Behavioral Therapy and Virtual Reality Exposure for Public Speaking Anxiety

Abstract

Virtual reality (VR) has been shown to be eff ective in the treatment of anxiety disorders. The eff ects of a behavioral intervention procedure that included exposure to VR, diaphragmatic breathing, diff erential reinforcement, and functional analysis of behavior of participants with public speaking anxiety were investigated. The Virtua Therapy simulator with an Oculus Rift® was used for VR exposure. Six university students participated in the procedure involving the following sequence of sessions: initial interview and baseline measures (3-5), intervention (6), closure (1), follow-up (2). In the baseline sessions, the participants gave a speech in a room without an audience (avatars): in the intervention sessions and follow-up they spoke in a classroom or auditorium with an audience, and verbal consequences (feedback) were provided for appropriate speech pitch and speed. Verbal and non-verbal measures of behaviors were recorded. In the intervention sessions, functional analyses of everyday public speaking situations were performed. There was statistically signifi cant diff erence in the pre-and post-intervention data in the Self-Statements during Public Speaking Scale (improvement in self-evaluation) and improvement in speech quality. The conclusion was reached that the intervention procedure contributed to the reduction of anxiety.

Unguided virtual-reality training can enhance the oral presentation skills of high-school students

“…In a systematic review, Daniels et al (2020) identified 14 studies conducted from 2009 to 2019 that used VR as a tool to diminish public speaking anxiety (PSA). From these 14 studies, 7 belonged to clinical settings (Wallach et al, 2009(Wallach et al, , 2011Lister et al, 2010;Lister, 2016;Lindner et al, 2018;Yuen et al, 2019;Zacarin et al, 2019). Three of the 7 clinical studies (Wallach et al, 2009(Wallach et al, , 2011Lister et al, 2010) compared PSA levels before and after VR immersion and found a significant PSA reduction.…”

“…Lister (2016), in a study with 98 participants that compared a VR condition to a control condition, concluded that six sessions were capable of increasing confidence of speakers and obtained positive self-statements. Two clinical studies included in the systematic review did not include control conditions, namely Yuen et al (2019) and Zacarin et al (2019). Yuen et al (2019) in two pilot studies with 11 and 15 participants each, showed that 6 weekly sessions were enough to significantly reduce PSA in a 3-month follow-up test.…”

Virtual Reality for Supporting the Treatment of Depression and Anxiety: Scoping Review

“…Multimedia Appendix 5 depicts the distribution of total participants. Most of the articles (13/34, 38%) included <10 participants [ 26 , 31 - 34 , 36 - 38 , 40 - 42 , 45 , 55 ], whereas two studies had >90 participants [ 35 , 54 ].…”

“…SAD was the most studied, with 3% (9/34) of studies focusing on using VR therapy solely for patients with SAD [ 29 , 34 , 37 , 41 , 47 , 50 , 52 - 54 ]. Generalized anxiety disorder (6/34, 18%) [ 27 , 28 , 39 , 42 , 46 , 49 ] was next, followed by public speaking anxiety (4/34, 12%) [ 14 , 31 , 51 , 56 ]. The rest of the studies aimed at specific clinical conditions such as paruresis [ 40 ], exam anxiety [ 48 ], driving-related [ 38 ] or car passenger anxiety [ 30 ], disruptive behavior in the classroom [ 45 ], or social anxiety in children with autism spectrum disorder [ 33 ].…”

“…The most frequent type of VR intervention was VRET (standard VR scene), which was used in 26% (9/34) of studies [ 25 , 31 , 34 , 40 , 41 , 47 , 53 , 55 , 56 ]. Interestingly, 6% (2/34) of studies used behavior therapy in addition to VRET, using commercial simulator software in the treatment of SAD [ 41 ] and public speaking anxiety [ 31 ]. It was followed by CBT inside VR (5/34, 15%) [ 26 , 28 , 37 , 50 , 54 ] and VR application (5/34, 15%) [ 30 , 33 , 35 , 43 , 52 ] interventions.…”