Usability, feasibility, and preliminary outcomes of VR EMDR therapy for specific phobia: mixed-method study

Purpose This study aims to evaluate the feasibility, usability and preliminary effectiveness of a VR-based EMDR system for specific phobia treatment. Design/methodology/approach A mixed-methods pilot study was conducted with five participants undergoing five daily VR EMDR sessions. Usability was evaluated using the Simulator Sickness Questionnaire (SSQ) and qualitative feedback on user experience, comfort and confidence in independent use. Feasibility was assessed through independent system use, interviews and monitoring of technical, health and psychological challenges. Preliminary effectiveness was evaluated using Subjective Units of Distress (SUD), Validity of Cognition (VOC) and the IAPT Phobia Scale to measure changes in distress, positive cognitions and avoidance. Qualitative and quantitative data were analysed using thematic, descriptive and time-series methods. Findings Usability ratings were high, with manageable motion sickness, strong confidence in independent use and positive user experiences. The system demonstrated high feasibility, with participants independently using it by the second session, though initial challenges highlighted support needs. Preliminary effectiveness showed reduced distress, improved positive cognitions and decreased avoidance. Thematic analysis revealed diminished phobia-related bodily sensations, cognitive shifts toward positive beliefs and greater confidence in confronting previously avoided situations. Originality/value This study is the first to explore VR EMDR for phobia treatment. Its user-friendly design integrates a calming, immersive environment, enhancing comfort and engagement, with potential for scalable, self-administered home-based therapy.