Virtual Reality Exposure Therapy for Emotion Regulation Difficulties in Adolescent Inpatients

The goal of this clinical trial is to evaluate whether a therapist-guided virtual reality (VR)-based intervention can improve emotion regulation in adolescents receiving inpatient psychiatric treatment. The study will also assess the feasibility, acceptability, and safety of the intervention, as well as explore factors that may predict treatment response. The main questions it aims to answer are: Does the VR-based intervention improve emotion regulation compared with a VR relaxation control intervention? Does the intervention reduce sensory sensitivities, anxiety, and related psychological symptoms? Which behavioral, physiological, and speech-based measures are associated with treatment response? Researchers will compare a personalized VR exposure intervention with a VR relaxation control intervention. Both groups will receive treatment as usual during their inpatient stay. Participants will: Be randomly assigned to either the VR exposure or the VR relaxation group. Complete questionnaires, behavioral tasks, and clinical assessments before and after the intervention, with a follow-up assessment approximately three months later. Participate in weekly therapist-guided VR sessions throughout their inpatient treatment. Complete additional assessments including speech recordings and standardized behavioral tasks to investigate predictors and mechanisms of treatment response. Throughout the study, participants will be monitored for adverse events and tolerability of the VR intervention.

Inclusion Criteria: * Written informed consent/assent. * Age 11-18 years. * Intelligence Quotient (IQ) ≥ 85. * Ability and willingness to participate in VR procedures, behavioral tasks, and questionnaires. Exclusion Criteria: * Major somatic or cardiovascular conditions. * Aggressive behavior posing a risk to self or others. * Participation in another clinical investigation within the previous 30 days. * Severe motion sickness or vestibular disorders. * Inability to comply with study procedures. * Discharge from the inpatient setting before completing the minimum intervention duration.