ORIGINAL RESEARCH article
Front. Virtual Real.
Sec. Virtual Reality in Medicine
Refugio: A Voice-Driven Generative Virtual Reality "Safe Place" for Personalized Emotion Regulation – Feasibility and Usability Study
Pau Mora García 1
Eugenio Ivorra Martínez 1
Elena Parra Vargas 1
Pau Soldevila-Matías 2,3,4,5
Mariano Luis Alcañiz Raya 1
1. Institute for Research on Human-Centered Technology, Universitat Politécnica de València, Valencia, Spain
2. INCLIVA - Health Research Institute, Valencia, Spain
3. TMAP - Evaluation Unit in Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain
4. Center for Biomedical Research in Mental Health Network (CIBERSAM), Health Institute, Carlos III, Madrid, Spain
5. Universitat de Valencia Facultat de Psicologia i Logopedia, Valencia, Spain
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Abstract
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 "safe places" 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. 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). The study provided compelling preliminary evidence of the system's feasibility and high user acceptance. Refugio achieved an "Excellent" 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). This study demonstrates that Refugio's 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.
Summary
Keywords
emotional regulation, Generative artificial intelligence, Mental Health, Speech-to-3D, virtual reality
Received
04 December 2025
Accepted
19 February 2026
Copyright
© 2026 Mora García, Ivorra Martínez, Parra Vargas, Soldevila-Matías and Alcañiz Raya. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Pau Mora García
Disclaimer
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.