Long-term effects of virtual reality exposure therapy for adolescents with public speaking anxiety: a one-year follow-up of a randomised controlled trial

Introduction Public Speaking Anxiety (PSA) is a highly prevalent disorder and may lead to adverse consequences. Virtual Reality Exposure Therapy (VRET) is an effective treatment for PSA in adults and adolescents, yet little is known about the long-term effects of VRET for PSA. Method The current study assessed the clinical effects of a two-phased, four-armed RCT study at 12-month follow-up. In the original trial, a total of 100 adolescents were randomly assigned to one of four conditions: 1). VRET-only, 2) VRET + online exposure program, 3) Online psychoeducation program + online exposure program, or 4) Waitlist + online psychoeducation program. Participants were assessed on public speaking anxiety-, social interaction anxiety- and social phobia symptoms. Results At group level, online psychoeducation and online exposure had a statistically significant reduction in PSAS scores from post-treatment to 12-month follow-up, whereas the other groups maintained their treatment gains. Social interaction anxiety symptoms remained unchanged following the intervention, while the improvement in social phobia symptoms was maintained at 12-month follow-up. Discussion This study provides an early indication that both VRET, and online psychoeducation + online exposure, could be effective methods of reducing PSA in adolescents over a 12-month period. However, as the findings have several limitations, including small sample size, this needs to be explored further. The study was pre-registered at Clinicaltrials.gov (NCT04396392) on the 11th of February 2020.