The potential of virtual reality for enhancing the efficacy and acceptability of mindfulness training in non-clinical adults: a pilot randomised controlled trial

Mindfulness-based programmes (MBPs) have proven effective in enhancing mental health outcomes among non-clinical populations, yet they face significant attrition rates. The role of virtual reality (VR) in improving engagement and effectiveness within this context remains uncertain. To explore the potential acceptability and effectiveness of VR-based mindfulness interventions for mental health outcomes in non-clinical adults, we conducted a pilot randomised controlled trial (RCT) with pre-treatment and post-treatment measures, alongside pre-post VR session assessments. A total of 51 participants were randomly assigned to three groups: “MBP” alone (n = 15), “MBP + VR” (n = 20) and “Relaxation” therapy (n = 16), the latter serving as the control condition. We utilised the innovative technology of the MK360 immersive experiences system, offering auditory and visual stimuli that allowed participants to immerse themselves in a virtual world. “MBP + VR” demonstrated greater acceptability compared to “Relaxation” but equal acceptability to “MBP” alone. All study conditions showed significant reductions in psychological distress, the primary outcome. Notably, “MBP + VR” outperformed “Relaxation” in reducing psychological distress (p =.0.015), with large effects. Both MBP and MBP + VR showed superior results compared to the Relaxation group. MBP demonstrated greater improvements in depressive symptoms (DASS-21), positive affect (PANAS), the Observing facet of mindfulness (FFMQ), and several self-compassion measures (total SCS, Self-Kindness, lower Self-Judgment, and Mindfulness subscale). MBP + VR was superior in the total FFMQ score, the Observing facet, and the SCS Mindfulness subscale. Participants in the “MBP + VR” group experienced significant improvements in state mindfulness (across six short sessions in mindfulness-based VR environments) and emotional states (relaxation in all VR environments, reduced sadness in VR-environment 3, increased surprise in VR-environment 5, and decreased anxiety in VR-environment 6). They reported an intermediate sense of presence in each of the VR environments. Despite these promising results, further research in this area is warranted.