Highly Interactive Virtual Reality Solutions

CleVR specializes in creating complete and customized Virtual Reality (VR) solutions from scratch, from developing the software base to designing the hardware framework, while providing service & support and user training after the delivery of our products.

An impression of our CleVRET system.

The VR systems are based on a treatment technique called Virtual Reality Exposure Therapy (VRET). VRET has been scientifically proven[1] [2] [3] to be effective by the University of Amsterdam (UvA) and the Delft University of Technology (TU Delft) after a decade of research; and many other international research groups. CleVR combines the effectiveness of exposure therapy with the accessibility of a virtual environment. Treatment with VRET offers advantages for both the participant and the therapist. The research validated that VRET is an effective method to treat fear of flying and fear of heights. By the end of 2013 more than 1000 people are treated successfully for their fear of flying or fear of heights.

The participant observes a virtual world through a head mounted display (HMD) which allows the participant to look around in all directions within the virtual environment.

Advantages using Virtual Reality Exposure Therapy (VRET)

  • VRET allows the therapist to control a large variety of situations and to create many different scenarios with different level of anxiety.
  • During the efficient sessions the therapist will gain a good insight in which situations are most troublesome for the participant. He can use this to tailor the treatment specifically for each participant. The therapist can expose the participant gradually to his fears, whenever the participant is ready for the next challenge.
  • Participants treated with VRET require fewer sessions to overcome their fears.
  • The therapist has complete control – just one push on the button and the participant is back in the real world.
  • VRET offers more security. The participant never has to leave the room of the therapist to encounter his fears. The participant has 100% privacy.
  • Low refuse rate. Research has shown that participants are much more likely to follow a VRET treatment than a regular cognitive treatment. [4]

Prior to each treatment session with Virtual Reality the participant and the therapist do an intake session. During their session the therapist makes an inventory of which conditions trigger the fears of the participant. This information allows the therapist to tailor the exact content of the therapy. In the field of mental health VRET is always executed by a psychologist using cognitive behavioral therapy.

The VRET system features a complete virtual reality experience that allows the patient to see the virtual environment through a Head Mounted Display (HMD), also known as 3D/VR-goggles, enabling the patient to look around in a natural manner. A tracking device translates the participant's view direction and movement in the real world to corresponding actions in the virtual environment. The patient can navigate through the virtual environment (either freely or in a guided manner) while interacting with all kinds of elements such as avatars (virtual characters). The therapists can influence the simulation using a user-friendly control panel (graphical user interface). The virtual environment is fully customized with vivid high quality graphics and audio enabling a natural and realistic simulation. Several scenarios can be included in order to offer a diversity of simulations.

Custom built Software

CleVR delivers highly interactive custom built VR software for a wide range of purposes in the (Mental) Health Care sector (such as fear of heights, fear of flying, Psychosis and Social Phobia) and training sector, where the participant is able to interact with the computer in a natural and intuitive way. The therapist controls this world with user-friendly software. This graphical user interface follows a uniform design for each world, which is based on extensive research[5] [6] .

Our software is always developed in co-creation with researchers (Universities), therapists (Mental Health Centers), trainers and end-users. This collaboration is our base to develop an effective and efficient product using VR, which is suitable and accepted in the market.

VR can also be used to develop training solutions for customized company training courses such as skill-training and safety-training. This new method can result in higher efficiency and better results.

CleVRET worlds

CleVRET (fear of flying, fear of heights)

One of our first products is a Virtual Reality system used for the treatment of fear of flying and fear of heights. This system is based on a treatment technique called Virtual Reality Exposer Therapy (VRET). This method offers certain advantages over the current ‘in vivo’ exposure therapy method in which the therapist and the participant encounter the fears of the participant together. Examples are visiting a high building or taking the airplane under guidance of the therapist. VRET also enables a new treatment method where people can easily, gradually and repeatedly be exposed to their fearful situations.

Therapists have the possibility to repeat a specific phase of a flight, for example simulating the take-off and landing procedure multiple times. Different scenarios can be chosen to simulate different flight experience like flying at night, during a thunderstorm, in the clouds or under a blue sky. Beside the convincing 3D images there are authentic sounds and realistic vibrations that will give the participants a more realistic flight experience.

Psychosis and Social Phobia

CleVR collaborates in a new research project for the treatment of Psychosis. A new Virtual Reality (VR) solution has already been developed by CleVR for this project, where psychotic people with symptoms of paranoia and social anxiety are virtually exposed to several social situations. CleVR created a software platform for the pilot and Randomized Controlled Trial (RCT) of this Psychosis project. The research focuses mainly on how VR could be used in order to treat Psychosis more efficiently and effectively.

This software includes four virtual worlds:

  • A shopping street – The participant gets the impression of walking through a lively shopping street. There are open areas of varying sizes and a narrow alley.
  • A bus tour – The participant is able to go on a virtual bus trip through a large city. The bus can be empty or filled with avatars (virtual characters).
  • A supermarket - The participant can walk around in a busy virtual supermarket.
  • A bar – In this world the participant can be exposed to a realistic situation with interaction in a bar or restaurant.

Within the various virtual worlds the therapist has the possibility to alter the virtual environment. The therapist is able to change the expressions on the faces of the avatars (virtual characters with dynamic emotions) and to modify their behavior, make them friendly or hostile and even dictate what they say. The ethnicity, the number of avatars and the number of male and female avatars can also be altered. The patients are being exposed to a controlled (virtual) social environment. The complexity of the environment and the level of exposure within a social (virtual) environment can gradually be increased or decreased by the therapist. The idea is that patients will become less anxious, learn to cope with their feelings of paranoia and will ultimately stop feeling the need to avoid social situations. These VR treatments are performed within the safety of a therapy room, so privacy should not be an issue. The therapist is able to observe in what circumstances certain behavioral patterns develop, so a more effective treatment will be possible.

Dynamic Virtual Emotions

CleVR has the ability to simulate dynamic emotions in avatars. This allows CleVR to create unique virtual social situations in which avatars are able to have an emotional state, along with corresponding facial expressions. By applying such emotional states to groups of avatars, the overall atmosphere within the virtual environment can be influenced.

Emotions in avatars result in projects like the D-Escalator, Psychosis and Social Phobia where aggressive avatars can interact with the participant and specifically within the D-Escalator project to recreate an escalating situation. This interaction could also be intensified with a hostile atmosphere within the virtual area.

CleVR Virtual Dynamic Emotions

Emotional avatars will be able to display six basic emotions (happy, sad, angry, scared, disgusted and surprised) next to the neutral emotion and many combinations of emotions. The intensity of the facial expressions is influenced by the emotional state of an avatar, whose mood can be dynamically altered by certain triggers or events.

An impression of the Dynamic Virtual Emotions.


CleVR uses high-quality hardware for its framework. The Virtual Reality system integrates real-time computer graphics, body-tracking devices, visual displays, physiological measurement systems and other sensory input devices to immerse participants in a computer generated virtual environment.

The participant is confronted with a simulated situation by displaying a virtual environment with provocative elements on a display such as a Head Mounted Display (HMD). A tracking device translates the participant's view direction and movement in the real world to corresponding actions in the virtual environment. Using an HMD gives a superior immersion compared to regular displays or projections. Combined with a head tracker the experience of realism is raised to a unique level.

The physiological measurement systems are for example used for heart-rate and galvanic skin response (GSR) measurements. The combination of the data are used to measure the stress levels, which can be used as input data for the virtual world. Different stress levels can automatically result in different scenarios within a virtual world, without the need for any manual intervention. Other sensor systems like body tracking devices (for example Microsoft Kinect sensor), can also be used to alter the scenario within a virtual world.

For each product, CleVR finds a hardware combination that is suitable for the software and that fits the customer's requirements. For instance some customers require a notebook instead of the powerful gaming computer. CleVR will advise the customer which hardware fits best with the software made for the customer. CleVR will install and supply all required hardware for VR systems.

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Support & Training

CleVR offers optional training sessions tailored to the demands of the customer. Our software is easy to use and mastered with one or two training sessions. We offer technical support on-demand or in packages tailored for the customer. We also offer hardware replacement options to bridge repair time in case of a hardware defect.


1. ^. M. Krijn, P.M.G. Emmelkamp, R.P. Ólafsson, M. Bouwman, L.J. van Gerwen, P. Spinhoven, M.J. Schuemie, and C.A.P.G. van der Mast (2007). Fear of flying treatment methods: virtual reality exposure vs. cognitive behavioral therapy. Aviat Space Environ Med 2007; 78:121-128.

2. ^. M.B. Powers and P.M. Emmelkamp (2007). Virtual reality exposure therapy for anxiety disorders: A meta-analysis. J Anxiety Disord. 2008;22(3):561-9. Epub 2007 Apr 27.

3. ^. J. Wiersma, A. Greeven, E. Berretty, M. Krijn, and P.M.G. Emmelkamp (2008). De effectiviteit van Virtual Reality Exposure Therapy voor hoogtevrees in de klinische praktijk. Gedragstherapie, 41, p. 253-259.

4. ^. A. Garcia-Palacios, C. Botella, H. Hoffman, and S. Fabregat (2007). Comparing Acceptance and Refusal Rates of Virtual Reality Exposure vs. In Vivo Exposure by Patients with Specific Phobias. CyberPsychology & Behavior. October 2007, 10(5): 722-724.

5. ^. L.T. Gunawan, C.A.P.G. van der Mast, M.A. Neerincx, P.M.G. Emmelkamp, and M. Krijn (2004). Usability of Therapist's User Interface in Virtual Reality Exposure Therapy for fear of Flying. Proceedings of the Euromedia’2004 Conference.

6. ^. W.-P. Brinkman, C.A.P.G. van der Mast, M.G. Sandino, L.T. Gunawan, and P.M.G. Emmelkamp (2010). The therapist user interface of a virtual reality exposure therapy system in the treatment of fear of flying. Interacting with Computers 22(4): 299-310.