January 13, 2021

Dear Colleagues,

The National Social Anxiety Center (NSAC) provides information about relevant and current research in service of disseminating and promoting evidence-based treatment. This month’s summary about virtual reality exposure therapy for public speaking anxiety in routine care is presented by John Montopoli, NSAC San Francisco. It focuses on the efficacy of virtual reality technology used in public speaking exposure therapy.

Virtual reality (VR) technology is advancing in its ability to provide an effective and immersive experience for clients. Hardware accessibility and reduced cost have made VR easily available in routine care settings.

Lindner et al (2020) developed and evaluated a treatment protocol for public speaking anxiety (PSA) using “off-the-shelf” consumer VR technology. Using single-subject design (n=25), researchers evaluated the effectiveness of clinician-led, one-session, VR exposure therapy (VRET) for PSA followed by an online transition program encouraging follow up in-vivo exposure.

The treatment protocol emphasizes inhibitory learning (Craske et al, 2014) by violating catastrophic beliefs through a series of speech tasks within the immersive VR environment. Researchers found a significant decrease in self-rated PSA following the primary, three-hour session. These results were sustained at three-month follow up.

During the current pandemic, providing VRET for PSA is increasingly important for treating this population. What strategies would you use to help clients generalize VRET learning to in-vivo opportunities?

Lindner, P., Dagöö, J., Hamilton, W., Miloff, A., Andersson, G., Schill, A., and Carlbring, P. Virtual Reality exposure therapy for public speaking anxiety in routine care: a single-subject effectiveness trial. Cognitive Behaviour Therapy, September 2020, volume 50, issue 1, pages 67-87

Craske, M. G., Treanor, M., Conway, C. C., Zbozinek, T., and Vervliet, B. Maximizing exposure therapy: An inhibitory learning approach. Behaviour Research and Therapy, July, 2014, volume 58, pages 10–23.

John R. Montopoli, LMFT, LPCC
Cofounder, National Social Anxiety Center
Representative of NSAC San Francisco
(Pacific CBT)