# Psychoeducation on Stress and Anxiety Using Virtual Reality: A Mixed-Methods Study
###### Abstract  
Virtual reality can help individuals to manage stress and anxiety. In addition to its efficacy in reducing stress and anxiety through relaxation, virtual reality can be helpful for psychoeducation. However, to date, few studies have explored this topic. Therefore, this mixed-methods sequential explanatory study, aimed to investigate the usability, sense of presence, emotional response, and effect on learning of MIND-VR, a psychoeducational virtual experience created to offer information on stress and anxiety. Twenty healthcare workers (60% female; mean age 43 \(\pm\) 10) tried MIND-VR. Psychometric outcomes served as quantitative variables, while participant interviews provided qualitative data. Results showed that the virtual reality psychoeducational experience: (a) was highly usable and satisfying: (b) increased positive emotions (i.e., happiness and surprise) and decreased negative emotions (i.e., fear, sadness) and state anxiety; (c) elicited a strong sense of presence, especially spatial presence; and (d) was practical, simple, motivating, and engaging for learning information about stress and anxiety. These findings offer promising insights into that virtual reality may be an effective tool to provide psychoeducation.  
virtual reality; psychoeducation; stress and anxiety management; anxiety; stress; healthcare workers; COVID-19 +
Footnote †: journal: Applied Sciences  
that includes the extent to which it is possible to step into the virtual world through interfaces\" [20]. VR systems can offer different levels of immersion within a three-dimensional (3D) environment [18; 21]: from desktop VR, which provides a simple presentation on a two-dimensional (2D) display screen, up to immersive VR, which adopts HMDs. Nowadays, on the market is available an extreme variety of HMDs, including low-budget mobile (e.g., Google Cardboard) and standalone (e.g., Meta Quest 2) systems, that have made VR an affordable and accessible consumer technology [22]. A second relevant feature of VR concerns interactivity which can be described as the degree to which a user can modify the virtual environment in real-time [23]. In VR, individuals interact with the virtual world using their bodies [24]. These features offer unique chances, combining engagement with intense emotions, thus providing a sense of presence, defined as \"the subjective experience of being in one place or environment, even when physically located in another\" [25].  
Several studies, reviews, and meta-analyses conducted over the last decades showed that VR can help individuals to learn valuable resources to manage better stress and anxiety [26]. In addition to its efficacy in reducing levels of stress and anxiety by immersing individuals in relaxing virtual worlds [27; 28; 29], a relevant feature is linked to the usefulness of VR for psychoeducation [30; 31; 32]. This seems important since mental health literacy, defined as knowledge and beliefs about mental disorders, which aid their recognition, management, or prevention [33], is an essential facilitator of formal help-seeking behavior [34; 35], and it is the first step intervention for the management of stress and anxiety [36; 37]. However, to date, there is limited knowledge on this topic (e.g., [30; 38; 39; 40]). Therefore, we developed and tested in a sample of healthcare workers MIND-VR, a VR-based psychoeducational experience on stress and anxiety [31].