Virtual therapeutic landscape: An immersive intervention for anxiety in university students

Anxiety among university students has become a critical global public health issue due to its high prevalence and impact. This study builds on prior work on virtual therapeutic landscape design and evaluation by operationalising therapeutic landscape principles in a virtual reality setting, aiming to develop and evaluate a multi-sensory immersive intervention for anxiety relief. Drawing on semi-structured interviews and the analytic hierarchy process, four core components – sensory, interactive, personalised and content experience – were identified, forming a systematic evaluation framework. A within-subject pre–post study involving 46 university students demonstrated that short-term virtual therapeutic landscape exposure significantly reduced state anxiety (p < 0.001, d = 0.916), negative affect (p < 0.001, d = 0.588) and enhanced subjective vitality (p < 0.001, d = 0.966). Physiological data showed decreased phasic skin conductance response and phase-related changes in tonic skin conductance level across baseline–intervention–recovery, both showing significant time effects. By contrast, virtual therapeutic landscape exposure produced comparatively smaller changes in trait anxiety (p < 0.001, d = 0.739) and positive affect (p = 0.005, d = 0.437). Taken together, virtual therapeutic landscape yielded convergent psychological and physiological benefits and provides an empirically grounded extension of therapeutic landscape theory into digital mental health interventions. Implications for practice or policy: Universities could use virtual therapeutic landscape as a low-burden adjunct to support short-term anxiety relief in students. Student support services can position virtual therapeutic landscape as a brief intervention for reducing state anxiety and negative affect rather than as a substitute for longer-term treatment. Designers of virtual reality mental health interventions should prioritise sensory immersion, user-friendliness and system stability to improve restorative outcomes.