VR-Counseling to Reduce Public Speaking Anxiety

Официальное название

Immersive Virtual Reality as a Tool for Reducing Public Speaking Anxiety in Students Accessing the University Psychological Counseling Service: A Randomized Controlled Trial

Обзор

Public Speaking Anxiety (PSA) is a common manifestation of social anxiety among university students that can negatively impact academic performance and psychological well-being. Virtual Reality (VR) based interventions combined with Cognitive Behavioral Therapy (CBT) represent a promising approach to address PSA by enabling controlled, gradual exposure to feared social situations through realistic simulations of audiences and settings. This randomized controlled trial will evaluate whether integrating VR sessions into standard psychological counseling provided by the University Psychological Counseling Service (UPCS) improves anxiety and PSA outcomes in university students compared with counseling alone. Participants will be randomized to one of two groups: (1) a control group receiving standard psychological counseling intervention, or (2) an experimental group receiving psychological counseling supplemented with VR interventions delivered via immersive 360° video scenarios. The VR-based intervention includes a VR-Exposure and Response Prevention (ERP) module offering graded exposure to anxiety-provoking public speaking contexts, and a VR-Acceptance and Commitment Training (ACT) module aimed at enhancing mindfulness and psychological flexibility through guided experiential exercises. Psychological outcomes and physiological responses recorded during sessions will be analyzed to compare the effectiveness of VR-integrated counseling versus standard counseling alone. This study addresses the limited evidence on CBT combined with 360° video-based VR exposure for PSA in university students and introduces a novel VR-based ERP and ACT protocol tailored to a university counseling setting.

Вмешательства

• Устройство Exposure and Response Prevention (ERP)
  to simulate feared-anxiety-evoking scenarios, allowing both assessment and training for situationally induced anxiety to progressively promote desensitization to the anxiety-provoking stimuli
• Устройство Acceptance and Commitment Therapy (ACT) training
  to provide an ACT-consistent mindfulness training targeting psychological flexibility processes, such as contact with the present moment, cognitive defusion, and acceptance, aimed at eliciting a grounding response within a digitally generated, safe environment.
• Поведенческое Counseling program
  Standard counseling sessions will be conducted by one psychotherapist for 6 consecutive weeks in 60-minute sessions.

Первичные конечные точки

• Change From Baseline in Public Speaking Anxiety at VR Post-Treatment [Срок оценки: Baseline (T0) and end of VR intervention sessions (T1, at the end of the 4-week intervention period).]

Вторичные конечные точки (6)

• Heart Rate During Intervention Sessions [Срок оценки: During VR intervention sessions, from session 1 (T0) through session 4 (T1 - end of the 4-week intervention period)]
• Heart Rate Variability During Intervention Sessions [Срок оценки: During VR intervention sessions, from session 1 (T0) through session 4 (T1 - end of the 4-week intervention period)]
• Electrodermal Activity During Intervention Sessions [Срок оценки: During VR intervention sessions, from session 1 (T0) through session 4 (T1 - end of the 4-week intervention period)]
• Skin Temperature During Intervention Sessions [Срок оценки: During VR intervention sessions, from session 1 (T0) through session 4 (T1 - end of the 4-week intervention period)]
• Movement and Activity Levels During Intervention Sessions [Срок оценки: During intervention sessions, from session 1 (T0) through session 4 (T1 - end of the 4-week intervention period)]
• Change From Baseline in Anxiety at VR Post-Treatment [Срок оценки: During intervention sessions, from session 1 (T0) through session 4 (T1 - end of the 4-week intervention period)]

Критерии участия

Inclusion criteria are:

• current enrollment at the university;
• request for psychological counseling at the UPCS;
• fluency in Italian;
• provision of written informed consent;
• the presence of at least moderate levels of anxiety and perceived stress, as indicated by scores on standardized assessment instruments. Specifically, scores between STAI scores from 35 to 50 and PRPSA scores from 85 to 110.

Exclusion criteria are:

• current psychotic disorder;
• acute suicidality;
• severe substance dependence;
• severe sensory or motor impairments that would prevent safe use of VR equipment;
• inability to attend the planned sessions;
• concurrent participation in other specialized psychotherapy programs.

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Простое слепое

Основная цель

Лечение

Центры проведения

Италия · 1 центр

• University of Calabria — Rende

Публикации

• Reeves R, Curran D, Gleeson A, Hanna D. A Meta-Analysis of the Efficacy of Virtual Reality and In Vivo Exposure Therapy as Psychological Interventions for Public Speaking Anxiety. Behav Modif. 2022 Jul;46(4):937-965. doi: 10.1177/0145445521991102. Epub 2021 Feb 3. PMID 33533265
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• Kampmann IL, Emmelkamp PM, Hartanto D, Brinkman WP, Zijlstra BJ, Morina N. Exposure to virtual social interactions in the treatment of social anxiety disorder: A randomized controlled trial. Behav Res Ther. 2016 Feb;77:147-56. doi: 10.1016/j.brat.2015.12.016. Epub 2015 Dec 29. PMID 26752328
• Kahlon S, Lindner P, Nordgreen T. Virtual reality exposure therapy for adolescents with fear of public speaking: a non-randomized feasibility and pilot study. Child Adolesc Psychiatry Ment Health. 2019 Dec 27;13:47. doi: 10.1186/s13034-019-0307-y. eCollection 2019. PMID 31890004
• Huang J, Nigatu YT, Smail-Crevier R, Zhang X, Wang J. Interventions for common mental health problems among university and college students: A systematic review and meta-analysis of randomized controlled trials. J Psychiatr Res. 2018 Dec;107:1-10. doi: 10.1016/j.jpsychires.2018.09.018. Epub 2018 Sep 29. PMID 30300732
• Hendriks GJ, Janssen N, Robertson L, van Balkom AJ, van Zelst WH, Wolfe S, Oude Voshaar RC, Uphoff E. Cognitive behavioural therapy and third-wave approaches for anxiety and related disorders in older people. Cochrane Database Syst Rev. 2024 Jul 8;7(7):CD007674. doi: 10.1002/14651858.CD007674.pub3. PMID 38973756
• Donnelly MR, Reinberg R, Ito KL, Saldana D, Neureither M, Schmiesing A, Jahng E, Liew SL. Virtual Reality for the Treatment of Anxiety Disorders: A Scoping Review. Am J Occup Ther. 2021 Nov 1;75(6):7506205040. doi: 10.5014/ajot.2021.046169. PMID 34817595
• Craig F, Colella GM, Tenuta F, Mauti M, Gravina A, Calomino ML, Plastina R, Polito A, Costabile A. From psychological wellbeing to distress: the role of psychological counseling interventions in university students. Front Psychol. 2025 Aug 8;16:1602009. doi: 10.3389/fpsyg.2025.1602009. eCollection 2025. PMID 40861352

Идентификаторы

NCT: NCT07351409 · RV-PSI_13/03/2023_n. 318

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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