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Virtual reality acceptance and commitment therapy intervention for social and public speaking anxiety: A randomized controlled trial (Pages 289-299)

Journal of Contextual Behavioral Science (JCBS)

Volume 28, April 2023, Pages 289-299

Authors

Simone Gorinelli, Ana Gallego, Päivi Lappalainen, Raimo Lappalainen

Abstract

Virtual reality (VR) offers new and flexible ways to provide psychological interventions. The aim of this study was to develop and investigate the effectiveness of a VR intervention based on acceptance and commitment therapy (ACT) for social and public speaking anxiety. ACT is a process-based approach that aims to (a) increase individuals’ abilities to handle difficult emotional and cognitive experiences and (b) develop the motivation required for change to occur. In this study, a sample of university students with social interaction or communication anxiety (N = 76; age M = 24.95, SD = 6.50, 69.7% females) was blindly randomized into a total of 2 h of VR ACT training (VRACT; n = 37) or a waiting list control (WLC; n = 39) group. The VRACT group was gradually exposed to social situations using a VR head-mounted display (HMD) and received audio-recorded ACT-based instructions aimed at increasing psychological flexibility. The outcome measurements included self-reported social and communication anxiety, well-being, psychological processes, and behavioral measures. At the final feedback meeting held one week after attending three VR sessions, we observed a significant decrease in social and communication anxiety (d = 0.55–0.61) and a significant improvement in psychological flexibility (d = 0.61), with moderate effect sizes. These findings contribute to advancing knowledge of how ACT can be efficaciously delivered using VR to improve mental health outcomes for university students with social anxiety.

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