Decrease Trauma-related Shame With Virtual Reality: The Effectiveness of SHINE-VR (SHINE-VR)

December 5, 2025 updated by: Carlijn Bergwerff, Universiteit Leiden

The Effectiveness of a Virtual Reality Intervention on Trauma-related Shame in Sexually Abused Adolescents: A Single-case Experimental Study

Suffering from PTSD in childhood can have detrimental formative consequences. Researchers have been eager to develop effective interventions and to enhance treatment motivation since the introduction of the diagnosis of PTSD in the DSM. With evolving understanding of the disorder, its definition and criteria have changed over the course of time. The most recent change involves the addition of the criterium D of negative affects or emotions in relation to PTSD, the feeling of shame amongst others. Individuals experiencing interpersonal trauma, such as sexual abuse, are at high-risk developing trauma-related shame, which in turn can impact the course and effectiveness of PTSD treatment. Shame-inducing situations are typically being avoided, and the feelings are not disclosed to peers and other people. Hence, acknowledging and sharing feelings of shame as well as practicing self-compassion have been proposed to reduce the impact of that negative self-conscious emotion. These aspects get partially tackled in evidence-based trauma therapies, however, there appears to be a need for a more specific trauma-related shame intervention in addition to existing treatments. Recent research has focused on developing such interventions for adults and has reported positive effects.

To our knowledge, there is no intervention specifically tackling trauma-related shame in adolescents. Virtual Reality (VR) is a promising tool for such an intervention. Findings suggest that including VR in a treatment results in high treatment satisfaction and that it is highly motivating for its users, which is a crucial component for treatment success.

The goal of this study is to test the effectiveness of a short-term VR shame intervention (SHINE-VR) for adolescents suffering from PTSD after having experienced sexual abuse. The primary objectives of this study to assess the effect of SHINE-VR on trauma-related shame, self-compassion, and PTSD symptom reduction, to investigate whether treatment motivation, an increase in self-compassion, and a decrease in trauma-related shame are associated with PTSD symptom reduction.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

6

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Netherlands
      • Amsterdam, Netherlands
        • LEVVEL
      • Haarlem, Netherlands
        • Kenter Jeugdhulp
      • Oegstgeest, Netherlands, 2342AK
        • LUMC Curium
    • Haaglanden
      • The Hague, Haaglanden, Netherlands
        • GGZ Delfland
    • South Holland
      • Leiden, South Holland, Netherlands, 2311 EX
        • iMindU Practice for Child, Adolescent and Adult Psychiatry

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Between 12 and 17 years old at inclusion
  • Interpersonal trauma (sexual abuse); in case of multiple traumas the main trauma should be sexual abuse
  • Indication for PTSD treatment
  • Getting trauma treatment as usual
  • Adequate command of the Dutch language

Exclusion Criteria:

  • Known mental disability
  • Epilepsy

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: SHINE-VR Baseline 1 week

Participants will receive SHINE-VR additionally to regular trauma treatment. The baseline phase starts after trauma processing, e.g. after module 6 of TF-CBT or processing of the traumatic event with EMDR.

This group has a one week baseline, 3 weeks intervention, and 2 week follow-up phase.
Behavioral: SHINE-VR

The SHINE-VR takes place after trauma processing, e.g. after module 6 of TF-CBT or processing of the traumatic event with EMDR, and is followed by the rest of the regular treatment. SHINE-VR consists of the following 3 VR sessions à 45min:

  • Introduction: getting acquainted with VR, playing a VR game developed for the feasibility study (Krupljanin et al., in preparation), receiving psychoeducation about seeking help.
  • Shame: virtual group therapy setting, psychoeducation about shame, virtual peers sharing thoughts of shame and their learnings/positive affirmations.
  • Self-compassion: practicing self-compassion using an immersive perspective-changing task in VR.
Active Comparator: SHINE-VR Baseline 2 weeks

Participants will receive SHINE-VR additionally to regular trauma treatment. The baseline phase starts after trauma processing, e.g. after module 6 of TF-CBT or processing of the traumatic event with EMDR.

This group has a two week baseline, 3 weeks intervention, and a 1 week follow-up phase.
Behavioral: SHINE-VR

The SHINE-VR takes place after trauma processing, e.g. after module 6 of TF-CBT or processing of the traumatic event with EMDR, and is followed by the rest of the regular treatment. SHINE-VR consists of the following 3 VR sessions à 45min:

  • Introduction: getting acquainted with VR, playing a VR game developed for the feasibility study (Krupljanin et al., in preparation), receiving psychoeducation about seeking help.
  • Shame: virtual group therapy setting, psychoeducation about shame, virtual peers sharing thoughts of shame and their learnings/positive affirmations.
  • Self-compassion: practicing self-compassion using an immersive perspective-changing task in VR.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Trauma-related shame
Time Frame: Daily throughout the 6 weeks, resulting in 42 assessments
Shame experienced in relation to sexual abuse will be measured with a self-developed questionnaire. The first 4 items are based on the Dutch translation of the Shame and Guilt After Trauma Scale. Each item is rated on a 5-point Likert scale. Higher scores mean worse outcome. 2 items are reversed. Higher scores mean worse outcome.
Daily throughout the 6 weeks, resulting in 42 assessments
Self-compassion
Time Frame: Daily throughout the 6 weeks, resulting in 42 assessments
Self-compassion will be measured with the Dutch translation of the Self-Compassion Scale-Youth version. Each of the 6 items is rated on a 1-5 Likert scale, 3 of them are reversed. The outcome measure is the sum score of all items divided by the number of items. Higher scores mean better outcome.
Daily throughout the 6 weeks, resulting in 42 assessments

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
PTSD symptoms
Time Frame: Daily on weekdays throughout the 6 weeks, resulting in 30 assessments
PTSD symptoms will be measured with the Kind en Jeugd Traumascreener. Items 1-20 measuring the symptoms will be used, each item is rated on a 0-3 Likert scale. The outcome measure is the sum score of all items. Higher scores mean worse outcome.
Daily on weekdays throughout the 6 weeks, resulting in 30 assessments

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Universiteit Leiden

Collaborators

University of Amsterdam

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

February 3, 2025

Primary Completion (Actual)

May 19, 2025

Study Completion (Actual)

May 19, 2025

Study Registration Dates

First Submitted

March 1, 2024

First Submitted That Met QC Criteria

April 24, 2024

First Posted (Actual)

April 25, 2024

Study Record Updates

Last Update Posted (Actual)

December 15, 2025

Last Update Submitted That Met QC Criteria

December 5, 2025

Last Verified

August 1, 2025

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • NL83340.058.23

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

Identifiable information of the participants will be encrypted for the further processing and analyzing of the corresponding data. Once the project is completed and the paper(s) has been published, the encryption key and the personal data will be deleted. Following paragraph from the template of the Institute of Education and Child Studies will be used:

I consent to my and my child's participation in the study (Title Research) I also give permission to store and use the pseudonymised research data about me and my child that is collected in this research and to share it with other researchers if necessary.

IPD Sharing Time Frame

We will store the data according to the University regulations on data management of projects assessed by the Medical Ethical committee, allowing the data to be FAIR for at least 15 years after publication.

IPD Sharing Access Criteria

A CC-BY license will be used. Since sensitive data will be collected, it will only be shared with researchers upon request. Requests for information will be reviewed by the first and last author.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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