{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T08:14:13Z","timestamp":1773389653433,"version":"3.50.1"},"reference-count":61,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004233","name":"Universitat Polit\u00e8cnica de Val\u00e8ncia","doi-asserted-by":"publisher","award":["PAID-06-23"],"award-info":[{"award-number":["PAID-06-23"]}],"id":[{"id":"10.13039\/501100004233","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Virtual Real."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Virtual Reality (VR) has emerged as a pivotal tool for mental health interventions, paving the way for innovative approaches to emotional regulation. While the customization of therapeutic \u201csafe places\u201d is believed to enhance outcomes, existing applications often depend on inflexible, pre-configured content. This paper introduces Refugio, a groundbreaking VR application designed to bridge this gap through an integrated, real-time personalization pipeline powered by a self-hosted Large Language Model (LLM) and an efficient voice-to-3D generative pipeline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a feasibility and usability study with 30 non-clinical participants to evaluate the feasibility and user acceptance of this natural language-driven approach, while preliminarily exploring its potential to support emotional outcomes and immersion while minimizing cognitive workload. We assessed usability (using the System Usability Scale - SUS), cognitive load (NASA-TLX), immersion (RJPQ), and emotional state before and after (Self-Assessment Manikin - SAM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study provided compelling preliminary evidence of the system\u2019s feasibility and high user acceptance. Refugio achieved an \u201cExcellent\u201d mean SUS score of 86.33, alongside low reported mental demand and frustration. Participants showed strong engagement, creating 147 objects, and reported positive emotional shifts, with the majority experiencing increased valence (21 out of 30) and decreased arousal (19 out of 30).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This study demonstrates that Refugio\u2019s architecture is a viable and well-received method for implementing deep generative personalization. Our findings suggest that this natural language driven approach adeptly balances creative freedom with high usability and low cognitive load, thereby establishing a robust foundation for future clinical validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/frvir.2026.1760765","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T05:26:27Z","timestamp":1773379587000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Refugio: a voice-driven generative virtual reality \u201csafe place\u201d for personalized emotion regulation \u2013 feasibility and usability study"],"prefix":"10.3389","volume":"7","author":[{"given":"Pau","family":"Mora","sequence":"first","affiliation":[{"name":"Institute for Research on Human-Centered Technology, Universitat Polit\u00e8cnica de Val\u00e8ncia","place":["Valencia, Spain"]}]},{"given":"Eugenio","family":"Ivorra","sequence":"additional","affiliation":[{"name":"Institute for Research on Human-Centered Technology, Universitat Polit\u00e8cnica de Val\u00e8ncia","place":["Valencia, Spain"]}]},{"given":"Elena","family":"Parra-Vargas","sequence":"additional","affiliation":[{"name":"Institute for Research on Human-Centered Technology, Universitat Polit\u00e8cnica de Val\u00e8ncia","place":["Valencia, Spain"]}]},{"given":"Pau","family":"Soldevila-Mat\u00edas","sequence":"additional","affiliation":[{"name":"INCLIVA - Health Research Institute","place":["Valencia, Spain"]},{"name":"TMAP - Evaluation Unit in Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia","place":["Valencia, Spain"]},{"name":"Center for Biomedical Research in Mental Health Network (CIBERSAM), Health Institute, Carlos III","place":["Madrid, Spain"]},{"name":"Faculty of Psychology, University of Valencia","place":["Valencia, Spain"]}]},{"given":"Mariano L.","family":"Alca\u00f1iz","sequence":"additional","affiliation":[{"name":"Institute for Research on Human-Centered Technology, Universitat Polit\u00e8cnica de Val\u00e8ncia","place":["Valencia, Spain"]}]}],"member":"1965","published-online":{"date-parts":[[2026,3,13]]},"reference":[{"key":"B1","first-page":"2319","article-title":"How people prompt generative ai to create interactive vr scenes","volume-title":"Proceedings of the 2024 ACM designing interactive systems conference","author":"Aghel Manesh","year":"2024"},{"key":"B2","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1007\/978-3-540-73216-7_29","article-title":"Emma: an adaptive display for virtual therapy","volume-title":"International conference on foundations of augmented cognition","author":"Alca\u00f1iz","year":"2007"},{"key":"B3","doi-asserted-by":"publisher","first-page":"219","DOI":"10.22937\/IJCSNS.2021.21.3.30","article-title":"An extended UTAUT2 model to explain the adoption of virtual reality technology in health Centers: an empirical study based in Riyadh","volume":"21","author":"Algahtani","year":"2021","journal-title":"Int. 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