Dr. Paul is a Clinical Assistant Professor in the Department of Psychiatry and Behavioral Sciences. She received her undergraduate degree from Tulane University where she graduated magna cum laude with departmental honors in psychology. She then received a master of science degree in behavioral health psychology the following year, after partaking in the 4+1 master's program. She graduated with her doctor of psychology degree from the PGSP-Stanford Psy.D. Consortium, where she won the award for Outstanding Overall Student (2021). She completed her clinical psychology doctoral internship at the Sepulveda VA in Los Angeles and her postdoctoral fellowship in the Department of Psychiatry and Behavioral Sciences at Stanford School of Medicine.

During her postdoctoral year she continued her research on using virtual reality (VR) as a method of engaging in behavioral activation for individuals with depression. Dr. Paul began her VR work in 2017 after joining Dr. Kim Bullock’s Virtual Reality-Immersive Technology Clinic & Laboratory in the Department of Psychiatry & Behavioral Sciences at Stanford School of Medicine. Dr. Paul won the Cheryl Koopman Dissertation of the Year Award for designing and implementing a feasibility study and three-arm pilot randomized controlled trial to examine the feasibility of using a VR headset as a way to administer behavioral activation therapy for participants with a diagnosis of major depressive disorder. She presented her past and ongoing research findings as a speaker at Shift Medical 2021: Virtual Medical XR Congress and Expo (2021), Stanford Psychiatry Grand Rounds (2022), IVRHA’s 7th Annual Virtual Reality and Healthcare Global Symposium (2023), VMed23 (2023), ADAA (2023), and CYPSY26 (2023). Dr. Paul has worked and consulted with VR companies and local Bay Area startups in the technology and mental health space. She has published on her virtual reality work.

Clinically, she is interested in working with adults with anxiety and mood disorders, interpersonal difficulties, health-related difficulties, and/or substance use disorders. Dr. Paul has experience working with high-performance individuals, such as healthcare providers and student athletes. She practices using predominantly cognitive behavioral and dialectical behavioral therapies, but integrates various skills depending on the presentation and need of each unique individual.

Clinical Focus

  • Clinical Psychology

Academic Appointments

  • Clinical Assistant Professor, Psychiatry and Behavioral Sciences

Honors & Awards

  • Cheryl Koopman Dissertation of the Year Award, PGSP-Stanford Psy.D. Consortium (2022)
  • Outstanding Overall Student, PGSP-Stanford PsyD Consortium, PGSP-Stanford Psy.D. Consortium (2021)

Boards, Advisory Committees, Professional Organizations

  • Inaugural Associate Editor, Journal of Medical Extended Reality (JMXR) (2023 - Present)

Professional Education

  • Fellowship: Stanford University Adult Psychology Postdoctoral Fellowship (2023) CA
  • Internship: VA Sepulveda Ambulatory Care Psychology Doctoral Internship (2022) CA
  • Medical Education: Palo Alto University PGSP Stanford PsyD Consortium (2022) CA
  • Postdoctoral Fellow, Department of Psychiatry and Behavioral Sciences, Stanford University, School of Medicine
  • Psy.D., PGSP-Stanford Psy.D. Consortium, Clinical Psychology (2022)
  • M.S., PGSP-Stanford Psy.D. Consortium, Clinical Psychology (2019)
  • M.S., Tulane University, Behavioral Health Psychology (2015)
  • B.S, Tulane University, Psychology and English (2014)

All Publications

  • Virtual Reality Behavioral Activation for Adults with Major Depressive Disorder: Feasibility and Randomized Controlled Trial. JMIR mental health Paul, M., Bullock, K., Bailenson, J. 2022


    BACKGROUND: Major depressive disorder (MDD) is a global crisis with increasing incidence and prevalence. There are many established evidence-based psychotherapies (EBP's) for depression, but numerous barriers still exist, most notably access and dissemination. Virtual reality (VR) may offer some solutions to existing constraints of EBP's for MDD.OBJECTIVE: To examine the feasibility, acceptability, and tolerability of using VR as a method of delivering behavioral activation (BA) for adults diagnosed with MDD during a global pandemic. To explore for signs of clinical efficacy by comparing VR enhanced BA (VR BA) to (1) a standard BA treatment and (2) a treatment as usual (TAU) group for individuals diagnosed with MDD.METHODS: A feasibility trial using a three-armed, unblinded, randomized controlled pilot design was conducted. The study took place remotely via Zoom telehealth visits between April 8, 2020 and January 15, 2021. This study employed a three-week, four-session protocol, in which VR BA participants used a VR headset to complete their BA homework. Feasibility was measured by dropout rates, serious adverse events, completion of homework, an adapted telepresence scale, a simulator sickness questionnaire, a brief agitation measure, and an adapted technology acceptance model. Efficacy was assessed by the Patient Health Questionnaire-9 (PHQ-9).RESULTS: Of the 35 participants assessed for eligibility, 13 were randomized to VR BA (n=5), traditional BA (n=4), or a TAU control (n=4). The mean age of the 13 participants (5 male, 7 female, 1 non-binary/third gender) was 35.4 (SD = 12.3). This study demonstrated VR BA feasibility in subjects with MDD by documented high levels of acceptability and tolerability while engaging in VR induced pleasurable activities in conjunction with a brief BA protocol. No adverse events were reported. This study also illustrated that VR BA may have potential clinical utility for treating MDD, as the average VR BA participant's clinical severity decreased by 5.67 points, signifying a clinically meaningful change in severity from a moderate to a mild level of depression, as per PHQ-9 scoring.CONCLUSIONS: The findings of this study demonstrate that VR BA is safe and feasible to explore for the treatment of MDD. This study documented evidence that VR BA may be efficacious, and it justifies examining further in an adequately powered RCT. This pilot highlights the potential utility that VR technology may offer patients with MDD, especially those who have difficulty accessing real-world pleasant activities. VR may also be a viable alternative to psychiatric medications for MDD, given its high tolerability and lack of side effects. Additionally, for those having difficulty accessing care, VR BA could be adapted as a first step to help people improve mood and increase motivation while waiting to connect with a healthcare professional for other EBP's.CLINICALTRIAL: Identifier: NCT04268316.INTERNATIONAL REGISTERED REPORT: RR2-10.2196/24331.

    View details for DOI 10.2196/35526

    View details for PubMedID 35404830

  • Case Report: Virtual Reality Behavioral Activation as an Intervention for Major Depressive Disorder. JMIR mental health Paul, M. n., Bullock, K. n., Bailenson, J. n. 2020


    Major depressive disorder (MDD) is a global problem with an increasing incidence and prevalence. There has additionally been an increase in depression due to the COVID-19 pandemic. Behavioral activation is considered an evidence-based treatment for MDD. However, there are many barriers that could hinder one's ability to engage in behavioral activation, with COVID-19 "shelter-in-place" and social distancing orders being current and large impediments. Virtual reality has been successfully used to help treat a variety of mental health conditions, but it has not yet been used as a method of administering behavioral activation to a clinical population. Using virtual reality to engage in behavioral activation could eliminate barriers that pandemic precautions place and help decrease symptoms of depression that are especially exacerbated in these times.The following case report examines the feasibility, acceptability, and tolerability of virtual reality behavioral activation for an adult with MDD during a global pandemic. This participant was part of a larger pilot study and the case serves as a description of the VR intervention.The participant engaged in a weekly 50-minute psychotherapy Zoom session for four weeks, in which a modified behavioral activation protocol was administered using a virtual reality headset. Data on mood ratings, homework compliance, and headset use were obtained from the headset. Acceptability, tolerability, and depression symptoms were obtained using self-report rating scales.The intervention was feasible, acceptable, and tolerable, as reported by this participant. The participant's depressive symptoms decreased by five-points on the PHQ-9 over a month, with a beginning score of a 10 (moderate depression) and a final score of a 5 (mild depression).The implications of these findings for future research are NCT04268316.

    View details for DOI 10.2196/24331

    View details for PubMedID 33031046

  • Embodied Virtual Reality Mirror Visual Feedback for an Adult with Cerebral Palsy American Journal of Psychiatry and Neuroscience Bullock, K. D., Stevenson Won, A., Bailenson, J., Muccin, J., Paul, M., Bronte-Stewart, H. 2021; 9 (2): 59-67