Learning Island: The Development of a
Virtual reality System for the Experiential
Training of Stress Management
Giuseppe RIVA 1-2, Cinzia VIGNA1, Alessandra GRASSI 1-2
Simona RASPELLI 1, Pietro CIPRESSO 1-2, Federica PALLAVICINI 1
Silvia SERINO 1-2, Andrea GAGGIOLI 1-2
1 Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano,
2 Psychology Department, Catholic University of Milan, Italy
Abstract. Psychological Stress occurs when an individual perceives that
environmental demands tax or exceed his or her adaptive capacity. Following this
view, that underlines the role of the situated experience of the patient in
experiencing a stressor, the European Union funded Interstress project
(http://www.interstress.eu) is exploring the possible use of the virtual simulation
technology offered by SecondLife (http://www.secondlife.com) to administer a
stress management experiential training. The structure of the environment and the
contents of the course are described and discussed.
Keywords: Stress-Management, SecondLife, Experiential training
According to Cohen and colleagues , “Psychological Stress” occurs when an
individual perceives that environmental demands tax or exceed his or her adaptive
capacity. In this view, stressful experiences depend a great deal on how the person
experiencing a stressor is put together —psychologically and physically. So the focus
for assessment, prediction and treatment has to be the situated experience of the patient.
2. The Interstress project
To reach this goal, he European project Interstress (http://www.interstress.eu) is
using a totally new paradigm for stress managment – “interreality” – that integrates
training, assessment and treatment within a hybrid environment, bridging physical and
virtual world [2, 3]. Within this paradigm, a critical role is played by the “Learning
Island”, a shared online virtual world, used for the experiential training of stress coping
skills (Figure 1; see this YouTube video for a walkthrough of the Island:
Figure 1. An overview of the Learning Island
3. Developing the Learning Island
Second Life (SL) is a virtual three-dimensional platform that has been used for
medical education . In the Interstress project we are exploring the potential of using
SL virtual simulation technology through the development of an interactive course to
administer experiential training of stress management. Specifically, we plan to use the
motivation and the engagement provided by a shared virtual experience to teach the
users about how to improve their stress knowledge and management skills.
The Learning Island is organized around different learning areas both without and
with teachers (classes). In this island the users:
• Learn the main causes of stress and how to recognize stress symptoms.
• Learn stressor-focused strategies (e.g., resource optimization and better
• Learn some stress relieving exercises (e.g., relaxation training or
diaphragmatic breathing, use of emotional support)
• Get the information needed to succeed, with daily tips and expert ideas.
Following a constructivist approach we organized the Learning Island around
different learning areas both without and with supervision (see Figure 2):
1) Area 1: Discover the causes of stress (individual, unsupervised)
2) Area 2: Discover the emotional and physical symptoms of stress (individual and
3) Area 3: Interact with different stress resources (individual, unsupervised)
4) Area 4: Experience different challenges (individual, supervised by the therapist)
5) Area 5: Coping skills training (individual and shared, supervised by the therapist)
6) Area 6: Discuss with the therapist and other patients.
4. Future steps
Future goals of this study are to:
1) explore the potential of the virtual world, Second Life, stress management training
2) determine possible instructional design approaches for using SL for SMT;
3) understand the limitations of SL for SMT activities; and
4) measure participant learning outcomes and feedback.
Figure 2. The structure of the training environment
This paper was partially supported by the FP7 European funded projects “Interstress -
Interreality in the management and treatment of stress-related disorders – FP7-247685l
 Cohen S, Janicki-Deverts D, Miller GE, Psychological Stress and Disease. JAMA. 2007; 298:1685-1687.
 Riva G, Interreality: A New Paradigm for E-health. Stud Health Technol Inform. 2009;144:3-7.
 Gaggioli A, Raspelli S, Grassi A, Pallavicini F, Cipresso P, Wiederhold BK, Riva G. Ubiquitous health in
practice: the interreality paradigm. Stud Health Technol Inform. 2011;163:185-91.
 Wiecha J, Heyden R, Sternthal E, Merialdi M, Learning in a Virtual World: Experience With Using
Second Life for Medical Education. J Med Internet Res 2010;12(1):e1