Intro: Virtual reality (VR)–based counseling is an emerging modality for digital mental health, offering immersive environments that can be experimentally controlled to test how social cues shape responses to therapeutic content. However, limited research has examined how counselor avatar gender and scenario severity jointly influence observers’ affective outcomes and neurophysiological dynamics during vicarious exposure to VR counseling.

Fifty-one female college students (ages 18‒25) from South Korea were randomly assigned to a 2 × 2 factorial design: counselor avatar gender (male vs. female) × scenario severity (mild-stressor vs. severe-crisis). Participants observed a scripted VR counseling scenario (∼12 min analyzable exposure; ∼20 min total including setup/instructions). Pre- and post-session assessments included State-Trait Anxiety Inventory (STAI-S; total scores 20–80) and Warwick-Edinburgh Mental Well-Being Scale (WEMWBS; total scores 14–70). Relative beta power (13–30 Hz) was measured via EEG ( Lovibond and Lovibond, 1995 ).

A 2 × 2 ANOVA on post-session STAI-S total scores revealed a significant counselor gender × scenario severity interaction, F (1,47) = 8.50, p  = 0.005, η ²  = 0.153. Participants observing severe-crisis scenarios with female counselors reported highest anxiety (M = 72.0, SD = 9.8) versus male counselors (M = 48.8, SD = 18.8), t (22) = 3.58, p  = 0.002, d  = 1.50. For WEMWBS, severe-scenario participants showed greater well-being with female counselors (M = 52.1, SD = 10.6) than male (M = 40.0, SD = 12.0), t (22) = 2.68, p  = 0.014, d  = 1.08. EEG revealed no main effect of group ( p  = 0.754), but a significant Group × Channel interaction ( p  = 0.014) in frontal-temporal regions.

Conclusion.

Counselor-avatar gender cues and scenario severity shaped observers’ immediate affective and neurophysiological responses to simulated VR counseling in complex ways. Elevated anxiety during severe-crisis content—particularly when observing a female-coded counselor avatar—may reflect intensified engagement with distressing material rather than simple discomfort. Neurophysiological findings indicate phase-dependent changes in arousal-related processing, with condition effects appearing regionally localized rather than global. These findings may inform future research on avatar design in digital mental health environments and motivate direct comparisons between observational and interactive VR counseling paradigms.