# Cognitive Behavioral Immersion: A Randomized Control Trial of Peer-Based Coaching in the Metaverse

> **NIH NIH R44** · VERY REAL HELP, LLC · 2024 · $910,362

## Abstract

PROJECT SUMMARY/ABSTRACT
Depression and anxiety rank among the largest public health burdens worldwide. While effective first-line
treatments like cognitive behavioral therapy have been shown to be effective, there are numerous barriers to
accessing this kind of clinician delivered care (e.g., cost, provider availability, stigma). There is a critical need for
effective and affordable interventions that can scale and provide mental health support for the millions of
individuals around the world with depression and anxiety who are currently underserved. The Phase I project
focused on the development and feasibility of Cognitive Behavioral Immersion™ (CBI), defined as the delivery
of cognitive behavioral skills training by peer-based coaches in the metaverse. CBI has the potential to deliver
effective, affordable, and scalable support to those with depression and anxiety. While there is initial evidence
supporting the feasibility of CBI for depression and anxiety, a direct comparison of this modality against its
absence or another effective treatment has yet to be conducted and its relative efficacy is unknown. In addition,
it is unknown whether immersive virtual reality confers benefits in cognitive behavioral skill training above and
beyond flat screens accessing the same content. The proposed Phase II project aims to evaluate the efficacy of
an immersive CBI program accessed via VR headsets (CBI-VR) as compared to a treatment-as-usual (TAU)
control and a non-immersive CBI condition accessed via flat screens (CBI-flat screen) in a randomized controlled
trial. Upon completion of this aim, the proposed project will have further developed the CBI platform as well as
tested the efficacy of this program. This will help with eventual partnerships with larger payers and employee
assistance programs. The proposed project will also enhance the value proposition for both direct to consumer
and business to business phases.

## Key facts

- **NIH application ID:** 10925359
- **Project number:** 5R44MH132202-03
- **Recipient organization:** VERY REAL HELP, LLC
- **Principal Investigator:** Noah Robinson
- **Activity code:** R44 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $910,362
- **Award type:** 5
- **Project period:** 2023-09-08 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10925359

## Citation

> US National Institutes of Health, RePORTER application 10925359, Cognitive Behavioral Immersion: A Randomized Control Trial of Peer-Based Coaching in the Metaverse (5R44MH132202-03). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10925359. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*