Creating Calm: A usability study of a virtual reality environment designed to reduce stress in adolescents. (Preprint)

Abstract

Adolescent mental health is a national mental health emergency amidst surging rates of anxiety and depression. Given the scarcity and lack of scalability of mental health services available, the use of self-administered, evidence-based technologies to support adolescent mental health is both timely and imperative.

The goal of this study was twofold: (1) to determine the feasibility and engagement of a participatory designed virtual reality (VR) environment. (2) Determine the preliminary efficacy of our self-administered VR environment on depression, mindfulness, and perceived stress.

We conducted a within-person, 3-week study with a community-based sample of 44 adolescents. Participants completed surveys of perceived stress, depression, cognitive fusion, and mindfulness at intake, post-intervention and at 3-week follow-up. Participants also completed short stress and mood surveys five times each day and before and after each VR session. Post-intervention, participants completed surveys on system and intervention usability and their experiences of using the VR system. Quantitative data were analyzed using descriptive statistics and mixed effects modeling to explore the effect of the VR environment on stress. Qualitative data were analyzed using a collaborative thematic analysis.

Participants’ use of the VR environment ranged from 1-24 sessions (mean 6.27) at home over a three-week period. The 44 participants completed all of the study protocols, indicating our protocol was feasible and the VR environment engaging for most. Both the use of the VR system and the novel VR intervention received strong usability ratings. Although [the VR Environment] did not significantly affect depression, mindfulness, or cognitive fusion, it did positively affect mood and decrease stress after VR sessions use. We found a significant reduction in within-day momentary stress that strengthened with increased VR use over time during the study period. Most teens indicated that they found the tool to be easily administered, relaxing, and helpful with stress. For some it offered space to process difficult emotions. The themes of calm, regulating, and forget about everything resulted from open-ended exit interview data.

These preliminary data inform our own virtual reality environment design, but also provide evidence of the potential for self-administered VR as a promising tool to support adolescent mental health. Self-administered VR for mental health may be an effective intervention for reducing adolescent stress. However, understanding barriers (including disengagement) to using VR, as well as further encouraging designing with and for teens may be imperative to the success of future mental health interventions.