VR-Counseling to Reduce Public Speaking Anxiety

University of Calabria

Status: Begins enrollment this month

Conditions: Anxiety and Distress; Anxiety Disease; Public Speaking Anxiety; Anxiety

Treatments: Device: Acceptance and Commitment Therapy (ACT) training; Device: Exposure and Response Prevention (ERP); Behavioral: Counseling program

Study type: Interventional

Funder types: Other

Identifiers

NCT07351409

RV-PSI_13/03/2023_n. 318

Details and patient eligibility

About

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.

Enrollment: 72 estimated patients

Sex: All

Ages: 18 to 40 years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion criteria are:

1. current enrollment at the university;
2. request for psychological counseling at the UPCS;
3. fluency in Italian;
4. provision of written informed consent;
5. 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:

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

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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72 participants in 2 patient groups

Experimental Arm: VR (360°) Modules (VR-ERP + VR-ACT) + Standard Counseling

Experimental group

Description:

The experimental intervention includes two distinct VR-based training scenarios: (A) VR-ERP, designed to gradually expose students to anxiety-provoking situations to prevent avoidance responses, and (B) VR-ACT training, a consistent mindfulness training aimed at enhancing psychological flexibility and value-oriented behaviors. Participants in the experimental group, after VR-ACT training, go to standard counseling intervention.

Treatment:

Device: Exposure and Response Prevention (ERP)

Device: Acceptance and Commitment Therapy (ACT) training

Control Arm: Standard Counseling (No VR)

Active Comparator group

Description:

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

Treatment:

Behavioral: Counseling program