Virtual Reality in Psychotherapy: A Three-Dimensional Framework to Navigate Immersive Clinical Applications.

Virtual Reality (VR) is becoming an increasingly prominent tool in psychotherapy, offering immersive and personalized experiences that can enhance therapeutic processes. However, the diversity and complexity of VR-based interventions pose challenges for clinicians and researchers seeking to understand and apply this technology effectively. This article introduces a three-dimensional conceptual framework to support the analysis, classification, and design of VR interventions in psychotherapy. The framework is organized around three axes: Strategy (the therapeutic purpose of the VR experience: exposure, training, and exploration), Focus (the psychological domain being targeted: symptoms, attitudes, and identity/flourishing), and Perspective (the point of view or identity adopted within the virtual environment: self, other, witness, and multi-perspective). Drawing on five clinical case reports, including chronic pain, PTSD, social anxiety, depression, and psychosis, this In Session issue illustrates how VR can be harnessed across diverse therapeutic aims and models (cognitive-behavioral therapy, acceptance and commitment therapy, systemic therapy, and personal construct therapy) to foster therapeutic breakthroughs. By presenting both well-established and innovative uses of VR, this issue offers valuable insights into how virtual environments can extend the boundaries of psychotherapy and address complex psychological challenges in novel, impactful, and transformative ways.