Partner organization: Mentaal Beter, Mental Care Group
Study type: comparative study with two groups
N: VR group 57 clients, control group 38 clients

Background and aim
Within trauma care, treatment capacity and waiting times are structural challenges. Interventions that can shorten total treatment time without loss of clinical quality are therefore relevant for both clients and care organizations. Autonomous use of VR at home between regular sessions is an approach that may enable intensification of exposure and processing without a proportional increase in face to face time. The aim of this study was to examine whether autonomous use of EMDR in VR at home results in comparable outcomes on trauma symptoms and general mental health, with a shorter total treatment duration, compared with traditional EMDR treatment without VR.

Experimental design
The study included two groups. In the VR group, clients used the VR application independently at home four times within two weeks, in between regular sessions with the clinician. The control group received standard EMDR treatment without VR. The comparison focused on treatment duration and outcomes on core measures for trauma symptoms and mental health.

Outcome measures
Trauma symptoms were assessed with the PCL 5 questionnaire. General mental health was assessed with the MHC SF questionnaire. In addition, total treatment duration in minutes was compared between groups. Satisfaction and treatment adherence were included as process outcomes, because intensifying autonomous sessions is only clinically relevant when clients sustain use and experience it as acceptable.

Results
The VR group showed a shorter treatment duration with a reduction of more than 20 percent. Total treatment duration was 617 minutes in the VR group compared with 786 minutes in the control group. Despite this reduction in time, reported outcomes were comparable between groups on trauma symptoms and satisfaction. Adherence was also comparable, suggesting that intensification via home use was not associated with clearly increased dropout or reduced acceptability.

Interpretation and clinical relevance
The findings suggest that autonomous EMDR in VR at home may provide a route to efficiency gains within trauma care, without being accompanied in this comparison by worse outcomes on the reported core measures. Clinically, this may fit within blended care or stepped care models, in which face to face sessions are supplemented with structured autonomous interventions. A plausible advantage is that clients can practice more frequently in a familiar environment, which may increase the intensity of processing. At the same time, appropriate indication is essential. Not every client is suitable for autonomous work, for example in cases of severe dissociation, limited stabilization, or preference for maximal therapeutic proximity. The results therefore do not support a one size fits all model, but rather a differentiated approach in which autonomy is offered as an option when appropriate.

Limitations
The available information describes core results, but without details on randomization, blinding, or follow up. Caution is therefore needed in causal interpretation. It is also important for future studies to focus on mechanisms, safety, and subgroups to determine for whom this approach is most suitable.

Conclusion
In this comparison, autonomous EMDR VR home use was associated with a substantial reduction in total treatment time, while outcomes on trauma symptoms, mental health, satisfaction, and adherence were comparable to standard EMDR. These findings provide relevant scientific support for Psylaris Care in autonomous and blended implementation, with emphasis on appropriate selection and careful embedding in treatment processes.