Using Virtual Reality to Treat Social Anxiety in Autistic Adolescents

King's College London

Status: Unknown

Conditions: Social Anxiety; Autism Spectrum Disorder

Treatments: Other: Virtual Reality Assisted Cognitive Behavioural Therapy

Study type: Interventional

Funder types: Other

Identifiers

NCT04301141

0c Valmaggia

Details and patient eligibility

About

This study will test the feasibility and acceptability of virtual reality assisted cognitive behavioural therapy for the treatment of social anxiety in autistic adolescents. Five adolescents will receive the intervention and a parent/caregiver of each adolescent will be asked to act as informants on some questionnaires and interviews.

Full description

Difficulties interacting with others in social situations is a core characteristic of autism spectrum disorder (ASD). These difficulties are intensified by social anxiety - commonly experienced in autistic adolescents. A promising psychological treatment is cognitive behavioural therapy (CBT), but there are constraints in its use for the autistic population. For example, CBT requires patients to imagine being in a social situation that would cause anxiety, but autistic people often experience difficulties with imagination. The use of virtual reality (VR) in CBT may help to lessen such constraints. VR uses 3D computer-generated visual environments displayed through a head-mounted display. The images are synchronised to the movements of the user such that they experience feeling immersed in the virtual scene. The virtual scene can involve social scenarios, making it an ideal tool for eliciting social anxiety in the treatment setting. The investigators can see if these virtual scenarios are indeed eliciting social anxiety by recording physiological responses (e.g. heart rate) in parallel with patients' anxiety ratings during exposure. This is important for CBT to be effective.

This study will test the feasibility and acceptability of VR-assisted CBT, combined with the use of physiological measurements, in autistic adolescents experiencing social anxiety. The therapy will typically consist of 8-20 weekly sessions and will be delivered by clinical psychologists in local mental health services. Conventional outcome measures will be used and feedback from youth and their parents/caregivers will be requested. The results of this study may lead to modification of the treatment and research methods. They will inform a later pilot randomised controlled trial.

Enrollment: 5 estimated patients

Sex: All

Ages: 13 to 18 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

Participants will be included at screening if:

• Aged between 13 and 18 years
• Clinically diagnosed with ASD by a neurodevelopmental clinician
• Experiencing anxiety in social situations that is impairing daily functioning as determined by clinicians
• Deemed suitable by the clinical team for the intervention based on factors such as sufficient verbal ability, desire to participate, willingness to undertake exposure-based activities, and no current/active suicidal plans.
• Able to speak and understand English fluently
• Patient and parents/caregivers agree to CBT

Exclusion criteria

Participants will be excluded at screening if:

• Diagnosed with photosensitive epilepsy
• Receiving concurrent psychological therapy
• Immediate plans are in-place to change their psychopharmacological medication regimen

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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5 participants in 1 patient group

Virtual Reality Assisted Cognitive Behavioural Therapy

Experimental group

Description:

Between 8 to 20 individual in-person sessions of VR-assisted CBT will be delivered on a weekly basis by NHS therapists who are trained in delivering CBT to this patient group.

Treatment:

Other: Virtual Reality Assisted Cognitive Behavioural Therapy