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Social Simulation for Integrating Self-Care: Measuring the Effects of Contextual Environments in Augmented Reality for Mental Health Practice

Anna Fang, Jiayang Shi, Hriday Chhabria, Bosi Li, Haiyi Zhu

TL;DR

This study investigates whether practicing self-care skills in a realistic, context-rich augmented-reality (AR) environment improves transfer to real-world social stress, specifically public speaking. In a 14-day, in-the-wild, randomized trial with 43 participants, the contextual AR condition (vs. non-contextual control) increased engagement (longer session durations) and, critically, improved transfer as evidenced by more frequent use of relevant techniques outside the headset and favorable physiological responses during a mock in-person task. While state stress changes did not differ day-to-day and anticipated stress showed no significant baseline shifts, treatment participants demonstrated slower heart-rate escalation and faster recovery during stress, and qualitative data highlighted meaningful shifts in stress framing and coping. The findings offer design guidance for embodied mental-health tech, suggesting that realistic social contexts can enhance skill adoption and transfer, though social norms and productive discomfort must be carefully balanced to maximize real-world applicability.

Abstract

Despite growing interest in virtual and augmented reality (VR/AR) for mental well-being, prior work using immersive interventions to teach mental health skills has largely focused on calming or abstract settings. As a result, little is known about how realistic social simulation may better support the transfer and application of skills to in-person environments. In this work, we present a 14-day user study with 43-participants comparing an augmented reality intervention simulating a realistic contextual environment against a matched non-contextual control, applied to the public speaking context. We found that participants who practice mental health skills in the contextual environment showed significantly greater likelihood to apply self-care techniques and greater physiological stress reduction when using skills in mock in-person tasks. Overall, our work provides empirical evidence for the effects of realistic stressor simulation, and offers design implications for mental health technology that supports effective transfer of skills to the real-world.

Social Simulation for Integrating Self-Care: Measuring the Effects of Contextual Environments in Augmented Reality for Mental Health Practice

TL;DR

This study investigates whether practicing self-care skills in a realistic, context-rich augmented-reality (AR) environment improves transfer to real-world social stress, specifically public speaking. In a 14-day, in-the-wild, randomized trial with 43 participants, the contextual AR condition (vs. non-contextual control) increased engagement (longer session durations) and, critically, improved transfer as evidenced by more frequent use of relevant techniques outside the headset and favorable physiological responses during a mock in-person task. While state stress changes did not differ day-to-day and anticipated stress showed no significant baseline shifts, treatment participants demonstrated slower heart-rate escalation and faster recovery during stress, and qualitative data highlighted meaningful shifts in stress framing and coping. The findings offer design guidance for embodied mental-health tech, suggesting that realistic social contexts can enhance skill adoption and transfer, though social norms and productive discomfort must be carefully balanced to maximize real-world applicability.

Abstract

Despite growing interest in virtual and augmented reality (VR/AR) for mental well-being, prior work using immersive interventions to teach mental health skills has largely focused on calming or abstract settings. As a result, little is known about how realistic social simulation may better support the transfer and application of skills to in-person environments. In this work, we present a 14-day user study with 43-participants comparing an augmented reality intervention simulating a realistic contextual environment against a matched non-contextual control, applied to the public speaking context. We found that participants who practice mental health skills in the contextual environment showed significantly greater likelihood to apply self-care techniques and greater physiological stress reduction when using skills in mock in-person tasks. Overall, our work provides empirical evidence for the effects of realistic stressor simulation, and offers design implications for mental health technology that supports effective transfer of skills to the real-world.
Paper Structure (33 sections, 3 figures, 7 tables)

This paper contains 33 sections, 3 figures, 7 tables.

Table of Contents

  1. Introduction
  2. Related Work
  3. Embodied and Immersive Technology for Mental Health
  4. Social Simulation in HCI
  5. Learning Self-Care and Coping Skills
  6. Hypotheses
  7. Methods
  8. System Design
  9. Overview of System
  10. Design Principles and Implementation
  11. Experiment Design
  12. Participants
  13. Stage 0: Onboarding (Day 0)
  14. Stage 1: Free Use Period (Days 1 through 7)
  15. Stage 2: Free Use Period (Days 8 through 14)
  16. ...and 18 more sections

Figures (3)

  • Figure 1: User flow through the control and treatment versions of the augmented reality system. Screenshots are taken from a classroom on our research team's campus.
  • Figure 2: Screenshots of the three mental health skills present in our system: Box Breathing (top), 3-3-3 grounding (middle), and Progressive Muscle Relaxation (bottom).
  • Figure 3: Average heart rate trajectories over time for participants in the speaking task (left) and during a calming technique task (right). Lines represent group means for Control (blue and light blue) and Treatment (orange and light orange), with shaded ribbons indicating ±1 standard error. The plots show the difference in heart-rate rise between treatment and control groups across time.