This image is shot entirely practically with real candles. (We had to be extremely careful not to light the model on fire with her hair (a wig) so close to the candles. We also had an assistant standing nearby who's entire role was to stand there with a fire extinguisher ready.
This sort of images was extremely difficult in the past just because of the ISO performance needed. Not only are the candles the main light source (There is also a massive octa above on very low power adding some fill into the shadows) but they aren't even in a position where their light is falling directly on the model. They are effectively just rim light. On top of all that we had to be a bit stopped down in order to preserve depth of field. All something we just couldn't have managed on older cameras. ISO and denoise has come such a long way.
On top of that, all the demonic artwork that is strewn around was generated using Midjourney which was then printed onto parchment paper at Staples. We were able to create 100 completely unique pieces of artwork in a consistent style because of this for the cost of a MJ subscription and about $60 of printing. In the past these would have all needed to be drawn by hand.