Objectives: Self-guided virtual-reality exposure therapy (VRET) is a psychological intervention that enables a person to increase their own exposure to perceived threat. Public-speaking anxiety (PSA) is an anxiety-provoking social situation that is characterized by fear of negative evaluation from an audience. This pilot study aimed to determine whether self-guided VRET (1) increases exposure to PSA-specific virtual social threats, and (2) reduces anxiety, arousal, heartrate and PSA over repeated exposure.Methods: Thirty-two University students (27 completers) with high self-reported public-speaking anxiety attended 2 weekly self-guided VRET sessions. Each session involved the participant delivering a 20-min speech in a virtual classroom. Participants were able to increase their exposure to virtual social threat through the audience size, audience reaction, number of speech prompts, and their own salience in the virtual classroom at 4-min intervals. Participants' heartrates and self-reported anxiety and arousal were monitored during these intervals. Participants completed psychometric assessments after each session and 1 month later.Results: Participants increased their exposure to virtual social threat during each VRET session, which coincided with a reduction in heartrate and self-reported anxiety and arousal. Improvement in PSA occurred post-treatment and 1 month later. The in-session improvement in anxiety correlated with reductions in fear of negative evaluation post-treatment and 1 month later.Conclusions: Increased self-exposure to virtual social threat from self-guided VRET relieves anxiety and shows immediate reductions in subjective and physiological arousal during application, but also yields sustained improvement in PSA.
Virtual Reality exposure therapy for public speaking anxiety in routine care: a single-subject effectiveness trial
