Virtual reality exposure therapy as a psychological intervention for public speaking anxiety

  • Rachel Reeves

Student thesis: Doctoral ThesisDoctor of Philosophy


1) Abstract for "A meta-analysis of the efficacy of virtual reality and in-vivo exposure therapy as psychological interventions for public speaking anxiety." Note this is a meta-analysis (form of literature review).

Public speaking anxiety (PSA) is a highly prevalent condition which can be associated with disabling occupational, educational and social consequences. A commonly utilised, efficacious treatment for PSA is exposure therapy. Traditionally, this intervention has been delivered as in-vivo exposure therapy (IVET). Limitations inherent to in-vivo as a mode of delivery have been identified and studies have increasingly explored the use of Virtual Reality Exposure Therapy (VRET) as an alternative.IVET is a long-established intervention, yet VRET has the potential to increase treatment accessibility. Thus, understanding the efficacy of both forms of exposure therapy for PSA is important. A systematic search yielded 11 studies with 508 participants. Of these; 5 employed VRET, 4 utilised IVET and 2 compared VRET toIVET. Meta-analysis yielded a large significant effect wherein VRET resulted insignificant reductions in PSA versus control of -1.39 (Z=3.96, p<.001)and a similar large significant effect wherein IVET resulted in significant reductions in PSA versus control of-1.41 (Z=7.51, p<.001). Although IVET was marginally superior to VRET for treating PSA, both interventions proved efficacious. Given the many practical advantages of utilising VRET, future research and clinical practice alike could explore virtual reality as mode of delivering PSA exposure therapy.

2) Abstract for "360° Video Virtual Reality Exposure Therapy for Public Speaking Anxiety: A Randomized Controlled Trial." Note this is an original research project (empirical study/Randomized Controlled Trial).

Public speaking anxiety (PSA) is a prevalent condition which is highly interrelated with social anxiety. PSA can be effectively treated with exposure therapy. Virtual reality exposure therapy (VRET) is being increasingly recognised as a novel and cost-effective treatment for PSA. The current randomized controlled trial investigates the efficacy of 360° video VRET when delivered as a stand-alone intervention for treating PSA and disorder relevant fears of social anxiety and fear of negative evaluation. To investigate whether media content of virtual reality videos impacts treatment efficacy, both emotion-evoking content and neutral content videos were trialled. Fifty-one participants with high PSA were randomly allocated to emotion-evoking content (EC) 360° video VRET, neutral content (NC) 360° video VRET and no treatment control. Outcomes were measured over four-time points with an additional 10 week follow-up. One-way ANOVA revealed that EC and NC participants had significantly lower PSA at post-intervention and follow-up than control participants. Media content emerged as important with regards a generalised effect as EC participants demonstrated significantly lower social anxiety and fear of negative evaluation at post-intervention than control, whereas NC participants did not. Findings are discussed with reference to treatment implications and further research recommendations.
Date of AwardDec 2020
Original languageEnglish
Awarding Institution
  • Queen's University Belfast
SupervisorDonncha Hanna (Supervisor) & David Curran (Supervisor)


  • Meta-Analysis
  • Public Speaking Anxiety
  • Exposure
  • Virtual Reality Exposure Therapy
  • VRET

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