A Case Series of Virtual Reality-Based Social Interactions for Adolescents with Psychiatric Disorders in a Television Program: Insights from NHK’s Project Aliens

BACKGROUND: Virtual reality (VR) technology is emerging as a tool in mental health care, providing a safe space for social interaction and therapeutic engagement. A social VR-based TV program broadcast on Japanese public television offers a virtual environment where adolescents with mental health challenges can engage in peer support using alien avatars, reducing barriers to communication and encouraging emotional expression. OBJECTIVE: This case series aimed to document the psychological trajectories of adolescents with psychiatric disorders participating in a social VR-based television program. METHODS: A single-center case series was conducted with three adolescents with psychiatric disorders (aged 15, 18, and 19) who participated in the social VR-based TV program. The study focused on examining patient-reported outcomes (including psychological measures and qualitative experiences) and clinical observations across program participation and broadcast viewing. Psychological measures, including the Japanese versions of the UCLA Loneliness Scale, the Resilience Scale, and the Patient Health Questionnaire-9, were assessed at three time points: baseline, pre-broadcast, and post-broadcast. Qualitative analysis of participant dialogue explored themes of self-disclosure, emotional expression, and social dynamics. RESULTS: Participants showed improvements in loneliness, resilience, and depressive symptoms after participating in the social VR program, as indicated by psychological measures and patient-reported outcomes. Qualitative analysis suggested that the structured facilitation embedded in the program enabled participants to express positive and negative emotions, promoting self-reflection and mutual support. CONCLUSIONS: This case series suggests that structured social VR programs can provide a supportive platform for emotional exploration and psychological growth among adolescents with psychiatric disorders. The combination of avatar-based interaction and therapeutic facilitation may offer a novel approach to engaging young people in mental health care, particularly during waiting periods for traditional psychiatric services.