The Effectiveness of Virtual Reality-Based Mindfulness Interventions for Managing Stress, Anxiety, and Depression: Protocol for a Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Ravi Shankar, Anjali Bundele, Amartya Mukhopadhyay
JMIR Research Protocols June 30, 2025 DOI: 10.2196/68231 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review protocol Randomized Peer reviewed |
|---|---|
| Population | Adults aged 18 to 65 years from general and clinical populations with diagnosed mental health conditions |
| Intervention | VR-based mindfulness interventions |
| Topics | Anxiety Depression Meditation |
| Keywords | Digital health interventions Meta-analysis Systematic review Vr Immersive virtual reality Mental well-being Stress Mental health support Rigorous evaluation Comprehensive effort Virtual reality mindfulness |
| Citations | 8 |
| Key findings | The protocol aims to evaluate whether VR-based mindfulness interventions effectively reduce stress, anxiety, and depression while improving mindfulness and well-being compared to traditional and control conditions. |
Abstract
While traditional mindfulness-based interventions demonstrate effectiveness in improving mental health outcomes, their delivery methods face significant challenges related to accessibility and engagement. Geographic barriers to trained facilitators, time constraints for in-person sessions, and participant dropout rates of 15% to 30% due to perceived monotony limit intervention reach and effectiveness. Virtual reality (VR) technology offers innovative solutions through multisensory immersion that creates presence, the subjective feeling of "being there," enhancing attention regulation and reducing external distractions. Meta-analyses demonstrate that VR interventions achieve higher engagement rates and lower dropout compared to traditional delivery methods; however, systematic evaluation of VR-based mindfulness interventions remains limited. Following the population, intervention, comparison, and outcome framework, this systematic review protocol aims to evaluate whether VR-based mindfulness interventions (intervention), compared to traditional face-to-face mindfulness interventions, digital mindfulness apps, active nonmindfulness controls, and waitlist or no-treatment groups (comparisons), effectively reduce stress, anxiety, and depression while improving mindfulness and well-being (outcomes) in adults aged 18 to 65 years from both general and clinical populations with diagnosed mental health conditions (population). We will conduct comprehensive searches across 8 databases (PubMed, Web of Science, Embase, CINAHL, MEDLINE, the Cochrane Library, PsycINFO, and Scopus) from inception to June 2025, including gray literature and unpublished trials. Eligible studies include randomized controlled trials evaluating VR-based mindfulness interventions using immersive technology (head-mounted displays and cave environments) with explicit mindfulness content in adult populations. Primary outcomes include stress, anxiety, and depression; secondary outcomes encompass mindfulness levels, well-being, and user experience. Two independent reviewers will screen studies, extract data, and assess risk of bias using the Cochrane Risk of Bias 2 tool with standardized criteria. Meta-analysis will use random effects models with inverse variance weighting, calculating standardized mean differences with 95% CIs. Preplanned subgroup analyses will examine intervention duration (8 wk), VR technology type (head-mounted displays vs cave environments), population characteristics (clinical vs nonclinical samples), and mindfulness technique type, with heterogeneity quantification using prespecified I2 thresholds. Database searches will commence in June 2025, with data extraction planned for August 2025 to September 2025 and systematic review completion planned by December 2025. Expected results include pooled effect sizes for primary outcomes, forest plots displaying individual and combined study effects with comprehensive subgroup analyses, and heterogeneity statistics with Grading of Recommendations Assessment, Development, and Evaluation evidence quality assessments. The review will provide definitive evidence regarding VR-based mindfulness interventions' effectiveness for mental health outcomes. The findings will inform clinical practice guidelines for integrating VR-based mindfulness, guide technology development specifications, and establish evidence-based recommendations for health care policy regarding therapeutic VR reimbursement and regulatory frameworks. PROSPERO CRD42024585899; https://tinyurl.com/288evyku. PRR1-10.2196/68231.
Comparable studies
Other systematic reviews and meta-analyses on anxiety, most cited first.
Citations in the library
Cited by 3
- Enhancing Mindfulness Effects on Well-Being Using Immersive Virtual Reality in Non-Clinical Populations: Where Are We Going? Mindfulness November 10, 2025
- Effectiveness of mindfulness-based cognitive therapy and virtual reality-based worry exposure therapy on cognitive avoidance and emotional capital in adolescents with social anxiety Preventing School Failure: Alternative Education for Children and Youth June 4, 2026
- Effectiveness of a virtual reality-based mindfulness intervention for ADHD symptoms in college students: A randomized controlled trial. Digital health 2026
Cites 6
- How Does Mindfulness Meditation Work? Proposing Mechanisms of Action From a Conceptual and Neural Perspective Perspectives on Psychological Science October 14, 2011
- Home practice in Mindfulness-Based Cognitive Therapy and Mindfulness-Based Stress Reduction: A systematic review and meta-analysis of participants' mindfulness practice and its association with outcomes Behaviour Research and Therapy May 10, 2017
- Mindfulness, Cyberbullying and Cognitive Emotion Regulation in Adolescents Journal of Research and Health 2025
- The effectiveness of immersive virtual reality (VR) based mindfulness training on improvement mental-health in adults: A narrative systematic review. Explore August 1, 2022
- Evaluation of a Mindfulness-Based Intervention With and Without Virtual Reality Dialectical Behavior Therapy® Mindfulness Skills Training for the Treatment of Generalized Anxiety Disorder in Primary Care: A Pilot Study Frontiers in Psychology January 28, 2019
and 1 more in the library