The Effectiveness of Self-Guided Virtual-Reality Exposure Therapy for Public-Speaking Anxiety

Abstract

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.

Experiences of Patients and Therapists Testing a Virtual Reality Exposure App for Symptoms of Claustrophobia: Mixed Methods Study

“…VRE is currently used for the assessment and treatment of anxiety and related disorders, such as obsessive-compulsive disorders and posttraumatic stress disorders [ 9 , 13 ], as well as a diagnostic tool for paranoid ideations [ 14 ]. Studies show promising results for the treatment of social anxiety disorders and fear of public speaking [ 15 , 16 ] by including virtual humans that may be controlled by a therapist [ 17 ]. A comparable effectiveness of VRE in the treatment of anxiety disorders compared to in vivo treatment has been successfully identified in the broad spectrum of anxiety-related disorders [ 18 , 19 ] and specific phobias [ 20 , 21 ].…”

The effect of virtual reality therapy and counseling on students' public speaking anxiety

“…The results of the PRPSA questionnaire showed that in both groups, the mean scores of speaking anxiety decreased, and this reduction was statistically significant in both groups. Premkumar et al, 16 by examining the effectiveness of VR therapy on public‐speaking anxiety in students, concluded that VR could reduce the reduction in heart rate and self‐reported anxiety and arousal in students. They believed increased self‐exposure to virtual social threats from self‐guided virtual‐reality exposure therapy alleviates anxiety and shows immediate decreases in subjective and physiological arousal during the application.…”

Handheld or head-mounted? An experimental comparison of the potential of augmented reality for animal phobia treatment using smartphone and HoloLens 2

“…Nevertheless, participants with greater control during a computerized exposure task were able to approach closer towards a spider (Healey et al, 2017). Perceptual control theory suggests that exposure is more effective when clients have increased control over the process, for example in selfguided virtual reality exposure therapy (Healey et al, 2017;Premkumar et al, 2021).…”