Virtual Reality Treatment for Public Speaking Anxiety in Students. Advancements and Results in Personalized Medicine

Desensitizing Anxiety Through Imperceptible Change: Feasibility Study on a Paradigm for Single-Session Exposure Therapy for Fear of Public Speaking

BACKGROUND

Exposure therapy (ET) for anxiety disorders involves introducing the participant to an anxiety-provoking situation over several treatment sessions. Each time, the participant is exposed to a higher anxiety-provoking stimulus; for example, in the case of fear of heights, the participant would successively experience being at a greater height. ET is effective, and its counterpart, virtual reality (VR) exposure therapy (VRET), where VR substitutes real-world exposure, is equally so. However, ET is time-consuming, requiring several sessions.

OBJECTIVE

This study aimed to compare the results of single-session exposure with those of traditional VRET with regard to reducing public speaking anxiety.

METHODS

We introduced a paradigm concerned with public speaking anxiety where the VR exposure occurred in a single session while the participant interacted with a virtual therapist. Over time, the therapist transformed into an entire audience with almost imperceptible changes. We carried out a feasibility study with 45 participants, comparing 3 conditions: single-session exposure (n=16, 36%); conventional multiple-session exposure (n=14, 31%), where the same content was delivered in successive segments over 5 sessions; and a control group (n=15, 33%), who interacted with a single virtual character to talk about everyday matters. A week later, the participants were required to speak on a stage in front of a large audience in VR.

RESULTS

Across most of the series of conventional public speaking anxiety measures, the single-session exposure was at least as effective in reducing anxiety as the multiple-session exposure, and both these conditions were better than the control condition. The 12-item Personal Report of Confidence as a Speaker was used to measure public speaking anxiety levels, where higher values indicated more anxiety. Using a Bayesian model, the posterior probabilities of improvement compared to a high baseline were at least 1.7 times greater for single- and multiple-session exposures compared to the control group. The State Perceived Index of Competence was used as a measure of anticipatory anxiety for speaking on a stage in front of a large audience, where lower values indicated higher anxiety. The probabilities of improvement were just over 4 times greater for single- and multiple-session exposures compared to the control group for a low baseline and 489 (single) and 53 (multiple) times greater for a middle baseline.

CONCLUSIONS

Overall, the results of this feasibility study show that for moderate public speaking anxiety, the paradigm of gradual change in a single session is worth following up with further studies with more severe levels of anxiety and a larger sample size, first with a randomized controlled trial with nonpatients and subsequently, if the outcomes follow those that we have found, with a full clinical trial with patients.

Exploring Differences in Student Learning and Behavior Between Real-life and Virtual Reality Chemistry Laboratories

Recent global events and educational trends have led schools to heavily rely on digital media to educate their students. Science classes, in particular, stand to lose substantial learning opportunities without the ability to provide physical laboratory experiences. Virtual reality (VR) technology has the potential to resolve this issue, but little is known if VR environments can produce similar results to real-life (RL) science learning environments. This 2 × 1, between-subjects study compares students' learning results and safety behaviors in VR and RL chemistry laboratories. The study attempts to identify differences in learning experience (i.e., general chemistry content, experiment comprehension, laboratory safety knowledge) and laboratory safety behavior. Results indicate learning general content knowledge, laboratory skills, and procedure-related safety behaviors were comparable between RL and VR conditions, but clean-up behaviors were less frequent in VR. Also, the exploratory, risk-free nature of VR environments may have allowed the learners to elaborate and reflect more on general chemistry content and laboratory safety knowledge than in the RL environment.

Virtual Reality as a Reflection Technique for Public Speaking Training

Video recording is one of the most commonly used techniques for reflection, because video allows people to know what they look like to others and how they could improve their performance, but it is problematic because some people easily fall into negative emotions and worry about their performance, resulting in a low benefit. In this study, the possibility of applying a simple VR-based reflection method was explored. This method uses virtual reality (VR) and a head-mounted display (HMD) to allow presenters to watch their own presentations from the audience’s perspective and uses an avatar, which hides personal appearance, which has low relevance to the quality of presentation, to help reduce self-awareness during reflection. An experimental study was carried out, considering four personal characteristics—gender, personal anxiety, personal confidence and self-bias. The goal of this study is to discuss which populations can benefit more from this system and to assess the impact of the avatar and HMD-based VR. According to the results, the individuals with low self-confidence in their public speaking skills could benefit more on self-evaluation from VR reflection with HMD, while individuals with negative self-bias could reduce more anxiety by using an avatar.

Virtual Reality exposure therapy for public speaking anxiety in routine care: a single-subject effectiveness trial

Virtual Reality (VR) can be used as a therapeutic tool to conduct efficacious in-session exposure therapy by presenting virtual equivalents of phobic stimuli, yet past hardware restrictions hindered implementation in routine care and effectiveness studies. The current study examines the effectiveness of a VR-assisted treatment protocol for public speaking anxiety with demonstrated efficacy, this time in routine care, using affordable VR hardware. Participants (n = 23) were recruited via a private clinic and treated by one of four psychologists with only minimal VR-training. Using a single-subject design and dual-slope modeling (adjusting the treatment-onset slope for treatment effects), we found a significant, large decrease in self-rated public speaking anxiety following the primary three-hour session, similar in magnitude to the previous efficacy trial. Multilevel modeling of in-session process measures suggests that the protocol works as intended, by decreasing catastrophic belief expectancy and distress, and increasing perceived performance quality. Adherence to the online transition program that followed-encouraging in-vivo exposure-was relatively poor, yet symptoms decrease continued. No change was observed over the three-month follow-up period. We conclude that VR exposure therapy can be effective under routine care conditions and is an attractive approach for future, large-scale implementation and effectiveness trials.