VR-Counseling to Reduce Public Speaking Anxiety

Condition(s) studied

Investigational drug(s) / intervention(s)

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

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.

Counseling program: Standard counseling sessions will be conducted by one psychotherapist for 6 consecutive weeks in 60-minute sessions.

Study summary

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.

Eligibility

Primary outcome measure(s)

• Change From Baseline in Public Speaking Anxiety at VR Post-Treatment — Baseline (T0) and end of VR intervention sessions (T1, at the end of the 4-week intervention period).
  Change from baseline to post-treatment in public speaking anxiety as assessed by the Personal Report of Public Speaking Anxiety (PRPSA), comparing the experimental arm with the control arm. The PRPSA is a self-report questionnaire designed to measure anxiety specifically related to speaking in front of an audience. It assesses cognitive, physiological, and behavioral components of public speaking anxiety, capturing both anticipatory anxiety and anxiety experienced during performance. The scale consists of 34 items rated on a 5-point Likert scale, with response options ranging from 1 = strongly disagree to 5 = strongly agree. Items reflect feelings of tension and nervousness, physiological arousal, negative self-appraisal, and fear of audience evaluation. Total scores range from 34 to 170, with higher scores indicating greater levels of public speaking anx

Trial sites (1)

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