VR-Counseling to Reduce Public Speaking Anxiety
Trial statusNot yet recruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18-40
SponsorUniversity of Calabria
About this trial
Public Speaking Anxiety (PSA) is a common manifestation of social anxiety among university students that can negatively impact academic performance and psychological well-being. Virtual Reality (VR) based interventions combined with Cognitive Behavioral Therapy (CBT) represent a promising approach to address PSA by enabling controlled, gradual exposure to feared social situations through realistic simulations of audiences and settings. This randomized controlled trial will evaluate whether integrating VR sessions into standard psychological counseling provided by the University Psychological Counseling Service (UPCS) improves anxiety and PSA outcomes in university students compared with counseling alone.
Participants will be randomized to one of two groups: (1) a control group receiving standard psychological counseling intervention, or (2) an experimental group receiving psychological counseling supplemented with VR interventions delivered via immersive 360° video scenarios. The VR-based intervention includes a VR-Exposure and Response Prevention (ERP) module offering graded exposure to anxiety-provoking public speaking contexts, and a VR-Acceptance and Commitment Training (ACT) module aimed at enhancing mindfulness and psychological flexibility through guided experiential exercises. Psychological outcomes and physiological responses recorded during sessions will be analyzed to compare the effectiveness of VR-integrated counseling versus standard counseling alone. This study addresses the limited evidence on CBT combined with 360° video-based VR exposure for PSA in university students and introduces a novel VR-based ERP and ACT protocol tailored to a university counseling setting.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
current enrollment at the university;
request for psychological counseling at the UPCS;
fluency in Italian;
provision of written informed consent;
Disqualifiers
current psychotic disorder;
acute suicidality;
severe substance dependence;
severe sensory or motor impairments that would prevent safe use of VR equipment;
Trial design
Design model
Parallel
Treatments tested in this trial
Exposure and Response Prevention (ERP)
Deviceto simulate feared-anxiety-evoking scenarios, allowing both assessment and training for situationally induced anxiety to progressively promote desensitization to the anxiety-provoking stimuli
Acceptance and Commitment Therapy (ACT) training
Deviceto provide an ACT-consistent mindfulness training targeting psychological flexibility processes, such as contact with the present moment, cognitive defusion, and acceptance, aimed at eliciting a grounding response within a digitally generated, safe environment.
Counseling program
BehavioralStandard counseling sessions will be conducted by one psychotherapist for 6 consecutive weeks in 60-minute sessions.
Treatment groups
72 Participants
are divided into 2 treatment groupsGroup A: Experimental Arm: VR (360°) Modules (VR-ERP + VR-ACT) + Standard CounselingExperimental treatment 2 interventions
Group B: Control Arm: Standard Counseling (No VR)Active comparator 1 intervention
Trial outcomes
Primary outcomes
1
Change From Baseline in Public Speaking Anxiety at VR Post-Treatment
Change from baseline to post-treatment in public speaking anxiety as assessed by the Personal Report of Public Speaking Anxiety (PRPSA), comparing the experimental arm with the control arm. The PRPSA is a self-report questionnaire designed to measure anxiety specifically related to speaking in front of an audience. It assesses cognitive, physiological, and behavioral components of public speaking anxiety, capturing both anticipatory anxiety and anxiety experienced during performance. The scale consists of 34 items rated on a 5-point Likert scale, with response options ranging from 1 = strongly disagree to 5 = strongly agree. Items reflect feelings of tension and nervousness, physiological arousal, negative self-appraisal, and fear of audience evaluation. Total scores range from 34 to 170, with higher scores indicating greater levels of public speaking anx
Time frame
Baseline (T0) and end of VR intervention sessions (T1, at the end of the 4-week intervention period).Secondary outcomes
1
Heart Rate During Intervention Sessions
Heart rate is continuously recorded during each intervention session to assess physiological arousal and recovery and to examine whether VR-supported counseling is associated with different within-session heart rate responses compared with counseling alone.
Time frame
During VR intervention sessions, from session 1 (T0) through session 4 (T1 - end of the 4-week intervention period)2
Heart Rate Variability During Intervention Sessions
Heart rate variability is continuously recorded during each intervention session as an index of autonomic regulation and physiological recovery, and to compare within-session variability between VR-supported counseling and counseling alone.
Time frame
During VR intervention sessions, from session 1 (T0) through session 4 (T1 - end of the 4-week intervention period)3
Electrodermal Activity During Intervention Sessions
Electrodermal activity is continuously recorded during each intervention session to assess sympathetic nervous system activation and physiological arousal during counseling, and to compare responses between treatment arms.
Time frame
During VR intervention sessions, from session 1 (T0) through session 4 (T1 - end of the 4-week intervention period)4
Skin Temperature During Intervention Sessions
Skin temperature is continuously recorded during each intervention session as an indicator of peripheral physiological responses associated with stress and recovery, and to evaluate differences between VR-supported counseling and counseling alone.
Time frame
During VR intervention sessions, from session 1 (T0) through session 4 (T1 - end of the 4-week intervention period)Other outcomes
1
Change From Baseline in Public Speaking Anxiety at 3-Month Follow-Up
Change from baseline (T0) to the 3-month follow-up (T2) in public speaking anxiety (PSA). The experimental arm (VR intervention sessions) is expected to show greater sustained improvements at T2 compared with the control arm (brief standard counseling only).
Time frame
Baseline (T0) and 3-month follow-up (T2) (approximately 3 months after treatment completion).Sponsors and contacts
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Source ClinicalTrials.gov
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