In 2022 the KidsPeace Foundation funded an effort to investigate the use of new technology in adolescent mental health treatment. After the original leader of the initiative stepped down, KidsPeace’s Corporate Clinical Director needed someone to ensure the project’s completion, and I volunteered to coordinate the work of the committee conducting the investigation.
The project was still little more than an idea—an initiative exploring how virtual reality might be applied in therapy. At that point, the vision was compelling but undefined: perhaps a partnership with a VR company specializing in therapeutic applications. The details, however, remained unwritten, and many of the pieces had yet to fall into place.
Committee members sat through what felt like endless sales meetings as IT professionals pitched their platforms, each claiming superiority and potential uses within KidsPeace’s behavioral health service lines. But the notion of relying on an expensive tool, accessible only to professionals, felt out of step with KidsPeace’s mission.
That’s when a new idea emerged: what if they used Meta Quest VR headsets instead? Affordable, portable, and practical, these devices could be integrated into KidsPeace programs while also being accessible to children and families outside the clinical setting.
The spark came from Jamie Chubb, clinical director of KidsPeace’s Pennsylvania residential treatment programming, whose vision led to a pilot program using Meta Quest headsets paired with two low-cost games that showed promise for therapeutic value:
- Flowborne VR, a meditative breathwork experience enhanced with biofeedback and designed by psychologists to promote calm, diaphragmatic breathing and deep relaxation, and
- Guided Meditation VR, which transports users into immersive 360° environments filled with nature scenes, music, and narrated sessions for guided or unguided meditation.
Both offered children a chance to breathe, release tension, refocus, and practice self-regulation in ways that felt engaging and accessible. The pilot proved successful, and the project moved from a somewhat vague concept to an innovative, affordable intervention with the potential to impact children’s lives both inside and outside of treatment. Since its pilot success the VR Program has begun expanding into other levels of care.
Yet the true measure of its value lies not just in the new technology itself, but in how clinicians embrace it—how they weave VR into the fabric of care, and how it enhances the healing process.
That’s where the work, detailed below, of Janice Lewis Stewart, Ph.D. comes in. Through research, practice, and integration, she has explored VR as A Modern Tool for Healing—demonstrating how innovation, when paired with compassion and clinical expertise, can open new doors for children on their journey toward wellness.
–Kaitlin Stefanski
Virtual reality (VR) technology has made remarkable strides over the past decade, moving far beyond the realm of video games and entertainment. One of the most promising frontiers for VR has been its integration into mental health treatment, where clinicians use immersive experiences to support therapeutic goals (Rowland, Casey, Ganapathy, Cassimatis, & Clough, 2022). I was first exposed to virtual reality therapy (VRT) during the COVID-19 pandemic, when many clinicians were searching for innovative ways to reach and engage clients remotely.
At the time, my exposure was limited to training modules and discussions of its potential; it was here at KidsPeace that I had the opportunity to see virtual reality therapy come to life in a more practical way. The experience not only broadened my clinical toolkit but also deepened my appreciation for how technology can complement evidence-based interventions such as mindfulness, acceptance and commitment therapy (ACT), and cognitive behavioral therapy (CBT).
What Is Virtual Reality Therapy?
Virtual reality therapy is a form of treatment that uses computer-generated environments to simulate real-life or imagined scenarios in an immersive way (Bell, Nicholas, Alvarez-Jimenez, Thompson, & Valmaggia, 2020). Clients wear VR headsets that provide visual, auditory, and sometimes even tactile feedback, allowing them to feel as though they are physically present within a new environment (Rowland, et. al, 2022).
Unlike traditional talk therapy, VR can provide a structured, guided, and multisensory space where clients can explore difficult emotions, practice coping strategies, and even rehearse new behaviors. In this sense, it bridges the gap between imagination and lived experience.
Theoretical Foundations
What makes virtual reality therapy particularly compelling is how it integrates well-established psychological approaches into a high-tech format.
Mindfulness: Many VR modules guide clients through calming environments, such as a forest, beach, or mountaintop, where they can practice grounding techniques, breathwork, and awareness of the present moment. These immersive experiences make mindfulness feel tangible and accessible, especially for adolescents who may find traditional meditation difficult.
Acceptance and Commitment Therapy (ACT): VR helps clients confront discomfort, practice acceptance of difficult thoughts and feelings, and commit to value-based actions. For example, modules may encourage clients to visualize letting go of burdens or to step into a space that symbolizes change.
Cognitive Behavioral Therapy (CBT): VR can simulate scenarios where cognitive restructuring and exposure are necessary. Whether addressing social anxiety or processing forgiveness, VR allows clients to practice new ways of thinking and responding in real-time. By combining these frameworks, VR therapy creates an interactive platform where insight is deepened, skills are practiced, and therapeutic change can take root.
Clinical Applications
Since incorporating virtual reality therapy into my work, I have used it with clients presenting with a wide range of challenges, including depression, anxiety, difficulties with forgiveness, and struggles with accepting change. The response has been consistently positive.
One of the key features of VR sessions is the use of the Subjective Units of Distress Scale (SUDS). At the beginning of each session, clients rate their level of emotional distress. After completing the VR module, they rate themselves again. Almost invariably, the number decreases. This measurable reduction in distress provides immediate reinforcement for clients and helps them recognize that coping strategies can be effective when practiced.
Over the course of completing a module series, clients often show significant improvements in mood regulation, self-insight, and judgment. For adolescents in particular, VR has proven especially engaging. The interactive and novel nature of the therapy captures their attention in ways that traditional interventions sometimes cannot, while still grounding them in therapeutic techniques.
Case Examples
While confidentiality prevents me from sharing detailed stories, I can reflect on general outcomes I have observed:
Depression: Adolescents struggling with low mood found the immersive calming environments of VR to be soothing. They practiced mindfulness exercises in settings that felt safe, leading to improved mood and willingness to engage in therapy.
Anxiety: Clients with generalized and social anxiety benefitted from exposure modules. Practicing relaxation while “facing” triggering scenarios helped reduce avoidance behaviors.
Forgiveness and Acceptance: Modules designed around symbolic imagery gave clients space to visualize letting go of resentment or embracing change. This creative and experiential process opened doors that traditional conversation alone may not have achieved.
Adjustment to Change: Adolescents coping with family transitions or academic stress found VR tools useful for practicing flexibility, calming self-talk, and resilience.
Benefits of Virtual Reality Therapy
Several advantages stand out from my experience with VRT:
- Engagement – VR captures clients’ attention and makes therapeutic exercises feel more concrete.
- Immediate Feedback – SUDS ratings before and after sessions provide measurable progress.
- Safe Exploration – Clients can face distressing emotions in a controlled, supportive environment.
- Accessibility of Skills – Mindfulness and acceptance strategies feel less abstract when practiced in vivid settings.
- Adolescent Appeal – Younger clients, who are digital natives, resonate with VR as a familiar yet novel tool.
Limitations and Considerations
Like any therapeutic intervention, VR therapy is not without limitations. Some clients may experience motion sickness or discomfort when using headsets. Others may find the technology distracting rather than helpful. Clinicians must also ensure that VR use is integrated thoughtfully into treatment planning, rather than as a stand-alone “gimmick.” Additionally, access to equipment and training can be barriers in some settings.
Looking Ahead
For adolescents navigating depression, anxiety, and the complexities of change, VR offers a way to connect with therapy in a fresh and engaging format. It is not a replacement for the therapeutic relationship but rather a dynamic tool that strengthens it.
My own journey, from learning about VR therapy during the pandemic to actively using it with clients today, has convinced me of its value as a supplement to traditional modalities. I plan to continue incorporating VR therapy into my clinical work, expanding its use where appropriate, and contributing to the growing body of practice-based evidence supporting its effectiveness.
Conclusion
Virtual reality therapy represents the intersection of innovation and tradition: modern technology infused with timeless therapeutic principles. By bringing together mindfulness, ACT, and CBT in immersive environments, VR enables clients to experience healing in powerful ways. The consistent reductions in distress, improvements in emotional regulation, and enhanced insight I have witnessed affirm that VR therapy is not just a trend, it is a meaningful step forward in how we approach mental health treatment.
For clinicians and clients alike, the message is clear: healing can happen not only within the walls of a therapy room, but also within the virtual spaces that allow us to see, feel, and practice change in new dimensions.
–Janice Lewis Stewart, Ph.D.
As mental health professionals continue to adapt to the evolving landscape of behavioral health care, tools like virtual reality provide exciting opportunities to enhance care. However, mental health professionals and organizations alike must also be mindful of sustainability assuring that new initiatives are not only innovative, but also practical, scalable, and capable of being maintained both within and beyond individual programs. Without this focus, even the most promising interventions risk becoming short-lived experiments rather than lasting solutions.
The innovative work completed by KidsPeace’s dedicated associates is not limited to clinical therapists alone, it extends across disciplines—bringing together clinicians, educators, program leaders, and support staff—to ensure that innovation touches every aspect of care and service delivery. By fostering collaboration among these diverse perspectives, KidsPeace strengthens its ability to meet the complex and evolving needs of those it serves.
Building on the success of the VR project, the committee broadened its focus to explore not only emerging technologies but also creative applications of established practices, and other tools. This evolution led to the development of a stronger, more forward-looking KidsPeace Innovative Interventions Committee (IIC) – a standing group charged with identifying, evaluating, and supporting projects that have the potential to advance KidsPeace’s tradition of best practices in quality of care.
Wherever those efforts lead us in the future, we see the work of IIC as an essential element of KidsPeace’s quality program—where hope is only an intervention away, help emerges through innovative approaches, and healing blossoms from bold new ideas.
–K.S.
Kaitlin Stefanski attended Moravian University, where she built an educational foundation in psychology and public health. She currently serves as the Corporate Quality Assurance and Medical Records Coordinator for KidsPeace. In addition to her current role, Kaitlin chairs KidsPeace’s Human Rights and Ethics Committee and the Innovative Interventions Committee, where she continues to advance the organizational quality incentives and support the rights and well-being of those served. She previously served for multiple years as a Certified Investigator through the ODP program, conducting thorough investigations into incidents of abuse, neglect, and other significant events impacting individuals with developmental disabilities.
Janice Lewis Stewart, Ph.D. is a clinician in KidsPeace’s Pennsylvania residential treatment program – recognized for her calm demeanor, decerning insight, and her natural ability to connect with children, adolescents and families. She offers a steady and compassionate presence, and her work is grounded in a holistic approach that helps clients find balance and well-being in mind, body, and spirit.
