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Cognitive Behavioral Immersion for Depression: Protocol for a Three-Arm Randomized Controlled Trial of Peer-Based
Noah Robinson1, Francisco N Ramos2, Steven D Hollon1
1Department of Psychology, Vanderbilt University, Nashville, TN, United States.
JMIR Research Protocols
|May 6, 2025
Summary
This study is evaluating cognitive behavioral immersion (CBI) delivered via virtual reality (VR) and flat-screen devices for depression and anxiety. Results will show if metaverse interventions improve mental health outcomes.
Area of Science:
- Mental Health
- Digital Therapeutics
- Psychiatry
Background:
- Depression and anxiety are prevalent global mental health concerns.
- Existing treatments like CBT face accessibility and scalability challenges.
- Cognitive Behavioral Immersion (CBI) offers a metaverse-based solution using peer coaches.
Purpose of the Study:
- To evaluate the efficacy of CBI delivered via virtual reality (CBI-VR) versus a flat-screen device (CBI-FS) and a delayed access control (DAC).
- To compare the effectiveness of immersive versus less immersive CBI delivery methods.
- To assess CBI's impact on depressive and anxiety symptoms and quality of life.
Main Methods:
- A national web-based randomized controlled trial involving 306 adults with clinical depressive symptoms.
- Participants randomized to CBI-VR, CBI-FS, or DAC, with an 8-week intervention and 6-month follow-up.
- Primary outcome: depressive symptoms; secondary outcomes: anxiety symptoms, quality of life. Data analyzed using hierarchical linear models.
Main Results:
- Hypothesis: Both CBI groups will show greater symptom improvement than DAC.
- Hypothesis: CBI-VR participants will demonstrate greater improvement than CBI-FS participants.
- Data collection is complete; analysis and results submission are expected in winter 2025.
Conclusions:
- This trial will determine the efficacy of CBI via VR and flat-screen devices compared to DAC.
- Findings will clarify if virtual reality enhances mental health intervention outcomes.
- Results will inform the use of the metaverse and VR for accessible mental health solutions, especially for depression.
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