Facing your inner critic: a randomized controlled trial investigating a virtual reality intervention with and without...

Excessive self-criticism has been associated with several psychiatric disorders, as well as poorer therapeutic outcomes. Compassion-based therapies are time-consuming and can be challenging because of the use of mental imagery. Virtual Reality interventions enable concrete visual representations and may be more efficient. We investigated a single-session VR intervention, based on chair dialogue exercises from schema therapy, for self-criticism and self-compassion. Furthermore, the additional effect of the novel VR technique perspective change was assessed.

Undergraduate students (n = 68) with high levels of self-criticism were randomized to either the intervention with or without an additional perspective change. Pre- and post-measures consisted of self-report questionnaires on self-compassion, self-criticism, negative and positive affect.

Participants underwent the single-session VR intervention where they had to respond assertively towards an avatar who expressed the participant's own excessive self-criticism. The perspective change consisted of a change to third person perspective.

The VR intervention significantly decreased self-criticism and negative affect and increased self-compassion for both conditions directly after the session. No additional effect was found for the perspective change.

This was the first study to apply VR within a schema therapy exercise. Positive effects indicate the potential of VR schema therapy for individuals with excessive self-criticism in clinical practice.

The trial was registered retrospectively at ClinicalTrials.gov (Trial ID: NCT05887141).