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Virtual Reality Exposure Therapy for Adolescents With Fear of Public Speaking: A Non-Randomized Feasibility and Pilot Study


Virtual Reality Exposure Therapy for Adolescents With Fear of Public Speaking: A Non-Randomized Feasibility and Pilot Study

Smiti Kahlon et al. Child Adolesc Psychiatry Ment Health.


Background: Public Speaking Anxiety (PSA) is a common anxiety with onset in adolescence and early adulthood. With the advent of consumer virtual reality (VR) technology, VR-delivered exposure therapy is now a scalable and practical treatment option and has previously been shown to be efficacious with adults. In this non-randomized feasibility and pilot trial, we explore the effect of one-session (90 min) VR-delivered exposure therapy for adolescents (aged 13-16) with PSA.

Methods: A total of 27 adolescents were recruited from Norwegian high schools and completed self-report measures of PSA twice prior to treatment, 1 week after treatment, and at 1 and 3 month follow-up. Heart rate was recorded during the treatment session. A low-cost head-mounted VR display with a custom-built VR stimuli material depicting a cultural and age appropriate classroom and audience were used when a series of speech (exposure exercises) were performed.

Results: Linear mixed effects model revealed a significant decrease in PSA symptoms (Cohen's d = 1.53) pre-post treatment, and improvements were maintained at follow-ups. Physiological data revealed a small increase in heart rate during exposure tasks. Based on feedback from the adolescents, the feasibility of the intervention was increased during the trial.

Conclusions: The results show that low-cost, consumer VR hardware can be used to deliver efficacious treatment for PSA in adolescents, in a feasible one-session format.

Keywords: Adolescents; Cognitive behavior therapy; Inhibitory learning; Public Speaking Anxiety; Virtual reality; Virtual reality exposure therapy.

Conflict of interest statement

Competing interestsAuthor PL reports having received consulting fees from Mimerse. The other authors declare that they have no competing interests.


Fig. 1
Fig. 1
Study flowchart
Fig. 2
Fig. 2
Screenshots from the VR application
Fig. 3
Fig. 3
Heart rate

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