VR role-play improved social skills and reduced social anxiety for people with schizophrenia
How this was rated
Small experimental study (n=12) in a complex clinical population. Informative for hypothesis generation; cannot establish effect.
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An experimental pilot study showing that VR-based role-play scenarios improved social skills and reduced social anxiety in adults with schizophrenia spectrum experiences.
A small experimental study suggesting that VR social scenarios can be used with adults with schizophrenia spectrum experiences; sample size precludes effect claims.
Key findings
- Participants showed significant improvements in social skills after 16 individual one-hour VR role-play sessions
- Social anxiety, discomfort, and social avoidance all decreased following the VR-based program
- Gains were maintained at 4-month follow-up assessment
- Participants engaged actively with VR scenarios and reported them as realistic and relevant
Background
Social communication differences are a core aspect of the experience of many people with schizophrenia. Difficulties with assertiveness, conversational flow, and reading nonverbal cues can contribute to social isolation and reduced quality of life. While social skills programs have a long history, they often rely on in-person role-play that can feel uncomfortable or artificial. Virtual reality offers the possibility of creating realistic social scenarios where people can practice without the interpersonal pressure of face-to-face interactions.
What the researchers did
Rus-Calafell and colleagues recruited twelve adults with schizophrenia or schizoaffective disorder who were living in the community and clinically stable. Participants completed 16 individual one-hour VR-based social skills sessions in which they interacted with virtual characters in common social situations, such as starting a conversation, making a request, and responding to social conflict. The researchers assessed social skills, social anxiety, discomfort, and social avoidance before the program, after completion, and at a 4-month follow-up.
What they found
After completing the 16 VR sessions, participants showed statistically significant improvements in social skills as measured by standardized assessments. Social anxiety, discomfort in social situations, and social avoidance all decreased, suggesting that repeated practice in safe virtual scenarios helped reduce the multiple barriers that often accompany social participation for this group. Participants described the VR scenarios as realistic and reported that practicing with virtual characters felt less intimidating than practicing with real people. Crucially, these gains were maintained at the 4-month follow-up assessment, supporting the durability of the program’s effects.
Why this matters
This study adds to growing evidence that VR can serve as a meaningful practice environment for social communication. For people whose social confidence has been affected by their experiences, VR role-play offers a way to rebuild skills gradually and safely. The reduction in social anxiety is particularly noteworthy, as anxiety is often a significant barrier to social participation and can make traditional group-based programs feel overwhelming.
Limitations
The sample was small (12 participants) and there was no control group, limiting the ability to draw causal conclusions. Participants were all clinically stable, so results may not generalize to people experiencing acute difficulties. The 4-month follow-up supports durability but is not a substitute for a controlled design.
Implications for practice
VR role-play provides a structured and controllable environment for practicing social communication skills. For people with schizophrenia spectrum experiences, the ability to rehearse conversations and social situations in a safe virtual space may reduce the anxiety that often accompanies real-world social interactions, supporting more confident and effective communication in everyday life.
Where this connects to Therapy withVR
The study above is independent research and does not endorse any product. The notes below are commentary from withVR on how the themes in this research relate to features of Therapy withVR. The research findings are not claims about Therapy withVR.
Sentence Groups
Pre-load role-play dialog into sentence groups so avatars deliver scripted conversational lines - enabling the structured social scenarios this study showed improve social skills and reduce anxiety.
Meeting Room Environment
This study used formal social role-play scenarios - Therapy withVR's Meeting Room creates structured interaction contexts ideal for practicing assertiveness and conversational skills.
Cite this study
If you reference this study in your work, the canonical citation formats are:
@article{ruscalafell2014,
author = {Rus-Calafell, M. and Gutierrez-Maldonado, J. and Ribas-Sabate, J.},
title = {A virtual reality-integrated program for improving social skills in patients with schizophrenia: A pilot study},
journal = {Journal of Behavior Therapy and Experimental Psychiatry},
year = {2014},
doi = {10.1016/j.jbtep.2013.09.002},
url = {https://withvr.app/evidence/studies/rus-calafell-2014}
}TY - JOUR
AU - Rus-Calafell, M.
AU - Gutierrez-Maldonado, J.
AU - Ribas-Sabate, J.
TI - A virtual reality-integrated program for improving social skills in patients with schizophrenia: A pilot study
JO - Journal of Behavior Therapy and Experimental Psychiatry
PY - 2014
DO - 10.1016/j.jbtep.2013.09.002
UR - https://withvr.app/evidence/studies/rus-calafell-2014
ER - Know of research that should be in this hub? If a relevant peer-reviewed study is not listed here, send the reference to hello@withvr.app. The hub is kept up to date as the literature grows.
Funding & independence
No withVR BV involvement in funding, study design, or authorship. Summary prepared independently by withVR using the published paper.