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Peer-reviewedCC BYJMIR research protocols

Virtual Reality Therapy Assistants for Adjunctive Cue Exposure Training in the Treatment of Alcohol Use Disorder (VITAACue-AUD): Protocol for a Technical Feasibility Study.

6 affiliations
  1. 1Center for Innovative Psychiatry and Psychotherapy Research, Central Institute of Mental Health, J5, Mannheim, Baden-Wurttemberg, 68159, Germany, 49 17036359.
  2. 2Partner Site Mannheim-Heidelberg-Ulm, Deutsches Zentrum für Psychische Gesundheit, Mannheim/Heidelberg/Ulm, Baden-Wurttemberg, Germany.
  3. 3Data and Web Science Group, School of Business Informatics and Mathematics, University of Mannheim, Mannheim, Baden-Wurttemberg, Germany.
  4. 4Human-Technology Interaction Lab, Department of Neurosurgery, University Medical Center Freiburg, Freiburg, Baden-Wurttemberg, Germany.
  5. 5Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Mannheim, Baden-Wurttemberg, Germany.
  6. 6neunzehn innovations GmbH, Heidelberg, Baden-Wurttemberg, Germany.

Abstract

Background

Alcohol use disorder (AUD) is associated with a substantial individual and societal burden. Cue exposure approaches can support treatment by targeting conditioned cue reactivity and high-risk contextual associations. However, routine implementation is limited by therapist time, scalability constraints, and the difficulty of reproducing ecologically valid drinking situations in standard care settings. Virtual reality (VR) and AI have been proposed as promising tools to support scalable and contextually rich interventions in mental health care.Objective

This study aims to develop and technically evaluate a prototype virtual reality-based therapy assistant (VRTA) for narratively guided alcohol cue exposure in immersive VR.Methods

This is a single-site technical feasibility study conducted at the Central Institute of Mental Health in Mannheim, Germany. It builds on a participatory development process, including multistakeholder workshops with developers, researchers, clinicians, and patient and public involvement contributors. The study began with workshops to refine implementation priorities. A VRTA prototype will be developed to guide alcohol cue exposure scenarios through speech-based interaction with a computer-generated character in immersive VR, informed by established exposure manuals (development ongoing, currently with a text-based chatbot prototype and a separate VR environment). An iterative qualitative expert appraisal will be conducted during development (ongoing). In addition, 20 adult patients with AUD will participate in an observer-based evaluation in which therapeutic staff demonstrate the prototype and patients provide qualitative feedback.Results

Results are expected on the technical feasibility of the VRTA prototype, including interaction quality and integration into therapeutic workflows. Qualitative findings from expert appraisal and patient feedback (observed from a third-person perspective) will provide insights into usability, manual conformity, acceptability, and perceived therapeutic relevance (audio transcript coding and qualitative evaluation are ongoing). Funding for this study has been approved by the Hetzler Foundation from November 2025 to October 2027. Initial workshops were conducted in January 2026 and May 2026. Prototype testing by expert participants with patient observers is planned to start in November 2026 and continue until April 2027.Conclusions

This study is intended to generate design specifications and feasibility data to inform subsequent prototype refinement and future clinical evaluation studies.

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BibTeX
@article{kammlersucker2026virtual,
  title = {{Virtual Reality Therapy Assistants for Adjunctive Cue Exposure Training in the Treatment of Alcohol Use Disorder (VITAACue-AUD): Protocol for a Technical Feasibility Study.}},
  author = {Kornelius I Kammler-Sücker and Carolin Heizmann and Katharina Eidenmueller and Leon Werner and Thomas Prexl and Frank Rust and Rolf-Dieter Schiermeyer and Melissa R M Mohr and Philipp Kellmeyer and Bernd Lenz},
  journal = {JMIR research protocols},
  year = {2026},
  month = oct,
  doi = {10.2196/99080},
  url = {https://europepmc.org/article/MED/42902919},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Virtual Reality Therapy Assistants for Adjunctive Cue Exposure Training in the Treatment of Alcohol Use Disorder (VITAACue-AUD): Protocol for a Technical Feasibility Study.
AU  - Kornelius I Kammler-Sücker
AU  - Carolin Heizmann
AU  - Katharina Eidenmueller
AU  - Leon Werner
AU  - Thomas Prexl
AU  - Frank Rust
AU  - Rolf-Dieter Schiermeyer
AU  - Melissa R M Mohr
AU  - Philipp Kellmeyer
AU  - Bernd Lenz
PY  - 2026
DA  - 2026/10/20
JO  - JMIR research protocols
DO  - 10.2196/99080
UR  - https://europepmc.org/article/MED/42902919
AB  - Background  Alcohol use disorder (AUD) is associated with a substantial individual and societal burden. Cue exposure approaches can support treatment by targeting conditioned cue reactivity and high-risk contextual associations. However, routine implementation is limited by therapist time, scalability constraints, and the difficulty of reproducing ecologically valid drinking situations in standard care settings. Virtual reality (VR) and AI have been proposed as promising tools to support scalable and contextually rich interventions in mental health care.Objective  This study aims to develop and technically evaluate a prototype virtual reality-based therapy assistant (VRTA) for narratively guided alcohol cue exposure in immersive VR.Methods  This is a single-site technical feasibility study conducted at the Central Institute of Mental Health in Mannheim, Germany. It builds on a participatory development process, including multistakeholder workshops with developers, researchers, clinicians, and patient and public involvement contributors. The study began with workshops to refine implementation priorities. A VRTA prototype will be developed to guide alcohol cue exposure scenarios through speech-based interaction with a computer-generated character in immersive VR, informed by established exposure manuals (development ongoing, currently with a text-based chatbot prototype and a separate VR environment). An iterative qualitative expert appraisal will be conducted during development (ongoing). In addition, 20 adult patients with AUD will participate in an observer-based evaluation in which therapeutic staff demonstrate the prototype and patients provide qualitative feedback.Results  Results are expected on the technical feasibility of the VRTA prototype, including interaction quality and integration into therapeutic workflows. Qualitative findings from expert appraisal and patient feedback (observed from a third-person perspective) will provide insights into usability, manual conformity, acceptability, and perceived therapeutic relevance (audio transcript coding and qualitative evaluation are ongoing). Funding for this study has been approved by the Hetzler Foundation from November 2025 to October 2027. Initial workshops were conducted in January 2026 and May 2026. Prototype testing by expert participants with patient observers is planned to start in November 2026 and continue until April 2027.Conclusions  This study is intended to generate design specifications and feasibility data to inform subsequent prototype refinement and future clinical evaluation studies.
SN  - 1929-0748
ER  -