In a study published in the journal JMIR XR and Spatial Computing, researchers have explored an innovative approach to addressing the mental health crisis among teenagers: virtual reality (VR). They found that a VR environment designed to reduce stress and improve mood was embraced by teens, who used it regularly and reported feeling less stressed and more relaxed during sessions. However, the study did not find significant reductions in overall levels of anxiety and depression.
Teens today face an array of unprecedented stressors: social media pressures, the climate crisis, political polarization, and the upheavals of the COVID-19 pandemic and online learning. These stressors have contributed to a significant decline in adolescent mental health over the past decade, with rising levels of anxiety and depression exacerbated by the pandemic. Compounding this issue is a severe shortage of mental health providers, with only 14 child and adolescent psychiatrists available for every 100,000 children in the United States.
Given the urgent need for accessible mental health interventions, researchers at the University of Washington investigated whether VR could offer a practical solution. By creating an engaging and immersive environment, the team aimed to provide stress-reducing activities based on established mental health practices, potentially making these interventions more appealing and accessible to teens.
The research team developed a VR environment called Relaxation Environment for Stress in Teens (RESeT), designed through a collaborative process with groups of teens over two years. The RESeT environment featured a snowy, open world with a forest and various interactive activities based on evidence-based mental health practices such as dialectical behavior therapy and mindfulness-based stress reduction. These activities were intended to engage teens and help them manage stress.
The researchers enrolled 44 teens aged 14 to 18 from Seattle in a three-week study. Each participant received a Meta Quest 2 VR headset and was instructed to use the RESeT environment three to five times a week. Importantly, the teens were not given any prompts or incentives to use the VR system, allowing the researchers to observe natural usage patterns. To assess the impact of the VR environment, the teens completed surveys before and after each session, measuring their stress levels and mood. These surveys provided data on how the VR sessions affected their immediate emotional state.
The VR environment included six specific activities designed to improve mental health:
- Riverboat: Teens placed negative words into paper boats and sent them down a river, symbolizing the release of negative emotions.
- Rabbit Hole: Teens stood still near a stump, and as they remained calm, rabbits appeared, rewarding their stillness and attention.
- Rock Stacking: Teens stacked rocks to focus their attention and practice mindfulness.
- Painting: Teens painted on a surface, with their artwork gradually disappearing to emphasize the temporary nature of stress.
- Bird Search: Teens listened for bird calls and located the birds, enhancing auditory mindfulness.
- Scavenger Hunt: Teens searched for rocks labeled with positive words, reinforcing positive thinking.
The researchers found that teens used the VR environment an average of twice a week for about 11.5 minutes per session without any external prompting. This regular usage indicated that the teens found the environment engaging and were willing to incorporate it into their routines. When using the RESeT environment, the teens reported feeling significantly less stressed and experienced slight improvements in mood during the sessions. This suggests that the immersive and interactive nature of the VR activities had a positive immediate effect on their emotional state.
Despite these positive short-term effects, the study did not find significant reductions in overall levels of anxiety and depression among the participants over the three-week period. While the VR environment succeeded in providing momentary relief from stress, it did not produce long-term changes in the teens’ broader mental health metrics. However, the teens’ enjoyment and regular use of the VR system highlight its potential as a supplementary tool for managing stress.
Lead author Elin Björling noted the importance of making effective mental health practices accessible in engaging formats: “We know what works to help support teens, but a lot of these techniques are inaccessible because they’re locked into counseling, which can be expensive, or the counselors just aren’t available. So we tried to take some of these evidence-based practices, but put them in a much more engaging environment, like VR, so the teens might want to do them on their own.”
The study’s findings suggest that while VR can provide immediate stress relief and improve mood during use, further research is needed to understand its potential for long-term mental health benefits. The researchers aim to conduct larger, longer-term studies with control groups to evaluate the sustained impact of VR interventions. They also plan to explore the integration of artificial intelligence to personalize the VR experience and consider implementing VR systems in community settings such as schools and libraries to increase accessibility for teens.
While the study’s results are promising, there are several limitations. The sample size of 44 teens is relatively small, and the study did not include a control group, which limits the ability to draw definitive conclusions about the effectiveness of the VR environment. Additionally, the study’s duration was only three weeks, which may not be sufficient to observe long-term effects on anxiety and depression.
The researchers also noted that while teens reported enjoying the VR environment and feeling calmer, some participants experienced mild discomfort, such as nausea or eye strain, particularly during initial use. These issues typically subsided as participants became accustomed to the VR system.
Future research should aim to conduct larger, longer-term studies with control groups to evaluate the sustained impact of VR interventions on mental health. Researchers are also interested in exploring the potential of integrating artificial intelligence to personalize the VR experience further. Another promising direction is to make VR headsets available in schools and libraries, increasing accessibility for teens who might benefit from such interventions.
“Reduced stress and improved mood are our key findings and exactly what we hoped for,” said co-author Jennifer Sonney, an associate professor in the UW School of Nursing. “We didn’t have a big enough participant group or a design to study long-term health impacts, but we have promising signals that teens liked using RESeT and could administer it themselves, so we absolutely want to move the project forward.”
The study, “Using Virtual Reality to Reduce Stress in Adolescents: Mixed Methods Usability Study,” was authored by Elin A Björling, Jennifer Sonney, Himanshu Zade, Sofia Rodriguez, Michael D. Pullmann, and Soo Hyun Moon.
