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A Virtual Reality-Based Cognitive Defusion Application for Youth Depression and Anxiety: Mixed Methods Experimental
Imogen H Bell1,2, Cassandra Li1,2, Andrew Thompson1,2,3
1Orygen, Parkville, Australia.
JMIR Mental Health
|August 7, 2025
Summary
This study found that a virtual reality (VR) cognitive defusion application was feasible, safe, and acceptable for youth. While both VR and audio exercises improved negative thinking, VR was preferred for its engaging format, suggesting potential for enhanced mental health treatment.
Area of Science:
- Psychology and Cognitive Science
- Human-Computer Interaction
- Virtual Reality Applications
Background:
- Third-wave therapies, like acceptance and commitment therapy, show promise for youth depression and anxiety.
- Cognitive defusion techniques can be abstract and difficult for young people to learn and apply.
- Virtual reality (VR) offers an interactive and engaging medium to translate complex therapeutic techniques.
Purpose of the Study:
- To evaluate the feasibility, acceptability, usability, and safety of a novel VR cognitive defusion application.
- To assess the VR application's impact on negative thinking and mood states.
- To compare the VR cognitive defusion experience with a traditional audio-based exercise.
Main Methods:
- A mixed-methods experimental design with 20 young participants.
- Participants completed both VR and audio cognitive defusion exercises in a randomized order.
- Quantitative measures assessed changes in psychological states, complemented by qualitative interviews comparing the experiences.
Main Results:
- The VR application was feasible, acceptable, and safe, with no severe adverse events.
- Both VR and audio exercises improved thought discomfort and cognitive defusion.
- Participants preferred the VR format for its novelty and engagement, despite a need for improved guidance.
Conclusions:
- The VR cognitive defusion tool is a viable, safe, and acceptable intervention for youth.
- VR's engaging nature holds potential for improving the learning of third-wave cognitive behavioral therapy techniques.
- Future research should refine VR design based on user feedback and conduct larger trials in real-world settings.
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