INTRODUCTION:

Art-making is an innate human tendency. Art therapy is a form of dynamic emotional therapy where art materials, creative processes, and the creative product serve as means of self-inquiry, self-expression, and a way to develop insights and create change.^2,3

In art therapy, recent research has focused on adapting and connecting the technological environment and the therapeutic environment for general use and specifically for adolescents. Adolescents are often referred to as "digital natives" because they were born in the digital age and consider technology to be a native language. Adolescents often perceive the use of technology in therapy as a pleasant and comfortable extension of a familiar form of discourse⁵.

Virtual Reality:

Virtual Reality is a technology that allows the individual to experience a reality different from the real world. It creates the illusion of another environment by generating digital, realistic, or imaginary visual images. Virtual reality is a computer-generated 3D virtual environment that can interact with and manipulate the user in real time. Head, hand, and body tracking systems are used by the user to be able to experience this virtual environment with one or more senses, move, and interact.

Characteristics of Art Therapy in Virtual Reality:

The unique characteristics of art therapy in Virtual Reality are positive emotions, play and exploration, learning and mastery, access, and storage⁶.

Positive Emotions: The immersive and engaging nature of Virtual Reality can create a safe space where people can experience positive emotions. VR can provide an environment where individuals can engage in artistic expression without fear of judgment, fostering self-acceptance and emotional healing.

Play and Exploration: The playful aspect of Virtual Reality allows for creative freedom and experimentation. Users can explore virtual spaces, try new techniques, and engage in activities that may feel less intimidating compared to real-world environments. This exploration promotes a sense of curiosity and joy.

Learning and Mastery: Virtual Reality can offer a structured yet flexible environment for learning new artistic skills. With interactive elements, users can gradually master new techniques at their own pace, which builds confidence and a sense of accomplishment.

Access: One of the major advantages of Virtual Reality art therapy is the ability to reach individuals who might not have access to traditional art therapy. Whether due to geographic limitations, physical disabilities, or other barriers, Virtual Reality can provide an accessible platform for individuals to engage with therapeutic art.

Storage: In Virtual Reality, users can store their creations and return them later. This allows individuals to reflect on their progress, revisit past emotions, and track their personal growth. It can also create a sense of permanence and continuity in their therapeutic journey.

Virtual Reality indeed holds great potential for improving mental health and well-being. It combines creativity with technology in a way that makes the process of self-discovery and healing both enjoyable and effective. Virtual reality can bridge the gap between art and realism⁶.

The most common form of virtual reality in the mental health field is exposure therapy (virtual reality E) where virtual reality replaces the sequential progression of physical exposure which allows the client to have step-by-step control over the experience.

The Concept of Virtual Reality:

The ultimate goal of virtual reality is to make the user feel the sense of being there while experiencing the virtual environment, even if they are physically located anywhere. Being there defines the concept of presence, which is one of the key features of virtual reality. Another key concept of virtual reality is immersion. Although the concepts of presence and immersion are related to one another, these two concepts do not have the same meaning. Immersion is about the technological capability of virtual reality systems.

Art therapy in virtual reality can be viewed as a kind of collage, in which images or selected parts of images are used, cut, and attached to a new network that expresses a different content. So it allows the human the express and reconnection different components of the human mentality⁷.

Virtual Reality Art Setting:

The setting and therapeutic space are influenced by the virtual reality's creative environment, which is driven by the nature of the technology. When using a virtual reality device the participants wear a Head Mounted Display (HMD) and use Tilt Brush within a closed virtual space. Participants operate two hand-held controllers which allow for Motion Capture and Creation (MOCAP) ³.

Fig 1: Virtual Reality Art Setting

One controller is designed for drawing and the other is for the controls and color menus simulating classic painting with a color palette and paintbrush. Both hand and full-body movements are involved. Free movement in space is made possible through HMD-lit grids that mark the boundaries of the physical space. In this way, the client can physically and metaphorically gain control and define the boundaries of the treatment room.

General Procedure

Virtual reality art therapy session is made up of three main segments. The first segment involves giving the client the freedom to choose the medium they feel most comfortable with. If the client prefers to use traditional art materials, they would be working at a dedicated workspace with a table, chair, and all the necessary supplies for their art. If the client chooses to use virtual reality making sure the HMD fits properly and is comfortable is key for the client's experience in virtual reality. Familiarizing the client with the virtual space and controllers will help them feel more at ease and ready to create. It is also a great time to guide them through the layout of the Google Tilt Brush software and the 3D canvas setup so they can focus on their creativity¹⁰.

In the creative process, the therapist accompanies the client in the virtual space on a 2D monitor that displays what the client is creating in her 3D world, as well as talking to the client. Alternating between traditional and digital media can enhance the creative process, allowing the client to connect with their physical work and then bring it into the virtual space for further exploration. Scanning an image or picture to incorporate into the virtual reality workspace can help bridge the gap between the two mediums and provide a deeper layer of personal connection and inspiration for the client¹⁰.

Fig 1: Virtual Reality Art – Creative Process

At the end of the session, the client removes the HMD and transitions back to the physical space, it is an opportunity for the therapist to help the client bridge the gap between the virtual experience and their present emotional or psychological state. This type of reflection allows the client to retain and process the insights gained in the virtual space and weave them into their therapeutic journey. It also helps in grounding the experience and integrating it into their understanding of themselves.

The Therapist's Role in Virtual Reality Therapy:

Therapists play a vital role in the success of virtual reality therapy. Their expertise ensures that virtual reality therapy software is used effectively to meet each patient's unique needs. Therapists begin by assessing the patient's condition and determining the appropriate virtual scenarios for treatment. During sessions, therapists guide patients through the VR experience, offering support and adjustments as needed. They interpret the patient's interactions within the virtual environment and provide real-time feedback to enhance the therapeutic process.

The therapist's role extends to educating patients on how to use Virtual reality equipment safely and effectively. They ensure patients feel comfortable with the technology, which is crucial for maximizing the therapeutic benefits. By combining clinical expertise with advanced technology, therapists ensure that virtual reality therapy is a powerful tool for improving patient outcomes.

Structured Session Plan for Individual Virtual Reality Art Therapy:

The frequency and duration of VR art therapy sessions vary depending on the therapeutic goals and populations involved. A common structure involves conducting weekly sessions over a defined period. Many studies adopting an 8-session format delivered over 8 weeks^10,21.

A sprint approach typically involves delivering multiple sessions within a condensed timeframe, with the primary objectives of generating ideas, developing creative outputs or prototypes, and evaluating or reflecting on them within a short, iterative cycle¹⁶. The number of sessions ranging from a single intervention to as many as seven, depending on the nature of the therapeutic approach and the participant’s level of engagement and responsiveness¹⁷.

Preventing Dependency

To prevent over-reliance on virtual reality (VR) therapy, the intervention was designed to gradually encourage the participant’s transition from virtual experiences to real-world applications. Sessions emphasized skill-building techniques that clients could practice outside the digital environment, fostering autonomy and reducing dependency on the technology. Additionally, participants were encouraged to incorporate the coping strategies and emotional regulation tools learned during VR sessions into their daily lives. This approach aligns with best practices in therapeutic interventions, which stress the importance of promoting self-efficacy and long-term psychological well-being^{10, 21}.

Individualized Work Plan

Each participant's treatment plan was individualized to ensure that the virtual reality (VR) art therapy sessions addressed their specific therapeutic goals, preferences, and emotional needs. The content of the VR sessions, such as the type of art-making activities or virtual environments, was adapted based on the participant's progress and feedback throughout the intervention. The therapist collaborated with each participant to identify personal objectives, such as stress reduction or emotional expression, and adjusted the therapy accordingly to maximize engagement and therapeutic benefit. This personalized approach is essential for ensuring that the therapy remains relevant and effective for each individual, fostering a sense of ownership and agency in the healing process ¹⁸.

Benefits of Virtual Reality in Art Therapy:

1. Enhanced Engagement and Immersion

VR’s immersive nature allows individuals to become fully absorbed in the creative process, reducing distractions and encouraging deeper emotional expression¹⁹.

2. Accessibility and Inclusivity:

People with physical disabilities or mobility issues can participate more easily in Virtual Reality art therapy, as the technology minimizes physical barriers to creative expression²⁰.

3. Stress and Anxiety Reduction:

Engaging with digital art in a VR setting has been shown to lower stress levels and promote relaxation, similar to traditional forms of meditation and mindfulness²¹.

5. Innovative Therapeutic Approaches:

Therapists can integrate Virtual Reality art therapy with other psychological interventions, such as cognitive-behavioral therapy (CBT) or exposure therapy, to enhance treatment outcomes²⁰.

Applications of VR Art Therapy:

· Trauma Recovery: Virtual Reality Art Therapy helps individuals process traumatic experiences by allowing them to visualize and reshape difficult emotions through art¹².

· Mental Health Treatment: People dealing with anxiety, depression, or PTSD can use VR to engage in creative expression, promoting positive mental health¹³.

· Cognitive and Motor Rehabilitation: Individuals recovering from strokes or neurological disorders can use Virtual reality to enhance fine motor skills and cognitive function¹⁵.

· Youth and Adolescent Therapy: Younger individuals find Virtual reality-based art therapy more engaging, making it an effective tool for treating behavioral and emotional challenges¹⁴.

Downsides to VitualReality in Art Therapy:

· When an art therapist focuses on the monitor instead of the client, it can create a sense of detachment, potentially affecting the therapeutic relationship. This split attention might make it harder for the therapist to pick up on nonverbal cues, emotional shifts, or physical discomfort the client is experiencing in real time²².

· It is a key consideration for the early stages of Virtual Reality therapy. Dizziness and disorientation—often linked to cybersickness can be common, especially for first-time users. In extreme cases, symptoms might persist briefly after the session²⁵.

Future of Virtual Reality Art Therapy:

As Virtual Reality technology continues to advance, its potential in therapeutic settings will only expand. Improved haptic feedback, Artificial intelligence-driven customization, and multi-user experiences may further enhance the effectiveness of Virtual Reality Art Therapy. Additionally, making Virtual Reality art therapy more accessible through affordable headsets and software can ensure that more people benefit from this innovative form of healing²⁵.

Virtual reality art therapy is revolutionizing the way we approach mental health treatment and creative expression. By merging technology with therapeutic art, Virtual Reality Art Therapy provides a unique, immersive, and effective means for individuals to heal, grow, and explore their emotions in an entirely new dimension.

REFERENCES:

1. Adams R, Gibson S, Arizona SM, editors. Transdisciplinary digital art: Sound, vision and the new screen. Springer Science & Business Media; 2008. p. 7.

2. Anderson A, et al. Virtual reality interventions in mental health care: A review. J Psychiatr Res. 2022.

3. Biocca F, Delaney B. Immersive virtual reality technology. In: Biocca F, Levy MR, editors. Communication in the Age of Virtual Reality. Vol. 15. Hillsdale, NJ: Erlbaum; 1995. p. 57-421.

4. Botella C, Baños RM, Alcañiz M, et al. The use of VR in psychological treatment: A meta-analysis. Clin Psychol Rev. 2018;63:65-79.

5. Dores A, et al. VR-based art therapy for trauma recovery. J Trauma Stud. 2021.

6. Freeman D, Haselton P, Freeman J, et al. Virtual reality in mental health treatment. Lancet Psychiatry. 2017;4(7):563-572.

7. Haeyen S, Jans N, Heijman J. The use of VR tilt brush in art and psychomotor therapy: An innovative perspective. Arts Psychother. 2021;76:101855. doi:10.1016/j.aip.2021.101855.

8. Hacmun I. The principles of art therapy in virtual reality. Psychol Clin Settings. 2018;9. doi:10.3389/fpsyg.2018.02082.

9. Hinz LD. Expressive Therapies Continuum: A Framework for Using Art in Therapy. Abingdon: Routledge; 2019.

10. Kaimal G. Virtual reality in art therapy: A pilot qualitative study of the novel medium and implications for practice. J Am Art Ther Assoc. 2020;37(1).

11. Laver K, Lange B, George S, et al. Virtual reality in stroke rehabilitation: Systematic review. Neurorehabil Neural Repair. 2019;33(9):775-788.

12. Leff J, Lee J, Wills R, et al. VR applications in disability inclusion. Disabil Rehabil Assist Technol. 2020;15(7):802-808.

13. Malchiodi CA. The Soul's Palette: Drawing on Art's Transformative Powers. Berkeley, CA: Shambhala Publications; 2002.

14. McLay R, et al. Youth engagement in VR therapy. J Adolesc Ther. 2020.

15. Nouchi R, Kawashima R. Effects of virtual reality on the human brain: Current research and future directions. Front Psychol. 2019;10:1655.

16. Chirico A, Serino S, Cipresso P, Gaggioli A, Riva G. Developing virtual reality therapy for mood disorders: A focus on contemplative practices. J Med Internet Res. 2016;18(6):e157. doi:10.2196/jmir.5568

17. Gao Z, Lee JE, McDonough DJ, Albers C. Virtual reality exercise as a health intervention: A review of the literature. J Clin Med. 2021;10(17):3635. doi:10.3390/jcm10173635

18. Haeyen S, van Hooren S, van der Veld W, Hutschemaekers G. Measuring the contribution of art therapy in multidisciplinary treatment of personality disorders. Arts Psychother. 2015;45:1-10. doi:10.1016/j.aip.2015.01.001

19. Prensky M. Digital natives, digital immigrants. Horizon. 2001;95:1-6.

20. Regev D, Snir S. Parent-Child Art Psychotherapy. Abingdon: Routledge; 2017.

21. Riva G, Wiederhold B, Mantovani F, et al. Virtual reality therapy: A clinical perspective. Front Psychiatry. 2021;12:751.

22. Rizzo AS, Koenig ST. Is clinical virtual reality ready for prime time? Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 2017; 24(1): 1-21.

23. Shamir Zeevi L. Making art therapy virtual: Integrating virtual reality into art therapy with adolescents. Front Psychol. 2021;12:584943. doi:10.3389/fpsyg.2021.584943.

24. Shwartz H. Dialogue with Forgotten Voices: Relational Perspectives on Child Abuse Trauma and Treatment of Dissociative Disorder. New York, NY: Basic Books; 2000.

25. Slater M, Sanchez-Vives MV. Enhancing our lives with immersive virtual reality. Front Robot AI. 2016; 3:74.

Received on 06.03.2025 Revised on 13.06.2025

Accepted on 07.08.2025 Published on 21.02.2026

Available online from February 23, 2026

Asian J. Nursing Education and Research. 2026;16(1):49-53.

DOI: 10.52711/2349-2996.2026.00011

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Creative Commons License.