Virtual Reality for Social Anxiety Disorder

Overseen By Craig Motsenbocker, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: The University of Texas Health Science Center, Houston

Disqualifiers: Schizophrenia, Bipolar, Severe depression, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 12 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests the effectiveness of combining virtual reality (VR) with cognitive behavior therapy (CBT) to reduce social anxiety in adults with autism. Participants will either use VR to practice social skills or engage in traditional CBT with mindfulness exercises. The researchers aim to determine which method is more effective and to refine the VR treatment for future use. Individuals diagnosed with autism and social anxiety who can use a computer may be suitable for this trial. As an unphased study, this trial offers a unique opportunity to contribute to innovative research that could enhance future therapies for social anxiety.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this VR method is safe for treating social anxiety?

Research shows that virtual reality-assisted cognitive behavioral therapy (VRCBT) is generally well-received by people with anxiety disorders. Studies have found that VRCBT can help reduce symptoms of anxiety and depression. Participants in these studies often experienced significant improvements in their outlook and felt less anxious, particularly in social situations.

For those concerned about safety, these therapies have been compared to standard treatments and often result in fewer social anxiety symptoms afterward. This indicates that VRCBT is not only effective but also safe for treating social anxiety. While virtual scenarios might cause slight discomfort, the overall evidence suggests that VRCBT is a safe way to manage anxiety symptoms. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about using Virtual Reality (VR) assisted Cognitive Behavior Therapy (CBT) for Social Anxiety Disorder because it offers a unique, immersive experience that traditional CBT alone cannot provide. Unlike standard CBT, which typically involves role-playing and imagined exposure, VR allows patients to engage in realistic social scenarios in a controlled environment. This can enhance the therapeutic process, making it easier for individuals to confront and manage their anxiety in real-world situations. Furthermore, VR technology can make therapy more engaging and accessible, potentially leading to better outcomes and adherence.

What evidence suggests that this trial's treatments could be effective for social anxiety?

Research has shown that using Virtual Reality (VR) with Cognitive Behavioral Therapy (CBT) can help treat anxiety disorders, such as social anxiety. In this trial, participants will receive either VR-assisted CBT or CBT alone. One study found that individuals who underwent VR-based exposure therapy reported fewer social anxiety symptoms. Another study demonstrated that it improved their feelings about public speaking and reduced stress. These findings suggest that combining CBT with VR can aid people with social anxiety by providing realistic situations to practice coping skills. The evidence supports VR-assisted CBT as a promising method to reduce social anxiety symptoms. ^{1 3 4 6 7}

Who Is on the Research Team?

Katherine Loveland, PhD

Principal Investigator

The University of Texas Health Science Center at Houstom

Are You a Good Fit for This Trial?

This trial is for adults with autism who also experience social anxiety. Participants should be interested in trying virtual reality (VR) as part of their treatment. The study aims to help them by using VR alongside cognitive-behavioral therapy (CBT). Specific eligibility details are not provided, but typically include being within a certain age range and having a formal diagnosis.

Inclusion Criteria

Average or greater intellectual ability based on history and interview

Autism Spectrum Disorder (ASD) diagnosed by a qualified professional

Able to operate a computer (Windows or Mac)

Exclusion Criteria

Current or historical severe mental illness such as schizophrenia, bipolar disorder, or severe depression

Intellectual disability or a learning disability that would interfere with participating (e.g., unable to read)

Unable to use the technology or do not have access to the technology

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive CBT VR exposure + VR social skills treatment or CBT Imaginal exposure + mindfulness

12 weeks

Weekly sessions

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• CBT
• VR

Trial Overview The study is testing whether combining CBT with VR exposure and social skills training is more effective than traditional CBT with imaginal exposure and mindfulness techniques at reducing social anxiety in autistic adults.

How Is the Trial Designed?

Group I: Virtual Reality (VR) assisted Cognitive Behavior Therapy (CBT) Experimental Treatment 2 Interventions

Group II: CBT alone Active Control 1 Intervention

Who Is Running the Clinical Trial?

The University of Texas Health Science Center, Houston

Lead Sponsor

Trials

974

Recruited

361,000+

Published Research Related to This Trial

Virtual reality exposure therapy (VRET) is a promising alternative for treating social anxiety disorder (SAD), offering a cost-effective and flexible approach compared to traditional in vivo exposure therapy (iVET).

While VRET showed similar effectiveness to iVET in improving social skills and reducing SAD symptoms, its advantages include lower costs and the ability to create customized therapeutic experiences for patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Simulation Game-Virtual Reality Therapy for the Treatment of Social Anxiety Disorder: A Systematic Review. Caponnetto, P., Triscari, S., Maglia, M., et al.[2021]

Virtual reality (VR) exposure therapy integrated into cognitive-behavioral therapy (CBT) for social anxiety disorder (SAD) was found to be more effective than traditional in-person exposure, with significant improvements on the Liebowitz Social Anxiety Scale and other measures.

The study involved 59 participants over 14 weekly CBT sessions, and results showed that VR exposure not only led to better outcomes immediately after treatment but also maintained improvements at a 6-month follow-up, while being more practical for therapists.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual reality compared with in vivo exposure in the treatment of social anxiety disorder: a three-arm randomised controlled trial. Bouchard, S., Dumoulin, S., Robillard, G., et al.[2019]

This trial will evaluate the effectiveness of cognitive behavioral therapy (CBT) combined with adaptive virtual reality (VR) exposure for treating social anxiety disorder (SAD) in 90 participants over 10 weekly sessions, aiming to provide real-time adjustments based on anxiety levels.

The study is designed with high methodological rigor, using a randomized controlled trial format and validated measures, which will help determine if the adaptive VR approach offers significant benefits over traditional CBT methods.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cognitive behavioral therapy with adaptive virtual reality exposure vs. cognitive behavioral therapy with in vivo exposure in the treatment of social anxiety disorder: A study protocol for a randomized controlled trial. Ørskov, PT., Lichtenstein, MB., Ernst, MT., et al.[2022]

A study involving 45 adults with social anxiety disorder (SAD) demonstrated that both traditional cognitive-behavioral therapy (CBT) and a combined CBT with virtual reality (CBT-VR) significantly reduced anxiety levels compared to a waiting list group.

The results indicate that CBT treatments, including innovative approaches like CBT-VR, are effective for managing social anxiety, suggesting that these methods can be beneficial for individuals beyond just fear of public speaking.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using virtual humans to alleviate social anxiety: preliminary report from a comparative outcome study. Robillard, G., Bouchard, S., Dumoulin, S., et al.[2019]

Virtual reality exposure therapy (VRET) has been shown to significantly reduce symptoms of social anxiety disorder (SAD) across six studies, indicating its effectiveness as a treatment option.

Most studies had small sample sizes and limitations in ecological validity, suggesting that future research should involve larger clinical samples to better assess VRET's impact on a wider range of social behaviors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Literature Review Examining Virtual Reality Exposure Therapy for Individuals Diagnosed With Social Anxiety Disorder. Arif, R., Ashraf, S., Bhatt, K., et al.[2023]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8342859/

Virtual Reality-Assisted Cognitive Behavioral Therapy for ... Conclusion: VRCBT treatment has a specific positive effect on patients with anxiety disorders (anxiety and depression). Compared with standard ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9589352/

Cognitive behavioral therapy with adaptive virtual reality ... In this trial, we will test the efficacy of CBT with adaptive VR exposure allowing adjustment of the exposure based on real-time monitoring of the participants ...

3. clinicaltrials.gov clinicaltrials.gov/study/NCT04850989

Efficacy of Virtual Reality Exposure Therapy Scripts for ... The purpose of this study is to test the efficacy virtual reality videos to facilitate exposure therapy in social anxiety disorder (SAD).

4. frontiersin.org frontiersin.org/journals/virtual-reality/articles/10.3389/frvir.2025.1588181/full

Virtual reality-based exposure with 360° video as part of ... Results: Intention-to-treat analysis showed that participants receiving CBT-ExpVR reported significantly fewer symptoms of social anxiety at ...

5. sciencedirect.com sciencedirect.com/science/article/pii/S277240852400139X

Virtual Reality exposure therapy in the treatment of public ... The results revealed significant improvements in participants' attitudes towards public speaking as well as subjective distress during public speaking ...

6. clinicaltrials.gov clinicaltrials.gov/study/NCT03973541

CBT With VR Based Exposure for Social Anxiety Disorder EXPOSURE IN VIRTUAL REALITY FOR SOCIAL ANXIETY DISORDER - A Randomized Controlled Superiority Trial Comparing Cognitive Behavioral Therapy With Virtual Reality ...

7. tandfonline.com tandfonline.com/doi/full/10.1080/10615806.2024.2392195

Virtual reality exposure therapy for social anxiety disorders Virtual reality exposure therapy has greater efficacy than waitlist comparators in reducing anxiety symptoms at post-intervention and follow-up assessment.