# The effect of empathy intervention and VR exergames on social anxiety in left-behind children

## TL;DR

This study compared empathy training and VR games to reduce social anxiety in rural Chinese children left without parents, finding VR games had faster effects while empathy training showed slower improvement.

## Contribution

The study reveals distinct therapeutic trajectories of empathy intervention and VR exergames in managing social anxiety among left-behind children.

## Key findings

- VR exergames showed stronger immediate reductions in social anxiety compared to empathy intervention.
- Empathy intervention demonstrated delayed but sustained improvement in social anxiety over time.
- The control group showed no significant changes in social anxiety scores throughout the study.

## Abstract

This study investigated the comparative effectiveness of empathy intervention and virtual-reality exergames in reducing social anxiety among rural left-behind children (RLBC) in China.

Sixty RLBC from Huangdu Primary School in Shaodong City, Hunan Province were randomly assigned to three groups—the Empathy Intervention Group (EG), the VR Exergames Group (VG), and the Control Group (CG)—with 20 participants each. The Children’s Social Anxiety Scale (CSAS) was administered at baseline (T0), post-intervention (T1, Week 12), and 4-week follow-up (T2).

Results showed no baseline differences between groups (P > 0.05). At T1, both EG and VG demonstrated significant reductions in overall CSAS and subscale scores, with VG outperforming EG. By T2, VG maintained significant gains (P < 0.05), while EG exhibited delayed but sustained improvement (P < 0.05), though no significant change occurred between T1 and T2 (P > 0.05). The control group remained stable throughout (P > 0.05).

These findings suggest VR exergames yield stronger immediate effects, while empathy interventions show gradual efficacy, highlighting distinct therapeutic trajectories for RLBC’s social anxiety management.