Virtual reality exposure therapy for music performance anxiety: evidence, advantages, and future directions

This study examines the use of Virtual Reality Exposure Therapy (VRET) as a novel intervention approach for addressing Music Performance Anxiety (MPA), a form of anxiety experienced by musicians during performance. MPA is a widespread phenomenon across levels of expertise, genres, and cultural backgrounds, and it negatively affects psychological well-being and musical performance quality. Although traditional interventions like cognitive-behavioral therapy (CBT), relaxation training, and in vivo exposure have proven effective, these methods often face constraints in terms of exposure intensity control, accessibility, standardization, and acceptability among highly anxious musicians. Findings indicate that VRET offers significant advantages, including immersive environments, adjustable and customizable exposure levels, repeatable performance scenarios, and improved access to treatment. The empirical studies reviewed suggest that VRET is effective in reducing performance anxiety, improving physiological responses such as heart rate variability, and enhancing overall music performance quality. However, the article also emphasizes that VRET should not be considered a complete replacement for traditional methods. Live performance continues to play a crucial role in artistic development, social communication, and stage sensitivity. Therefore, a more effective approach may lie in an integrative model that combines VRET with conventional interventions within a comprehensive therapeutic and music training framework. In conclusion, VRET holds substantial potential as a supportive tool in managing music performance anxiety, particularly in terms of flexibility, safety, and therapeutic effectiveness. Nevertheless, further research employing longitudinal designs, standardized protocols, and interdisciplinary collaboration is required to optimize its application and ensure sustainable long-term benefits for musicians’ psychological well-being and artistic development.