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In particular, the effectiveness of VR-based exposure therapy (VRET) has been well-demonstrated for treatment of anxiety disorders. However, most applications of VRET remain localized to clinic spaces. We aimed to explore mental health therapists\u2019 perceptions of telehealth-based VRET (tele-VRET) by conducting semi-structured, qualitative interviews with 18 telemental health therapists between October and December 2022. Interview topics included telehealth experiences, exposure therapy over telehealth, previous experiences with VR, and perspectives on tele-VRET. Therapists described how telehealth reduced barriers (88.9%, 16\/18), enhanced therapy (61.1%, 11\/18), and improved access to clients (38.9%, 7\/18), but entailed problems with technology (61.1%, 11\/18), uncontrolled settings (55.6%, 10\/18), and communication difficulties (50%, 9\/18). Therapists adapted exposure therapy to telehealth by using online resources (66.7%, 12\/18), preparing client expectations (55.6%, 10\/18), and adjusting workflows (27.8%, 5\/18). Most therapists had used VR before (72.2%, 13\/18) and had positive impressions of VR (55.6%, 10\/18), but none had used VR clinically. In response to tele-VRET, therapists requested interactive session activities (77.8%, 14\/18) and customizable interventions components (55.6%, 10\/18). Concerns about tele-VRET included risks with certain clients (77.8%, 14\/18), costs (50%, 9\/18), side effects and privacy (22.2%, 4\/18), and inappropriateness for specific forms of exposure therapy (16.7%, 3\/18). These results reveal how combining telehealth and VRET may expand therapeutic options for mental healthcare providers and can help inform collaborative development of immersive health technologies.<\/jats:p>","DOI":"10.1007\/s10055-024-00956-7","type":"journal-article","created":{"date-parts":[[2024,3,8]],"date-time":"2024-03-08T04:02:33Z","timestamp":1709870553000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Therapist perspectives on telehealth-based virtual reality exposure therapy"],"prefix":"10.1007","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2512-2026","authenticated-orcid":false,"given":"Triton","family":"Ong","sequence":"first","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5852-200X","authenticated-orcid":false,"given":"Julia","family":"Ivanova","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2054-3737","authenticated-orcid":false,"given":"Hiral","family":"Soni","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3034-0087","authenticated-orcid":false,"given":"Hattie","family":"Wilczewski","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1010-6365","authenticated-orcid":false,"given":"Janelle","family":"Barrera","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7078-8479","authenticated-orcid":false,"given":"Mollie","family":"Cummins","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2214-9282","authenticated-orcid":false,"given":"Brandon M.","family":"Welch","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4964-0688","authenticated-orcid":false,"given":"Brian E.","family":"Bunnell","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2024,3,8]]},"reference":[{"key":"956_CR1","first-page":"1","volume":"3","author":"K Aafjes-Van Doorn","year":"2023","unstructured":"Aafjes-Van Doorn K, B\u00e9k\u00e9s V, Luo X, Hopwood CJ (2023) Therapists\u2019 perception of the working alliance, real relationship and therapeutic presence in in-person therapy versus tele-therapy. 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