Virtual Reality Therapy for Emotional Regulation in Youth

(VERVE Trial)

Overseen By Justin D Russell, PhD

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: University of Wisconsin, Madison

Disqualifiers: Active psychosis, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 6

Duration: 6 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores a new virtual reality (VR) video game treatment designed to help youth improve their emotional management skills. It targets those aged 13 to 17 within the juvenile justice system. Participants will engage in up to six VR sessions using a headset to immerse themselves in calming virtual environments. The trial is best suited for teens who can read English text on screens and have no prior issues with VR or similar media. The goal is to determine if this VR therapy, called DEEP VR, can aid in emotional regulation. As an unphased trial, it offers participants a unique chance to contribute to innovative research that could shape future emotional regulation therapies.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this virtual reality therapy is safe for youth?

Research has shown that virtual reality therapy is generally safe for treating emotional issues. Studies have found that this therapy is effective and manageable for young people. For example, the DEEP virtual reality experience reduces anxiety and improves self-control through deep breathing exercises. Participants use slow, deep breaths to control the game, which can be calming.

Other studies have successfully used virtual reality to lessen symptoms of depression and anxiety. Although specific data on side effects for DEEP VR is limited, virtual reality therapy in similar settings has a good safety record. This suggests that DEEP VR is likely safe for young people under the supervision of the juvenile justice system. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about DEEP VR because it offers a fresh approach to emotional regulation in youth by using virtual reality technology. Unlike traditional methods such as therapy sessions or medication, DEEP VR immerses participants in a calming virtual environment, allowing for a unique and interactive experience. This method captures physiological responses in real-time, providing immediate feedback that can help users learn to manage their emotions more effectively. The immersive nature of VR may engage young participants more fully than conventional treatments, potentially leading to faster and more impactful results.

What evidence suggests that DEEP VR is effective for emotional dysregulation in youth?

Research shows that DEEP VR, the virtual reality therapy under study in this trial, may help people manage their emotions better. Studies have found that this VR therapy can reduce anxiety and disruptive behavior. For instance, some participants felt less anxious and gained better control over their emotions. Another study suggested that VR can improve mental health by aiding mindfulness training, potentially lowering stress and anger, especially in challenging situations. Overall, DEEP VR appears to be a useful tool for supporting emotional well-being. ^{1 6 7 8 9}

Who Is on the Research Team?

Justin D Russell, PhD

Principal Investigator

University of Wisconsin, Madison

Ryan J Herringa, MD,PhD

Principal Investigator

University of Wisconsin, Madison

Are You a Good Fit for This Trial?

This trial is for youth aged 13-17 under juvenile justice supervision, who can read English and have a caregiver's consent. It's not for those with severe psychiatric conditions or discomfort with immersive experiences like VR.

Inclusion Criteria

I can read text on a computer screen clearly.

Availability of a caregiver to provide oral consent

I am between 13 and 17 years old.

Exclusion Criteria

Report of previous discomfort with immersive experiences, including virtual reality, 3D films, or similar media

Active psychosis or comparably impairing psychiatric condition

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo up to 6 virtual-reality-based biofeedback sessions to improve emotional regulation

6 weeks

Up to 6 visits (in-person)

Follow-up

Participants are monitored for changes in physiological arousal and symptom severity after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• DEEP VR

Trial Overview The study tests a virtual reality video game designed to help manage emotions in teens exposed to violence. Participants will undergo up to six sessions of the VR-based treatment called DEEP VR.

How Is the Trial Designed?

Group I: DEEP VR Experiment Group Experimental Treatment 1 Intervention

Participants identified from the Dane County Juvenile Court Program will be asked to experience up to 6 VR-B sessions. Participants will wear a lightweight, ultra-high-resolution, wireless, head-mounted display (Oculus Quest 2 Enterprise VR Headset). Each session will proceed through a series of four stages. First, participants will begin with a 5 minute acclimation period inside a demo VR environment. Second, baseline levels of physiological arousal will be captured over a 5 minute resting period where participants will be asked to sit quietly in a serene virtual environment. Third, participants will progress through the DEEP VR experience for 15 minutes. Finally, participants will complete a short series of online questionnaires.

Who Is Running the Clinical Trial?

University of Wisconsin, Madison

Lead Sponsor

Trials

1,249

Recruited

3,255,000+

University of Toronto

Collaborator

Trials

739

Recruited

1,125,000+

Radboud University Medical Center

Collaborator

Trials

1,203

Recruited

1,157,000+

Explore DEEP Inc

Collaborator

Trials

1

Recruited

140+

Published Research Related to This Trial

Virtual reality (VR) interventions significantly reduced anxiety (effect size g = 0.79) and depression (effect size g = 0.73) compared to control conditions in a meta-analysis of 39 trials involving various psychological interventions.

Despite the effectiveness of VR therapies for anxiety and depression, they did not significantly reduce treatment attrition rates, indicating that while VR can help with symptoms, it may not keep participants engaged in treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effectiveness of virtual reality based interventions for symptoms of anxiety and depression: A meta-analysis. Fodor, LA., Coteț, CD., Cuijpers, P., et al.[2019]

Immersive virtual reality (VR) exposures are feasible and show clinical benefits in reducing anxiety severity in youth with specific phobias, based on a study involving three youth and their parents who underwent a one-session treatment.

The use of VR exposures resulted in significant changes in both physiological arousal and subjective distress, with evidence of physiological habituation observed in participants who responded positively to the treatment at follow-up.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Immersive Virtual Reality Exposures for the Treatment of Childhood Anxiety. Ramsey, KA., Essoe, JK., Boyle, N., et al.[2023]

Virtual reality (VR) exposure therapy integrated into cognitive-behavioral therapy (CBT) for social anxiety disorder (SAD) was found to be more effective than traditional in-person exposure, with significant improvements on the Liebowitz Social Anxiety Scale and other measures.

The study involved 59 participants over 14 weekly CBT sessions, and results showed that VR exposure not only led to better outcomes immediately after treatment but also maintained improvements at a 6-month follow-up, while being more practical for therapists.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual reality compared with in vivo exposure in the treatment of social anxiety disorder: a three-arm randomised controlled trial. Bouchard, S., Dumoulin, S., Robillard, G., et al.[2019]

In a study involving 115 boys with aggressive behavior problems, using interactive virtual reality alongside Cognitive Behavioral Therapy (CBT) significantly reduced aggressive behaviors compared to standard care and traditional roleplays.

The virtual reality approach not only improved treatment outcomes but also enhanced children's emotional engagement and overall appreciation of the therapy, suggesting it could be a valuable tool in behavioral interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Treating children's aggressive behavior problems using cognitive behavior therapy with virtual reality: A multicenter randomized controlled trial. Alsem, SC., van Dijk, A., Verhulp, EE., et al.[2023]

Virtual reality (VR) shows promise as an effective assessment and treatment tool for anxiety disorders, including post-traumatic stress disorder and obsessive-compulsive disorder, but its use in clinical practice remains limited despite rapid advancements in technology.

VR is particularly appealing for younger patients due to its engaging and playful elements, which may facilitate treatment and preventive interventions, highlighting the need for further research and integration into clinical settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The use of virtual reality in assessment and treatment of anxiety and related disorders. Meyerbröker, K., Morina, N.[2021]

Virtual Reality Based Exposure Therapy (VRBET) showed positive effects in treating agoraphobia in a trial with 10 participants, indicating its potential as an effective standalone treatment.

Combining VRBET with cognitive therapy did not result in significant improvements over VRBET alone, suggesting that VRBET may be sufficient for addressing agoraphobia without the need for additional cognitive interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Isolating the effect of Virtual Reality Based Exposure Therapy for agoraphobia: a comparative trial. Malbos, E., Rapee, RM., Kavakli, M.[2011]

Virtual reality interventions have shown large treatment effects and are considered effective for various anxiety disorders and post-traumatic stress disorder, particularly when used in cognitive behavioral therapy.

There is significant variability in the implementation of these interventions, including cost and technology used, which may affect their translation from research to clinical practice; future studies should focus on improving methodology and exploring their use for other emotional disorders.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Decade in Review: A Systematic Review of Virtual Reality Interventions for Emotional Disorders. Rowland, DP., Casey, LM., Ganapathy, A., et al.[2023]

Virtual reality exposure therapy (VRET) has emerged as a promising alternative for treating anxiety disorders, particularly in cases where traditional imaginal exposure therapy is challenging to implement, allowing for controlled exposure to phobic stimuli in a safe environment.

High levels of 'immersion' and 'presence' during VRET are linked to better therapeutic outcomes, enabling therapists to tailor exposure intensity to individual patient needs, although the technology requires specialized training and can have mild side effects like nausea or dizziness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Virtual reality therapy in anxiety disorders]. Mitrousia, V., Giotakos, O.[2017]

Citations

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Efficacy of a Virtual Reality Biofeedback Game (DEEP) to ... From analyzing the individual profiles, it was found that 6 participants showed reductions in anxiety, and 5 participants showed reductions in disruptive ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11904249/

Effectiveness of virtual reality therapy in the treatment ... The current findings suggest that VR therapy interventions have a positive effect on improving the anxiety state of patients with anxiety disorders.

3. frontiersin.org frontiersin.org/journals/digital-health/articles/10.3389/fdgth.2023.1239435/full

A systematic review on the efficacy of virtual reality and ... This systematic review aims to assess the effectiveness of virtual reality (VR) and gamification interventions in addressing anxiety and depression.

4. sciencedirect.com sciencedirect.com/science/article/pii/S1550830722001227

The effectiveness of immersive virtual reality (VR) based ... This review suggests that using VR to assist mindfulness training is an effective and innovative way to improve mental health conditions within the adult ...

5. formative.jmir.org formative.jmir.org/2025/1/e65206

Mixed Methods Single-Case Experimental Design DEEP shows promise in teaching deep breathing techniques to forensic psychiatric inpatients, potentially decreasing stress, emotional tension, and anger in ...

6. exploredeep.com exploredeep.com/

deep vr DEEP is a poetic VR experience that is controlled by slow, deep diaphragmatic breathing which aims to soothe anxiety, build confidence in selfregulation, and ...

7. withpower.com withpower.com/trial/phase-stress-disorders-post-traumatic-2022-ad2c4

Virtual Reality Therapy for Emotional Regulation in Youth · ... Virtual reality therapy is generally considered safe for treating emotional disorders, with studies showing it to be feasible and tolerable for youth with ...

8. frontiersin.org frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1617483/full

A public health perspective on virtual reality interventions This study aimed to evaluate the effectiveness of virtual reality (VR)-based extreme sports games in reducing symptoms of depression, anxiety, and stress in ...

9. link.springer.com link.springer.com/article/10.1007/s44202-025-00384-x

Using virtual reality technology to treat adolescent and ... The results of meta-analysis revealed that VR intervention demonstrated an overall medium effect size (Hedge's g = 0.486) in treating depression ...