Design and Usability Evaluation of a Portable VR Serious Game for Adolescent Social Anxiety

Aim/Purpose
This study aims to design and evaluate the usability and user experience of a portable Virtual Reality-based Serious Game (VRSG) informed by Cognitive Behavioral Therapy (CBT) principles to support exposure-oriented practice for adolescents with Social Anxiety Disorder (SAD).

Background
Adolescents with SAD often face barriers to accessing conventional mental health services, including stigma, limited availability of therapists, and low engagement with traditional treatment formats. While digital mental health interventions and Virtual Reality Exposure Therapy (VRET) have shown promise, many existing systems rely on non-portable hardware and provide limited integration between therapeutic structure and engagement-oriented design. There remains a need for accessible, portable, and user-centered VR solutions tailored to adolescent users.

Methodology
A VR serious game prototype, named SAVIRE, was developed using a Rapid Game Development approach and deployed on untethered VR hardware. An early-stage evaluation was conducted in two phases. First, mental health professionals (n = 3) assessed user experience and perceived therapeutic alignment using the User Experience Questionnaire (UEQ). Second, adolescents clinically diagnosed with SAD (n = 20) participated in usability testing using the System Usability Scale (SUS). Qualitative feedback was also collected to explore perceptions related to engagement, comfort, and system design features.

Contribution
This study contributes a design-focused and usability-oriented evaluation of a portable VR serious game informed by CBT principles for adolescent social anxiety. By foregrounding usability, user experience, and feasibility, the study provides foundational evidence to support further development and future efficacy-oriented research.

Findings
Results indicate high levels of usability and acceptance. Expert reviewers reported positive user experience ratings (overall UEQ mean = 2.75), with particularly strong scores for ease of understanding. Usability testing with adolescents yielded an excellent mean SUS score of 80.38, suggesting that the system is user-friendly and appropriate for repeated use. Qualitative findings further highlighted design features that supported engagement and emotional comfort during simulated social exposure.

Recommendations for Practitioners
Mental health practitioners may consider portable VR serious games as supplementary tools to support exposure-oriented activities, particularly in non-clinical or resource-limited settings, provided they are integrated into appropriate clinical frameworks.

Recommendation for Researchers
Future research should extend this work through controlled clinical studies to evaluate therapeutic outcomes and explore adaptive system features that personalize exposure scenarios.

Impact on Society
By demonstrating the feasibility of a portable, engaging VR-based system, this research highlights the potential of immersive technologies to expand access to mental health support for adolescents, especially in underserved contexts.

Future Research
Future studies may build on this work by conducting larger-scale, longitudinal investigations to examine clinical outcomes and sustain user engagement. The design framework applied in this study, integrating CBT-informed exposure with social learning theory and Bloom’s revised taxonomy, may also be adapted for the development of similar VR-based serious games in other adolescent mental health contexts.