Cutting-edge research at the UW School of Medicine and Public Health is studying whether a new virtual reality video game can help teens self-regulate breathing and improve their mental health.

A team of researchers in the school’s Department of Psychiatry, led by Justin Russell, PhD, research scientist in the Building Resilience to Adversity and Violent Experiences (BRAVE) Research Center, under the direction of Ryan Herringa, MD, PhD, associate professor of psychiatry, UW School of Medicine and Public Health, is examining how virtual reality can improve emotional regulation in children ages 13 to 17.

The game – codenamed VERA, short for Virtual Emotion Regulation in Adolescents – allows players to control progress through their breathing patterns, according to Russell.

“This game utilizes what we call ‘biofeedback,’ which is something you don’t see in these types of games, though video games have been used in clinical studies or as treatments for some time,” he said. “We are very excited to study its impact in helping kids who need it.”

The game’s setting is a three-dimensional underwater world navigated by the player, but without the use of a hand-held controller. The only way to move about the game is to practice deep breathing via a chest monitoring strap the child wears, Russell said.

“It’s directed by focusing on breathing in through the nose, out through the mouth, and they have to keep the breathing measured or the game starts to get out of control and the environment becomes chaotic,” he said.

Russell and the researchers at BRAVE partnered with DEEP, an international collaboration of video game developers, producers and researchers who developed the game. With funds provided by a Young Investigator Grant from the Brain and Behavior Research Foundation, Russell is working with DEEP to tweak their technology to make the game optimal for children’s mental health therapy, he said.

The project involves a key partnership with Dane County Juvenile Court Program (DCJCP), Russell said.

The researchers have been meeting with adolescents through DCJCP to evaluate the game and improve it. This helps provide insight about the game from the perspective of a population of youth often in need of care and resources to support mental health. The partnership has been mutually beneficial, Russell said.

“We as adults can’t just develop a game and say, ‘Here you go, use it and we’ll run some tests to see if this helps you,’” Russell said. “We need the game to be something they will use and want to play, and nobody knows more about video games than children; they pick this stuff up so much faster than us adults.”

Using the feedback from the kids at DCJCP, BRAVE researchers hope to start clinical trials to evaluate the effectiveness of the game in treating children who have challenges controlling their emotions.

On the heels of the United States surgeon general’s advisory on a youth mental health crisis in the United States, it is critical that we explore new ways of tackling this epidemic, according to Russell.

“The demand for mental health services fueled by the COVID-19 pandemic forces us to develop new, more effective tools, and one of those tools could be technology kids already use,” Russell said.