Virtual Reality Exposure versus Cognitive Restructuring for Treatment of Public Speaking Anxiety: A Pilot Study

Objectives: To determine the utility of Virtual Reality Exposure Therapy (VRE) in comparison with Cognitive Therapy (CT) and with Cognitive-Behavior Therapy (CBT). Method: Subjects suffering from public speaking anxiety (PSA) were randomly allocated to VRE and CT, and received 12 therapy sessions, employing standardized treatment manuals. Outcome (questionnaires, observer and self ratings of a behavioral task) was compared to results of subjects in a previous study CBT and Wait List Controls who were not significantly different on demographic data. Results: CT was not superior to VRE on cognitive measures, but was superior to VRE on one behavioral measure (LSAS fear). VRE was superior to CT on one behavioral measure (fear reduction on a behavioral task). No differences were found between either CT, or VRE, and CBT and all were superior to WL. Limitations: Subject group was small and homogeneous. It appeared advisable to increase number of therapy sessions. Conclusions: VRE and CT proved to be equally effective to CBT in reducing PSA relative to a control group, with minimal differential effects between them. Therefore, employing either one may be satisfactory and sufficient.