One-session versus three-session virtual reality exposure therapy for public speaking anxiety: a randomized controlled trial

VR technology has been a useful tool in exposure therapy working with public speaking anxiety. The common approach to treating public speaking anxiety is a single prolonged VR exposure session, but there is still lack of consensus, whether dividing the same amount if exposure into several shorter sessions would jeopardize its efficacy. This study aims to compare the efficacy of a single extended session versus the same intervention divided into three shorter sessions of VR-based exposure intervention for public speaking anxiety.37 students (mean age 22.4, 70.3% female) participated in a two-armed parallel group randomised controlled trial. The intervention involved 9 speaking tasks that were administered in a single session or divided into 3 equal parts. Public speaking anxiety scale, Liebowitz social anxiety scale and Brief Fear of Negative Evaluation scale were used as outcome measures pre- and post-exposure. Additionally, convenience, duration, fatigue, adaptability and intensity of the intervention were evaluated.Results indicate a significant reduction in the level of public speaking anxiety and social anxiety in both groups, but no differences between intervention groups and no interaction observed between time and intervention group. Participants reported single three-hour session to be more tiring and longer compared to the same amount of exposure split into 3 sessions, but did not indicate any difference in terms of convenience, adaptability, or intensity. It can be concluded that one-session treatment can be split up into three shorter ones without compromising the efficacy of public speaking anxiety VR exposure treatment.