The safe-place exercise in virtual reality versus guided imagery : a brief intervention for psychotherapists to reduce stress, burnout, and enhance relaxation

Abstract

Objectives: Psychotherapists face substantial occupational stress and emotional demands placing them at risk of burnout, yet interventions aimed at enhancing their well-being remain understudied. This study investigated the effectiveness of a brief relaxation intervention comparing the traditional safe place imagination exercise with a virtual reality (VR) adaptation. The main hypotheses posited that both interventions would increase relaxation and that burnout and stress would decrease over the course of the study, with VR yielding superior effects both times. Further, the roles of imagery ability, presence, and technological affinity were explored as well as attitudes towards VR and artificial intelligence (AI).Methods: Five psychotherapists from an outpatient setting participated in a six-week, within-subject study that used an alternating treatments design (ABCABC) which was created via a user-involvement approach where participants actively engaged in the planning of the study. Imagination- (B) and VR-based (C) relaxation interventions alternated weekly with baseline weeks (A) in between. The VR environments were tailored to participants’ preferences through generative AI.Results: Relaxation significantly increased in both conditions based on self-report and physiological (skin conductance levels) measures. Burnout and stress did not significantly decrease over time and VR did not yield significantly greater effects on all primary outcomes. Imagery ability and technological affinity were not associated with greater relaxation, whereas presence showed a positive correlation for the first VR session only. Attitudes towards AI and VR did not significantly change over the course of the study. Overall, participants reported high satisfaction with the AI-generated VR environments, and most would recommend VR relaxation to others.Conclusion: These findings suggest that brief imagination and VR interventions can enhance relaxation in psychotherapists. The lack of significant differences between conditions suggests that VR does not inherently outperform traditional methods, especially with participants already familiar with imagination exercises. Overall, VR was well received and provided an immersive, relaxing experience for most participants. The small sample size, however, limits statistical power and generalizability. Further, session frequency was likely too low to significantly change burnout and stress levels. Future research should include larger samples and higher session frequency to better understand the potential of VR and relaxation in burnout prevention for mental health professionals.submitted by Viktoria WollweberLiteraturverzeichnis: Seite 36-50Masterarbeit Paris-Lodron-University of Salzburg 2025Abstract in englischer und deutscher Sprach