The clinical background     Many of us grew up with the naive assumption that couches are the best used therapeutic tools in psychotherapy. But tools for psychotherapy are evolving in a much more complex environment than a designer's made chaise longue. In particular virtual reality (VR) devices have the potential for appearing soon in many consulting rooms. The use of Virtual Reality in medicine it is not a novelty. Applications of Virtual Environments for health care have been developed in the following areas: surgical procedures (remote surgery or telepresence, augmented or enhanced surgery, and planning and simulation of procedures before surgery); preventive medicine and patient education; medical education and training; visualization of massive medical databases; and architectural design for health-care facilities. However, there is a growing recognition that VR can play an important role in clinical psychology, too. This project aims to make a major contribution in exploiting and understanding this potential.   The technical background     Telemedicine is an exciting new technique for health care delivery and one which is potentially very important. Studies show that this approach is liked by doctors and that patients are enthusiastic about it. However, it is also true that the ultimate place of telemedicine in health care remains to be found. This is even more true for VR an exciting new technology that is usually considered by clinicians no more than an expensive toy. But what is VR? A Virtual Environment (VE) can be defined as interactive, virtual image display enhanced by special processing and by nonvisual display modalities, such as auditory and haptic, to convince users that they are immersed in a synthetic space.   In a different fashion, VR is an application that lets users navigate and interact with a three-dimensional, computer-generated environment in real time. VR, however, is not only a hardware system.   According to different authors the essence of VR is the inclusive relationship     between the participant and the virtual environment, where direct experience of the immersive environment constitutes communication. In this sense, VR can be considered as the leading edge of a general evolution of present communication interfaces like television, computer and telephone. Main characteristic of this evolution is the full immersion of the human sensorimotor channels into a vivid and global communication experience: VR provides a new methodology for interacting with information. Since telemedicine is principally involved with transmitting medical information, VR has the potential to enhance the telemedicine experience. The two principle ways in which VR can be applied are a) as an interface, which enables a more intuitive manner of interacting with information, and b) as an environment that enhances the feeling of presence during the interaction. So, why is technology not being used widely as remote healthcare tool? As noted recently by a well know expert in the field "There are basically two reasons why telemedicine is used: either because there is no alternative, or because telemedicine is in some sense better than traditional medicine". Unfortunately, there is a lack of controlled clinical studies showing any significant advantage of VR over traditional methods. Moreover the efficacy of a VR system is strongly linked to the technology used. However, there is now a general agreement that the lack of suitable technology is no longer a barrier to the use of VR. By and large the technology is now available and even low-cost PC-based VR systems are emerging.. On the other hand, it has been demonstrated that there is a high level of acceptance of this new way of providing services in mental health, given the fact that the studies carried out about this issue indicated that most participants reported a similar degree of satisfaction between the attention provided at a distance and traditional consultation. It is not strange that specialised literature insists on the necessity of testing every possible program before recommending its use. We are, therefore, facing a new era that, from our view, it may be a deeper revolution for the basic concepts and functioning ways in mental health field than it was the development of Community Psychology and Psychiatry principles at that time.