Virtual reality exposure therapy: a systematic review and bibliometric analysis of clinical applications and research trends

Abstract

Introduction – This systematic review and bibliometric analysis investigates the evolution of Virtual Reality Exposure Therapy (VRET) from 2015 to 2025, identifying core research themes and clinical application domains to map the field’s intellectual structure. Methods – An extensive literature search was conducted across Scopus and Web of Science, resulting in a deduplicated corpus of 1, 583 unique publications. A quantitative bibliometric analysis using the Bibliometrix R package was integrated with a qualitative thematic synthesis of 40 highly relevant studies. Results – The analysis reveals a steady expansion of the field across 720 journals and involving 6, 485 authors, with annual publications rising from 76 in 2015 to 281 in 2025 (an annual growth rate of 13.97%). Science mapping and keyword co-occurrence analysis identified three primary thematic clusters: core clinical VRET applications, study design/participant characterization, and pain management. Qualitative synthesis confirms VRET remains most established in treating specific phobias, social anxiety disorder, PTSD, panic disorder, and eating disorders, with emerging integration patterns converging around AI-adaptive systems, biofeedback architectures, and digital twin frameworks. Discussion – Thematic mapping indicates that despite significant volume growth, the field has yet to consolidate around a single, dominant integrative paradigm. Critical gaps remain, most notably the scarcity of large-scale randomized controlled trials (RCTs) and health economic evaluations. Ultimately, these findings provide a roadmap for future innovation toward AI-driven, globally accessible VRET systems.