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Cited by 175Virtual Reality Applications and ImpactsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesDigital Mental Health Interventions

Therapist-led and self-led one-session virtual reality exposure therapy for public speaking anxiety with consumer hardware and software: a randomized controlled trial

Lindner, Philip, Miloff, Alexander, Fagernäs, Simon, Andersen, Joel, Sigeman, Martin, Andersson, Gerhard, Furmark, Tomas, Carlbring, Per·2019·Journal of Anxiety Disorders
DOI 10.1016/j.janxdis.2018.07.003
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Abstract

Public speaking anxiety (PSA) is a common condition which can be treated effectively with exposure therapy. However, inherent difficulties in stimuli presentation and control limits dissemination and the therapeutic potential. Virtual Reality (VR) technology has the potential to resolve these issues and provide a scalable platform for self-help interventions. No previous study has examined whether this can be achieved using the first generation of consumer VR hardware and software. In the current trial, n = 25 + 25 participants were randomized to either one-session therapist-led VR exposure therapy for PSA followed by a four-week internet-administered VR to in-vivo transition program, or a waiting-list. Linear mixed effects modeling revealed significant, large (within Cohen's d = 1.67) decreases in self-reported PSA. The waiting-list was then given access to an internet-administered, self-led version of the same VR exposure therapy to be conducted at home, followed by the same transition program. Dual-slope mixed effects modeling revealed significant, large (d = 1.35) decreases in self-reported PSA. Results were maintained or improved at six- and twelve-month follow-ups. We show for the first time that low-cost, off-the-shelf consumer VR hardware and software can be used to conduct exposure therapy for PSA, both in the traditional, previously impractical one-session format, and in a novel self-led, at-home format.

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Crossref · 10.1016/j.janxdis.2018.07.003

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  • In the same RCT, therapist-led VRET produced better outcomes at six- and 12-month follow-up than self-guided VRET.

    “Comparing both active interventions directly revealed better outcomes at both six- and 12-month follow-up if the intervention was led by a therapist as opposed to the self-guided intervention.”

    From Virtual Reality exposure therapy in the treatment of public speaking anxiety and social anxiety disorder (2024) · cites this paper as Lindner et al., 2019

  • In an RCT (Lindner et al., 2019), both therapist-led and self-led one-session VRET followed by a four-week online VR to in vivo transition program resulted in significant reductions in self-reported PSA symptoms compared to a waitlist control condition.

    “Both therapist- and self-led treatments resulted in significant reductions in self-reported PSA symptoms in comparison to the waitlist condition.”

    From Virtual Reality exposure therapy in the treatment of public speaking anxiety and social anxiety disorder (2024) · cites this paper as Lindner et al., 2019

  • Performance of in vivo exposure exercises during the post-VR transition period was associated with higher symptom decreases.

    “Notably, performance of in vivo exposure exercises during the post-VR transition period was associated with higher symptom decreases (Lindner et al., 2019).”

    From Virtual Reality exposure therapy in the treatment of public speaking anxiety and social anxiety disorder (2024) · cites this paper as Lindner et al., 2019

  • In a subclinical population with PSA, a therapist-led one-session VRET intervention complemented by a four-week online program including in vivo exposure resulted in greater symptom improvements than a self-guided intervention complemented by the same online program.

    “In a similar vein, in a subclinical population with PSA, a therapist-led one-session VRET intervention complemented by a four-week online program including in vivo exposure also resulted in greater symptom improvements than a self-guided intervention complemented by the same online program (Lindner et al., 2019).”

    From Virtual Reality exposure therapy in the treatment of public speaking anxiety and social anxiety disorder (2024) · cites this paper as Lindner et al., 2019

  • Approaches to address the uncanny valley effect include utilizing video recordings of real audiences within VR instead of computer-rendered virtual humans.

    “Different approaches have been explored to address this effect, for instance utilizing video recordings of real audiences within VR instead of computer-rendered virtual humans (cf. Lindner et al., 2019).”

    From Virtual Reality exposure therapy in the treatment of public speaking anxiety and social anxiety disorder (2024) · cites this paper as Lindner et al., 2019

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Authors
Lindner, P., Miloff, A., Fagernäs, S., Andersen, J., Sigeman, M., Andersson, G., Furmark, T., & Carlbring, P.
Affiliations
  • Stockholm University (SE)
  • Uppsala University (SE)
  • Linköping University (SE)
Corresponding author
Lindner, Philip
ORCID
Venue
Journal of Anxiety Disorders
Publisher
Elsevier BV
Published
2019-01
Volume
61
Pages
45-54
ISSN
0887-6185 (ISSN-L)
DOI
10.1016/j.janxdis.2018.07.003
OpenAlex
W2884316046
Cited by
175
References
67
Citations by year
2026: 19 · 2025: 25 · 2024: 18 · 2023: 19 · 2022: 17 · 2021: 33 · 2020: 26 · 2019: 17 · 2018: 1
FWCI
19.17
Type
journal article
Language
en
Update notices
erratum (2019-05-01)
Open access
closed
Licence
Locations
  • Journal of Anxiety Disorders (publishedVersion)
  • PubMed (publishedVersion)
  • University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion)
Topics
  • Physical Sciences › Computer Science › Human-Computer Interaction › Virtual Reality Applications and Impacts
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Keywords
public speaking anxiety, virtual reality exposure therapy, low-cost technology, treatment dissemination, maintenance of treatment effects
MeSH terms
Adult, Anxiety, Anxiety Disorders, Female, Humans, Implosive Therapy, Male, Self Care, Software, Speech, Virtual Reality Exposure Therapy

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