Self-CriticismVirtuSNCT05887141
Self-compassion and Self-criticism: a Virtual Reality Intervention
A study testing Double Standards and Self-criticism avatar in people with Self-Criticism, run by University Medical Center Groningen at 1 site in Netherlands.
Trial summary
The purpose of this study is to investigate two independent Virtual Reality interventions for self-criticism and self-compassion and the use of perspective-change in these interventions. Read more about this study
- Who is it for?
- Ages 17 to 30 yearsHealthy volunteers can take part
- Conditions the study is for
- Self-Criticism
- What is being tested?
- Double Standards and Self-criticism avatar
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 136 participants
- Where
- 1 siteNetherlands
- Study dates
- 12 Oct 2021to 9 Jun 2023
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 17 to 30 years
- All sexes
- Healthy volunteers accepted
- Child, Adult
Who may be able to join
- Enrolled in a study
- Score above 20 (>20) on the subscale 'Inadequate self' of the FSCRS questionnaire
Who cannot join
- N/A
Trial locations and contacts
1 site in 1 country.
About this study
The purpose of this study is to investigate two independent Virtual Reality interventions for self-criticism and self-compassion and the use of perspective-change in these interventions.
Read the detailed description
The current study will use two novel Virtual Reality (VR) exercises that will be investigated through two independent sub-studies. First of all, an exercise that uses the CBT (Cognitive Behavioral Therapy) technique called 'Double standards'. People with excessive self-criticism often set higher standards for themselves, which makes them more critical towards themselves. A way to distance from this, to enable a more nuanced reflection, is to ask the patient what they would say to a friend having those same negative thoughts about themselves. Doing this utilizing a role play in a realistic VR environment of which the avatar has the characteristics of a friend, the effect could be even stronger. Furthermore, VR offers the chance to switch perspectives, in which the participants receive their own compassionate comments from the perspective of the friend, and experience themselves as a good friend.
The second exercise, 'Self-criticism avatar', has common grounds with the (two-)chair exercises of schema therapy and the voice dialogue method in which a patient enters a dialogue between one's inner voices. In the VR exercise, the participant will be able to choose a virtual character with a voice that represents their own inner critic and that gives them their own self-criticism. By assertively and strictly speaking up to the inner critic, after which the virtual character becomes smaller and smaller until it backs down, the participant can experience a sense of control over their self-criticism, which leaves more room for self-compassion. A discussion with the inner critic enables a more nuanced image with more self-compassion. The switch in perspective after the role-play allows the participant to see himself/herself speaking assertively to the avatar, which can strengthen the increase in self-compassion and decrease in self-criticism.
Switching of perspectives is a relatively new technique within VR, that can be of added value to regular psychological therapies. Regular psychological therapies use switching of perspectives by switching roles in a physical role-play between a therapist and a patient or in a group. Furthermore, imaginative switches of perspective are used in, for example, schema therapy or imagery rescripting. Even though this can bring new insight into another perspective, it is not possible to replay the role play where the participant can see himself/herself from someone else's perspective. This is, however, possible through VR.
The current study will investigate the two beforementioned VR exercises using two independent sub-studies, to determine whether they contribute to self-compassion and if the switch in perspective is of added value. This will be done by comparing two conditions for each VR exercise; one with a switch in perspective and one without a switch in perspective. The study aims to answer the following research questions:
- Do the two VR-self compassion exercises have a positive effect on self-compassion (increase) and self-criticism (decrease)?
- Is the switch in perspective for the exercise 'Double standards of added value? In other words: is receiving one's own compassionate response of added value in addition to showing compassion to a vulnerable other.
- Is the switch in perspective for the exercise 'self-criticism avatar' of added value? In other words: is watching oneself in a strong and resilient manner of added value in addition to assertively speaking up to one's inner critic?
- Conditions
- Self-Criticism
- Being tested
- Double Standards, Self-criticism avatar
- Keywords
- Virtual Reality, self-criticism, self-compassion, perspective change, Cognitive Behavioral Therapy
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Double StandardsBehavioural
We created a VR intervention based on the Cognitive Behavioral Therapy (CBT) technique 'double standards'. In the intervention the participants have to respond to a virtual character they imagine as their friend, who expresses similar self-criticism as they struggle with themselves. Two role-plays are played in Virtual Reality (either with or without perspective change after the role-plays). In the perspective change condition, the perspective is changed with the virtual friend (second person perspective).
Self-criticism avatarBehavioural
We created a VR intervention called 'Self-criticism avatar' that has common ground with two-chair dialogue. Participants have to assertively respond to their inner critic who criticizes them using their own self-critical thoughts. After responding assertively (for example: 'Go away, I don't need you', 'Good is good enough'), the virtual character becomes weaker until they give up. Two role-plays are played in Virtual Reality (either with or without perspective change after the role-plays). In the perspective change condition, the perspective is changed with a bystander (third person perspective).
| Study group | Role | What they receive |
|---|---|---|
| Control Condition (no perspective change) | Other | The intervention (two role-plays), however without using a perspective change afterwards. Receives: Behavioral: Double Standards; Behavioral: Self-criticism avatar |
| Perspective change condition | Experimental | The intervention (two role-plays) with a perspective change after each role-play. Receives: Behavioral: Double Standards; Behavioral: Self-criticism avatar |
What is being measured
The primary outcome is the main question the study is designed to answer.
Self-Criticism and Self-Compassion Scales (SCCS) - Change in Self-Criticism
Levels of state self-criticism as measured by the SCCS. The questionnaire consists of five scenarios that could induce self-critical and/or self-compassionate reactions. For the self-criticism scale, participants indicate on a 7-point Likert scale (1= not at all to 7= highly) to what extent they would react towards themselves in a contemptuous, critical, and harsh manner (range 15-105, higher scores reflect more self-criticism).
Measured: Right before (Timepoint 1) and directly after (Timepoint 2) the +/- 60 minute intervention
Self-Criticism and Self-Compassion Scales (SCCS) - Change in Self-Compassion
Levels of state self-compassion as measured by the SCCS. The questionnaire consists of five scenarios that could induce self-critical and/or self-compassionate reactions. For the self-compassion scale, participants indicate on a 7-point Likert scale (1= not at all to 7= highly) to what extent they would react towards themselves in a reassuring, soothing, and compassionate manner (range 15-105, higher scores reflect more self-compassion).
Measured: Right before (Timepoint 1) and directly after (Timepoint 2) the +/- 60 minute intervention
Secondary outcomes (3)
Change in negative affect
Visual Analogue Scales (VAS) measuring negative affect with three questions (range 0-100 for each question, higher scores reflect a higher negative affect)
Measured: Right before (Timepoint 1) and directly after (Timepoint 2) the +/- 60 minute intervention
Change in positive affect
Visual Analogue Scales (VAS) measuring positive affect with three questions (range 0-100 for each questions, higher scores reflect a higher positive affect)
Measured: Right before (Timepoint 1) and directly after (Timepoint 2) the +/- 60 minute intervention
Change in self-compassion and self-esteem
Visual Analogue Scales (VAS) measuring self-compassion and self-esteem with six questions (range 0-100 for each question, higher scores reflect higher self-compassion and self-esteem)
Measured: Right before (Timepoint 1) and directly after (Timepoint 2) the +/- 60 minute intervention
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted2 Jun 2023
- Study start12 Oct 2021
- Primary completion9 Jun 2023
- Study completion9 Jun 2023
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Self-CriticismStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Two independent substudies, each with two arms. N=68 per substudy (N=136 total)
- Masking
- None (open label)
- Enrolment
- 136 participants (actual)
Sponsor and investigators
- Lead sponsor
- University Medical Center Groningen
- Sponsor type
- University, hospital or other
- Collaborators
- PPO, University of Groningen
- Responsible party
- Sponsor
- Investigators
- Elise van der Stouwe, Principal investigator, University Medical Center Groningen
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05887141
- Sponsor's protocol ID
- 10036
- Acronym
- VirtuS
- Status last verified
- Jul 2024
- First submitted
- 1 May 2023
- Last updated
- 17 Jul 2024
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: The data that support the findings of this study are available from Marit Hidding, upon reasonable request.
Publications
Hidding M, Veling W, Pijnenborg GHM, van der Stouwe ECD. Facing your inner critic: a randomized controlled trial investigating a virtual reality intervention with and without a perspective change for excessive self-criticism. J Behav Ther Exp Psychiatry. 2025 Dec;89:102053. doi: 10.1016/j.jbtep.2025.102053. Epub 2025 Jul 16.
PubMed 40714698
Study at a glance
From the registry record, last updated by the sponsor on 17 Jul 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Self-compassion and Self-criticism: a Virtual Reality Intervention
- ClinicalTrials.gov ID
- NCT05887141
- Acronym / sponsor ID
- VirtuS / 10036
- Conditions
- Self-Criticism
- Keywords
- Virtual Reality, self-criticism, self-compassion, perspective change, Cognitive Behavioral Therapy
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 136 participants (actual)
- Lead sponsor
- University Medical Center GroningenUniversity, hospital or other
- Collaborators
- PPO, University of Groningen
- Study start
- 12 Oct 2021 (actual)
- Primary completion
- 9 Jun 2023 (actual)
- Study completion
- 9 Jun 2023 (actual)
- First posted
- 2 Jun 2023 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study is to investigate two independent Virtual Reality interventions for self-criticism and self-compassion and the use of perspective-change in these interventions.
Detailed description
The current study will use two novel Virtual Reality (VR) exercises that will be investigated through two independent sub-studies. First of all, an exercise that uses the CBT (Cognitive Behavioral Therapy) technique called 'Double standards'. People with excessive self-criticism often set higher standards for themselves, which makes them more critical towards themselves. A way to distance from this, to enable a more nuanced reflection, is to ask the patient what they would say to a friend having those same negative thoughts about themselves. Doing this utilizing a role play in a realistic VR environment of which the avatar has the characteristics of a friend, the effect could be even stronger. Furthermore, VR offers the chance to switch perspectives, in which the participants receive their own compassionate comments from the perspective of the friend, and experience themselves as a good friend.
The second exercise, 'Self-criticism avatar', has common grounds with the (two-)chair exercises of schema therapy and the voice dialogue method in which a patient enters a dialogue between one's inner voices. In the VR exercise, the participant will be able to choose a virtual character with a voice that represents their own inner critic and that gives them their own self-criticism. By assertively and strictly speaking up to the inner critic, after which the virtual character becomes smaller and smaller until it backs down, the participant can experience a sense of control over their self-criticism, which leaves more room for self-compassion. A discussion with the inner critic enables a more nuanced image with more self-compassion. The switch in perspective after the role-play allows the participant to see himself/herself speaking assertively to the avatar, which can strengthen the increase in self-compassion and decrease in self-criticism.
Switching of perspectives is a relatively new technique within VR, that can be of added value to regular psychological therapies. Regular psychological therapies use switching of perspectives by switching roles in a physical role-play between a therapist and a patient or in a group. Furthermore, imaginative switches of perspective are used in, for example, schema therapy or imagery rescripting. Even though this can bring new insight into another perspective, it is not possible to replay the role play where the participant can see himself/herself from someone else's perspective. This is, however, possible through VR.
The current study will investigate the two beforementioned VR exercises using two independent sub-studies, to determine whether they contribute to self-compassion and if the switch in perspective is of added value. This will be done by comparing two conditions for each VR exercise; one with a switch in perspective and one without a switch in perspective. The study aims to answer the following research questions:
- Do the two VR-self compassion exercises have a positive effect on self-compassion (increase) and self-criticism (decrease)?
- Is the switch in perspective for the exercise 'Double standards of added value? In other words: is receiving one's own compassionate response of added value in addition to showing compassion to a vulnerable other.
- Is the switch in perspective for the exercise 'self-criticism avatar' of added value? In other words: is watching oneself in a strong and resilient manner of added value in addition to assertively speaking up to one's inner critic?
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
- Model description
- Two independent substudies, each with two arms. N=68 per substudy (N=136 total)
| Arm | Type | Receives |
|---|---|---|
| Control Condition (no perspective change) | Other | Behavioral: Double Standards, Behavioral: Self-criticism avatarThe intervention (two role-plays), however without using a perspective change afterwards. |
| Perspective change condition | Experimental | Behavioral: Double Standards, Behavioral: Self-criticism avatarThe intervention (two role-plays) with a perspective change after each role-play. |
Who may qualify
- Ages
- 17 to 30 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child, Adult
Key inclusion criteria (2 listed)
- Enrolled in a study
- Score above 20 (>20) on the subscale 'Inadequate self' of the FSCRS questionnaire
Key exclusion criteria (1 listed)
- N/A
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Double StandardsWe created a VR intervention based on the Cognitive Behavioral Therapy (CBT) technique 'double standards'. In the intervention the participants have to respond to a virtual character they imagine as their friend, who expresses similar self-criticism as they struggle with themselves. Two role-plays are played in Virtual Reality (either with or without perspective change after the role-plays). In the perspective change condition, the perspective is changed with the virtual friend (second person perspective). | Behavioural | Control Condition (no perspective change), Perspective change condition |
| Self-criticism avatarWe created a VR intervention called 'Self-criticism avatar' that has common ground with two-chair dialogue. Participants have to assertively respond to their inner critic who criticizes them using their own self-critical thoughts. After responding assertively (for example: 'Go away, I don't need you', 'Good is good enough'), the virtual character becomes weaker until they give up. Two role-plays are played in Virtual Reality (either with or without perspective change after the role-plays). In the perspective change condition, the perspective is changed with a bystander (third person perspective). | Behavioural | Control Condition (no perspective change), Perspective change condition |
Primary outcome
Self-Criticism and Self-Compassion Scales (SCCS) - Change in Self-Criticism
Time frame: Right before (Timepoint 1) and directly after (Timepoint 2) the +/- 60 minute intervention
Levels of state self-criticism as measured by the SCCS. The questionnaire consists of five scenarios that could induce self-critical and/or self-compassionate reactions. For the self-criticism scale, participants indicate on a 7-point Likert scale (1= not at all to 7= highly) to what extent they would react towards themselves in a contemptuous, critical, and harsh manner (range 15-105, higher scores reflect more self-criticism).
Self-Criticism and Self-Compassion Scales (SCCS) - Change in Self-Compassion
Time frame: Right before (Timepoint 1) and directly after (Timepoint 2) the +/- 60 minute intervention
Levels of state self-compassion as measured by the SCCS. The questionnaire consists of five scenarios that could induce self-critical and/or self-compassionate reactions. For the self-compassion scale, participants indicate on a 7-point Likert scale (1= not at all to 7= highly) to what extent they would react towards themselves in a reassuring, soothing, and compassionate manner (range 15-105, higher scores reflect more self-compassion).
3 secondary outcomes
Change in negative affect
Time frame: Right before (Timepoint 1) and directly after (Timepoint 2) the +/- 60 minute intervention
Change in positive affect
Time frame: Right before (Timepoint 1) and directly after (Timepoint 2) the +/- 60 minute intervention
Change in self-compassion and self-esteem
Time frame: Right before (Timepoint 1) and directly after (Timepoint 2) the +/- 60 minute intervention
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 17 Jul 2024.
- Derived from this study: PubMed 40714698Hidding M, Veling W, Pijnenborg GHM, van der Stouwe ECD. Facing your inner critic: a randomized controlled trial investigating a virtual reality intervention with and without a perspective change for excessive self-criticism. J Behav Ther Exp Psychiatry. 2025 Dec;89:102053. doi: 10.1016/j.jbtep.2025.102053. Epub 2025 Jul 16.
- Individual participant dataSharing planned: No. The data that support the findings of this study are available from Marit Hidding, upon reasonable request.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Elise van der Stouwe principal investigator
University Medical Center Groningen
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Double Standards and Self-criticism avatar in people with Self-Criticism, run by University Medical Center Groningen at 1 site in Netherlands.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 2 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 17 Jul 2024. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Netherlands. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Self-Criticism and Self-Compassion Scales (SCCS) - Change in Self-Criticism (time frame: Right before (Timepoint 1) and directly after (Timepoint 2) the +/- 60 minute intervention). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT05887141, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Jul 2024.