Virtual reality exposure therapy for adolescents with fear of public speaking: a non-randomized feasibility and pilot study

Smiti Kahlon; Philip Lindner; Tine Nordgreen

doi:10.1186/s13034-019-0307-y

Virtual reality exposure therapy for adolescents with fear of public speaking: a non-randomized feasibility and pilot study

Child Adolesc Psychiatry Ment Health. 2019 Dec 27:13:47. doi: 10.1186/s13034-019-0307-y. eCollection 2019.

Authors

Smiti Kahlon¹, Philip Lindner^{1

2

3}, Tine Nordgreen^{1

4}

Affiliations

¹ 1Division of Psychiatry, Haukeland University Hospital, Haukelandsbakken 15, 5009 Bergen, Norway.
² 2Department of Psychology, Stockholm University, Stockholm, Sweden.
³ 3Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden.
⁴ 4Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway.

Abstract

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.