.

In order to use virtual reality, it is necessary to immerse yourself in a virtual environment. There are several ways to do this.

Indeed, the use of CAVE, a 3D system composed of several screen walls, was mainly used in the past.

The user finds himself totally immersed in the virtual world and his movements are detected in real time. This solution has the drawback of being very expensive and not very accessible.

Since around 2016, with the appearance of the Oculus Rift and the HTC Vive, virtual reality headsets, its use has become much more accessible. It allows you to immerse yourself in virtual reality thanks to a blackout screen on which virtual images are projected. The user's head movements are taken into account, allowing them to turn their head to look around them as in the real world.

Exposure is a behavioral method based on the principle of habituation. It is defined as the reduction of a reaction following repetition of the stimulus that arouses it.

Concretely, it involves confronting the subject according to strict rules with the stimuli triggering the dysfunctional response. This makes it possible to obtain extinction of the latter via the activation of habituation.

Several forms of exhibition exist, such as exhibition by imagination. That is to say, we invite the patient to imaginatively confront feared situations (being behind the wheel of a car on the highway, speaking in public during a meeting).

Then, in vivo exposure. We place the subject in a concrete exhibition situation.

For a patient afraid of dogs, the therapist will first confront him with a small dog placed behind a fence. Gradually, it will reduce the existing proximity between the patient and the dog.

Finally, the last form of existing exhibition is the virtual reality exhibition. Through a synthetic concretization of real environments, the patient will be able to expose himself to situations provoking the dysfunctional emotional response.

This last technique has the considerable advantage of combining the advantages of in vivo exposure while benefiting from unique qualities (accessibility of environments, security, controllability).

A virtual environment allows the user to be immersed in various situations of places or spaces. Depending on the functionalities, the user will be able to move and interact with avatars.

The therapist, for his part, has control over the exposure scenario. He can in fact modify certain elements of the environment, add or remove stimuli (visual, sound) or program interactions.

The primary objective is to reproduce environments that are difficult to access from the therapist's office. Thanks to this technology, new perspectives, then limited by the reality on the ground, are offered to caregivers and patients: relaxation environments or personifications of abstract substrates (hallucinations, complex anxieties, etc.).

Depending on the VR headsets, other devices may be required. Standalone headsets, like the Pico Neo 4, can be used as-is without needing to connect them to other devices.

For wired headsets such as the HP Reverb G2, it is necessary to connect the headset to a “gaming” type computer.

Depending on the therapeutic objectives, you can also equip yourself with additional modules such as a pedal board and a steering wheel in the case of treating amaxophobia (fear of driving).