The effectiveness of virtual reality in enhancing mindfulness: a systematic review and meta-analysis

In recent years, virtual reality (VR) has been increasingly applied in mindfulness training. Although the number of studies in this area has grown rapidly, their quality remains inconsistent. Substantial variations exist across studies in terms of participant populations, modes of VR application, experimental designs, intervention durations, and measurement instruments, which in turn have led to divergent findings. Therefore, a systematic review and meta-analysis is warranted to synthesize the existing evidence, evaluate the robustness of current findings, and provide guidance for future research and clinical applications.

A meta-analytic approach was employed, incorporating 25 studies published in both Chinese and English with a total sample of 1,485 participants. A random-effects model was applied, and Hedges' g was used as the effect size metric to evaluate the effectiveness of VR in enhancing mindfulness. The study also examined the potential moderating effects of participant characteristics, modes of VR implementation, experimental designs, intervention durations, and measurement instruments.

(1) VR interventions significantly enhanced mindfulness, with a large effect size (Hedges' g = 0.975). (2) The effectiveness of VR-based mindfulness training was moderated by usage mode and participants' health status. Fully immersive VR demonstrated greater benefits than active-interaction VR. Participants with mental health disorders experienced greater improvements compared to healthy individuals, whereas those with chronic physical conditions showed no significant effects. (3) No significant moderating effects were observed for experimental design, intervention duration, or measurement instruments.

The findings of this study contribute to the theoretical foundation of mindfulness training and offer practical implications for the design of future VR-based interventions. Specifically, the results suggest that prioritizing the development of highly immersive, low-interaction, and nature-friendly virtual environments may enhance the effectiveness of VR interventions.