Prospects for using systematic desensitization in virtual reality for resocialization of combat veterans
Abstract
Background. In the context of modern comprehensive psychological rehabilitation, habilitation, and readaptation of combat veterans, there is a high need to develop effective methods for reducing their distress and anxiety.
Objective. The study had its purpose to provide a theoretical review for substantiating the scientific and methodological principles of resocialization for combat veterans.
Methods. The study employed the method of theoretical analysis and generalization of domestic and foreign sources on the problem of resocialization for combat veterans.
Results. Meta-analytic data indicate that systematic desensitization based on virtual reality demonstrates effectiveness in reducing anxiety and distress in post-traumatic stress disorder and social phobias, offering advantages over traditional exposure therapy, including greater procedural flexibility and consideration of patient preferences. Its integration with eye movement desensitization and reprocessing, biofeedback, and transcranial stimulation enhances the therapeutic effect. Public speaking training in a virtual reality environment appears prospective for promoting active resocialization by developing communication and speech skills.
Conclusions. The innovative method of cognitive-behavioral therapy by means of virtual reality exposure enables high potential for restoring the integrity of personality functioning by creating situations in which the individuals actively organize their own activity. Systematic desensitization in virtual reality, supplemented by the principle of subject's activity implemented through public speaking training, serves as an effective means of reducing distress and developing communication skills. It can be regarded as a promising direction in the resocialization of combat veterans. The conducted analysis highlights the necessity of normative regulation of resocialization as a comprehensive set of measures including systematic desensitization, social support, training and, consequently, the establishment of specialized socio-rehabilitation institutions for combat veterans.
References
Alekseeva, M.V., Almazova, O.V., Batysheva, T.T., et al. (2025). Scientific foundations of comprehensive psychological rehabilitation, habilitation, resocialization and readaptation of combat veterans and their family members. Moscow: Moscow University Press. (In Russ.)
Bastrykin, A.I., Salnikov, V.P., Romanovskaya, V.B., Voronkov, K.I. (2020). Anti-criminogenic resocialization: foreign experience. Vserossiiskii kriminologicheskii zhurnal = All-Russian Criminological Journal, 14(3), 371–378. (In Russ.)
Erilov, N.A., Pepelyaev, A.V. (2023). Application of virtual reality in military training centers: pedagogical aspect and practical significance. In: Theory and Practice of Military Education in Civilian Universities: Pedagogical Search. VI All-Russian Scientific and Practical Conference with International Participation (November 16–17, 2023). (pp. 86–91). Ekaterinburg: UMC UPI Publ. (In Russ.)
Golovanova, I.I. (2009). Methodology of public speaking. Kazan: Center for Innovative Technologies Publ. (In Russ.)
Minenko, K.O., Minenko, A.O. (2023). System of resocialization efforts, social adaptation and social rehabilitation of pardoned participants of the special military operation. Filosofiia prava = Philosophy of Law, 3(106), 125–134. (In Russ.)
Postnov, V.V., Nikiforov, I.A., Kostyuk, G.P., Burygina, L.A., Belova, M.Yu., et al. (2023). Psychocorrection and psychotherapy in medical rehabilitation: Textbook for psychiatrists, addiction psychiatrists, clinical residents and graduate students. Moscow: Poster-M Publ. (In Russ.)
Semiglasova, T.Yu., Kluge, V.A., Kasparov, B.S., Kondratyeva, K.O., Krutov, A.A., Zernova, M.A., Semiglasov, V.V. (2018). International model of rehabilitation of oncological patients. Meditsinskii sovet = Medical Council, (10), 108–116. (In Russ.)
Smolenko, E.D., Dudarev, A.N. (2009). Ergotherapy and physical rehabilitation in psychiatry: lectures. Vitebsk: VGU im. P.M. Masherova Publ. (In Russ.)
Vygotsky, L.S. (1982). Collected works: in 6 vol. Vol. 1. Historical meaning of the psychological crisis. Moscow: Pedagogika Publ. (In Russ.)
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Washington: APA Publ.
Beck, A.T., Emery, G., Greenberg, R.L. (2005). Anxiety disorders and phobias: A cognitive perspective. New York: Basic Books Publ.
Beidel, D.C., Rao, P.A., Scharfstein, L., Wong, N., Alfano, C.A. (2010). Social skills and social phobia: an investigation of DSM-IV subtypes. Behaviour Research and Therapy, 48(10), 992–1001. http://doi.org/10.1016/j.brat.2010.06.005
Bisson, J.I., van Deursen, R., Hannigan, B., Kitchiner, N., Barawi, K., Jones, K., Pickles, T., Skipper, J., Young, C., Abbott, L.R., van Gelderen, M., Nijdam, M.J., Vermetten, E. (2020). Randomized controlled trial of multi-modular motion-assisted memory desensitization and reconsolidation (3MDR) for male military veterans with treatment-resistant post-traumatic stress disorder. Acta Psychiatrica Scandinavica, 142(2), 141–151. http://doi.org/10.1111/ACPS.13200
Dalrymple, K.L., Zimmerman, M. (2011). Treatment-seeking for social anxiety disorder in a general outpatient psychiatry setting. Psychiatry Research, 187(3), 375–381. https://doi.org/10.1016/j.psychres.2011.01.004
Dobson, K.S., Dozois, D.J.A. (2019). Handbook of cognitive-behavioral therapies (4th ed.). New York: The Guilford Press.
Emmelkamp, P.M., Krijn, M., Hulsbosch, A.M., de Vries, S., Schuemie, M.J., van der Mast, C.A. (2002). Virtual reality treatment versus exposure in vivo: a comparative evaluation in acrophobia. Behaviour Research and Therapy, 40(5), 509–516. http://doi.org/10.1016/s0005-7967(01)00023-7
Garcia-Palacios, A., Botella, C., Hoffman, H., Fabregat, S. (2007). Comparing acceptance and refusal rates of virtual reality exposure vs. in vivo exposure by patients with specific phobias. Cyberpsychology & Behavior, 10(5), 722–724. http://doi.org/10.1089/cpb.2007.9962
Gorinelli, S., Gallego, A., Lappalainen, P., Lappalainen, R. (2023). Virtual reality acceptance and commitment therapy intervention for social and public speaking anxiety: A randomized controlled trial. Journal of Contextual Behavioral Science, (28), 289–299. http://doi.org/10.1016/j.jcbs.2023.05.004
Graham, W.M., Drinkwater, R., Kelson, J., Kabir, M.A. (2025). Self-guided virtual reality therapy for anxiety: A systematic review. International Journal of Medical Informatics, 200(1), 1–17. http://doi.org/10.1016/j.ijmedinf.2025.105902
Jonathan, N.T., Bachri, M.R., Wijaya, E., Ramdhan, D., Chowanda, A. (2023). The efficacy of virtual reality exposure therapy (VRET) with extra intervention for treating PTSD symptoms. Procedia Computer Science, (216), 252–259. http://doi.org/10.1016/j.procs.2022.12.134
Kuleli, D., Tyson, P., Davies, N.H., Zeng, B. (2025). Examining the comparative effectiveness of virtual reality and in-vivo exposure therapy on social anxiety and specific phobia: A systematic review & meta-analysis. Journal of Behavioral and Cognitive Therapy, 35(2), 1–14. http://doi.org/10.1016/j.jbct.2025.100524
Lindner, P., Miloff, A., Fagernäs, S., Andersen, J., Sigeman, M., Andersson, G., Furmark, T., Carlbring, P. (2019). Therapist-led and self-led one-session virtual reality exposure therapy for public speaking anxiety with consumer hardware and software: A randomized controlled trial. Journal of Anxiety Disorders, (61), 45–54. http://doi.org/10.1016/j.janxdis.2018.07.003
Maples-Keller, J.L., Jovanovic, T., Dunlop, B.W., Rauch, S., Yasinski, C., Michopoulos, V., Coghlan, C., Norrholm, S., Rizzo, A.S., Ressler, K., Rothbaum, B.O. (2019). When translational neuroscience fails in the clinic: Dexamethasone prior to virtual reality exposure therapy increases drop-out rates. Journal of Anxiety Disorders, (61), 89–97. http://doi.org/10.1016/j.janxdis.2018.10.006
McGinn, L.K., Newman, M.G. (2013). Status update on social anxiety disorder. International Journal of Cognitive Therapy, 6(2), 88–113. https://doi.org/10.1521/ijct.2013.6.2.88
Mitsui, N., Fujii, Y., Asakura, S., Imai, H., Yamada, H., Yoshinaga, N., Kanai, Y., Inoue, T., Shimizu, E. (2022). Antidepressants for social anxiety disorder: A systematic review and meta-analysis. Neuropsychopharmacology Reports, 42(4), 398–409. http://doi.org/10.1002/npr2.12275
Morales, C., Luks, K.L., Sibrava, N.J. (2023). Cognitive-behavioral therapy. In H.S. Friedman, C.H. Markey, (eds.), Encyclopedia of mental health (third edition). (pp. 438–447). New York: Academic Press.
Noda, S., Nishiuchi, M., Andreoli, G., Shirotsuki, K., Hofmann, S.G. (2025). Network structure of social anxiety in patients with social anxiety disorder and university students: Examining the cognitive behavioral model and the role of mindfulness. Journal of Affective Disorders, (387), 1–10. http://doi.org/10.1016/j.jad.2025.119498
Reeves, R., Curran, D., Gleeson, A., Hanna, D. (2022). A meta-analysis of the efficacy of virtual reality and in vivo exposure therapy as psychological interventions for public speaking anxiety. Behavior Modification, 46(4), 937–965. http://doi.org/10.1177/0145445521991102
Reeves, R., Elliott, A., Curran, D., Dyer, K., Hanna, D. (2021). 360° video virtual reality exposure therapy for public speaking anxiety: A randomized controlled trial. Journal of Anxiety Disorders. URL: https://www.sciencedirect.com/science/article/abs/pii/S0887618521000980?via%3Dihub (access date: 12.08.2020).
Salari, N., Heidarian, P., Hassanabadi, M., Babajani, F., Abdoli, N., Aminian, M., Mohammadi, M. (2024). Global prevalence of social anxiety disorder in children, adolescents and youth: a systematic review and meta-analysis. Journal of Prevention, 45(5), 795–813. http://doi.org/10.1007/s10935-024-00789-9
Seuling, P.D., Czernin, N.S., Schiele, M.A. (2024). Virtual Reality exposure therapy in the treatment of public speaking anxiety and social anxiety disorder. Neuroscience Applied, (3), 1–11. https://doi.org/10.1016/j.nsa.2024.104074
Shapiro, F. (1989). Efficacy of the eye movement desensitization procedure in the treatment of traumatic memories. Journal of Traumatic Stress, 2(2), 199–223. http://doi.org/10.1007/BF00974159
Stein, D.J., Lim, C.C.W., Roest, A.M. et al. (2017). The cross-national epidemiology of social anxiety disorder: Data from the World Mental Health Survey Initiative. BMC Medicine, 15(143), 1–21. http://doi.org/10.1186/s12916-017-0889-2
Tang, X., Liu, Q., Cai, F., Tian, H., Shi, X., Tang, S. (2022). Prevalence of social anxiety disorder and symptoms among Chinese children, adolescents and young adults: A systematic review and meta-analysis. Frontiers in Psychology, (13), 1–13. http://doi.org/10.3389/fpsyg.2022.792356
Taylor, S. (2002). Classical conditioning. In: M. Hersen, W. Sledge, (eds.). Encyclopedia of psychotherapy. (pp. 415–429). New York: Academic Press
Trent, E.S., Zhou, R.J., Mammo, L., Goodman, W.K., Storch, E.A. (2025). High intensity approaches to exposure and response prevention for obsessive-compulsive disorder. Behavioural Brain Research. URL: https://www.sciencedirect.com/science/article/pii/S0166432825000130 (access date: 26.09.2024).
van Gelderen, M.J., Nijdam, M.J., Haagen, J.F.G., Vermetten, E. (2020). Interactive motion-assisted exposure therapy for veterans with treatment-resistant posttraumatic stress disorder: A randomized controlled trial. Psychotherapy and Psychosomatics, 89(4), 215–227. http://doi.org/10.1159/000505977
van ‘t Wout-Frank, M., Shea, M.T., Larson, V.C., Greenberg, B.D., Philip, N.S. (2019). Combined transcranial direct current stimulation with virtual reality exposure for posttraumatic stress disorder: Feasibility and pilot results. Brain Stimulation, 12(1), 41–43. http://doi.org/10.1016/j.brs.2018.09.011
Vermetten, E., Lanius, R.A. (2012). Biological and clinical framework for posttraumatic stress disorder. In: M.J. Aminoff, F. Boller, D.F. Swaab, (eds.). Handbook of Clinical Neurology. (pp. 291–342). Amsterdam: Elsevier Publ.
Wolpe, J. (1961). The systematic desensitization treatment of neuroses. The Journal of Nervous and Mental Disease, 132(3), 189–203. http://doi.org/10.1097/00005053-196103000-00001
Wolpe, J. (1968). Psychotherapy by reciprocal inhibition. Conditional Reflex: A Pavlovian Journal of Research & Therapy, 3(4), 234–240. http://doi.org/10.1007/BF03000093
Received: 10/17/2025
Revised: 01/07/2026
Accepted: 02/12/2026
Keywords: systematic desensitization; resocialization; training; public speaking; virtual reality exposure cognitive-behavioral therapy; post-traumatic stress disorder; combat veterans
DOI: https://doi.org/10.11621/TEP-26-10
Available in the on-line version with: 07.04.2026
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