Augmented Reality Exposure Therapy (ARET) for military-related PTSD: A thematic analysis of stakeholder perspectives guiding iterative development

Despite the efficacy of trauma-focused therapies, many veterans with PTSD leave treatment prematurely and experience persistent functional impairments. This is often due to anxiety and logistical difficulties surrounding in vivo exposures. Augmented Reality Exposure Therapy (ARET) offers a novel approach to delivering trauma-relevant stimuli within real-world environments. The current study gathered stakeholder feedback to refine an ARET platform (ExpandXR), originally developed for first responders with PTSD, to better meet the needs of veterans with military trauma. Ten veterans and eleven national expert clinicians participated in structured feedback sessions. Veterans completed the Credibility Expectancy Questionnaire (CEQ) and responded to open-ended prompts, while expert clinicians provided narrative feedback. Qualitative data were analyzed using reflexive thematic analysis. Themes emphasized the importance of realism, social engagement, and contextual triggers (e.g. noise, confinement). Clinicians highlighted the need for clinical flexibility and applicability across diverse trauma presentations. Stakeholder feedback informed key platform enhancements, including Artificial Intelligence (AI)-driven interactions and customizable exposure scenarios. ARET was perceived by both veterans and clinicians as a feasible, engaging, and clinically impactful intervention. It holds promise as a tool for enhancing functional recovery in veterans with PTSD.