The Future of Virtual Reality and Therapeutic Art-Making
What role can virtual reality (VR) play in therapeutic art approaches for patients? In this article, we will review two recent publications that explored this question.
The first is a quality improvement study from Stanford Health Care, where VR-assisted therapeutic art programs were offered to adult inpatients. The second is a scoping review of 26 publications on the topic to determine advantages and disadvantages of VR-assisted therapeutic art programs.
Before diving into the science, let’s review a few definitions.
Art Therapy is a psychotherapeutic process of creative art-making found to reduce pain, anxiety, stress, and improve coping in patients. It is facilitated by a professional art therapist holding a masters degree in art therapy.
By contrast, Therapeutic Art-Making is the creative process of artmaking that does not require facilitation by an art therapist. Its goals and applications are broader to include creative expression and experimentation. While not a psychotherapeutic process, it has similarly been found to reduce stress and anxiety, and improve overall well-being.
Virtual Reality is a sensory immersion experience supported by virtual, computer-generated environments.
VR assisted art therapy and therapeutic art-making involves creative expression within computer-generated immersive environments.
The following studies seek to elaborate on our understanding of the role, applications, benefits and potential risks related to VR-assisted art making for patient populations.
Results from the Stanford Quality Improvement Study
From February - June 2024, 105 participants were enrolled in a quality improvement project at Stanford Health Care, out of which 40 completed the full VR art experience and survey. Adult hospital inpatients identified as having a need for adaptive art tools, for example those who had physical limitations due to their medical conditions, were offered VR-assisted art therapy.
A VR facilitator met these patients at their bedside to assist their engagement with one of two artmaking applications using a VR headset. These applications were Tilt Brush and Color Space - painting and coloring VR apps respectively.
Of the 40 participants who completed the intervention, 85% reported that they were “very likely” to recommend this program to others and 97% indicated that the program had an impact on their overall hospital experience.
Participants responded to open-ended survey questions, which uncovered 4 themes of benefits:
Escape & Distraction: The VR program offered an escape from the hospital environment and a welcome distraction from their medical concerns.
Therapeutic: Participants felt that the experience was calming and beneficial to their overall wellbeing.
Enjoyment: Individuals described the program as both fascinating and engaging.
Positive Facilitator Interactions: Patients appreciated the kindness and helpfulness demonstrated by the VR facilitator.
In addition, patients suggested the following improvements:
More Access and Time: Participants expressed an interest in being able to “rent” the VR headset from the nurse’s station for ease and flexibility of access.
Program Variety: Survey respondents expressed interest in additional VR applications, including meditation and music studio programs.
While this quality improvement project offers insights to innovative approaches for therapeutic art programs to adults in inpatient settings, the results are limited by not being a controlled study. This means that there was no comparison group to assess benefits to those who engage in the program versus those who do not.
Additionally, after reading the publication, I am left with the following questions that may offer helpful direction for future studies or replication of the program model at other healthcare institutions:
Only 38% of initially enrolled patients completed the study - what held back participants from compliance with study completion?
What was the duration of each VR session?
What was the exact role of the facilitator?
Advantages and Disadvantages
Separately, a scoping review of VR-assisted art therapy was published in 2023 that sought to answer how VR has been integrated into art therapy and the applicability of VR interventions for achieving therapeutic goals in relation to traditional art therapy. A total of 26 studies published between 2011-2022 were included in this review, and the following advantages and disadvantages were found across the studies:
Advantages
Safe Spaces. Virtual environments could be tailored according to the client’s needs to create “safe spaces” of familiarity that enhance opportunities for self-reflection and meditation.
Minimizing Distractions. VR-assisted programs decreased distracting thoughts while also eliciting attention, awareness, presence and embodiment.
Expanding Perspectives. The ability to view objects from different vantage points in virtual environments gave rise to broad and fresh perspectives.
Portability. The portability of VR headsets allowed for their use in a variety of settings.
Decreased Anxiety. Participants in VR-assisted artmaking demonstrated a reduction in feelings of anxiety.
Appeal to Tech-Savvy Generations. People who grew up with high technology use may feel more comfortable with VR therapeutic interventions than with traditional art therapy, thereby also increasing rapport between the client and therapist.
Disadvantages
Tactile Stimulation. As compared to using traditional artmaking materials, VR-assisted programs do not provide the same level of tactile stimulation.
Professional Training. Most art therapists don’t have training in VR technology and so they feel like they don’t have clear direction on how to incorporate it.
Confidentiality. Clients may have concerns about their confidentiality and privacy with regards to how data is accumulated and used during their VR sessions.
Barriers to Inclusivity. VR is not appropriate for all patients; among those who do not qualify for VR use are children <12 years old, those with vestibular issues, major neurocognitive disorders, those prone to headache and nausea, and hallucinations.
Limited Tools and Materials. As compared to physical artmaking materials, VR-assisted programs offer a limited number of tools and materials.
Isolation. May impair client-therapist relationship through difficulties reading facial and social cues when using VR headsets.
Cost. The costs associated with obtaining and maintaining VR equipment and associated software may be a hindrance to accessibility.
In conclusion, VR-assisted therapeutic art making activities may play a role in reducing stress and anxiety in patients, while also increasing coping and resilience through embodiment and presence. These studies offer a foundation for further research and broader applicability of this innovative tool within healthcare settings.
Further research, through controlled studies and pilot programs, will be helpful to determine specific recommendations with regards to ideal populations, dose and duration of VR-assisted sessions, and to evaluate for potential adverse effects.
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Resources:
Hartley L, Varma S. Art as therapy in virtual reality: A scoping review. Front Virtual Real. 2023;4:1065863. doi:10.3389/frvir.2023.1065863
McDaniel S, Pines R, He EM, Collins F, Arshad F, Menendez M, Prabhu VG, Caruso TJ. Virtual Reality Therapeutic Art for Adult Hospitalized Patients and Caregivers: A Mixed-Methods Project. J Patient Exp. 2025 Mar 25;12:23743735251330467. doi: 10.1177/23743735251330467. PMID: 40144534; PMCID: PMC11938894.