A Meta-Analysis of the Efficacy of Virtual Reality and In Vivo Exposure Therapy as Psychological Interventions for Public Speaking Anxiety.
Level 1 - systematic review of randomized trials
Meta-analysis of controlled exposure therapy trials
PubMed 33533265 · doi:10.1177/0145445521991102
What was done
A systematic review and meta-analysis evaluated the efficacy of virtual reality exposure therapy (VRET) and in vivo exposure therapy (IVET) compared to control conditions for treating public speaking anxiety (PSA). The search identified 11 studies comprising a total of 508 participants.
What was found
Both interventions demonstrated large and statistically significant reductions in public speaking anxiety compared to control conditions: VRET achieved an effect size of -1.39 (Z = 3.96, p < .001), while IVET achieved an effect size of -1.41 (Z = 7.51, p < .001). Although IVET was marginally superior in magnitude, both interventions demonstrated large efficacy.
Why it matters
Virtual reality exposure therapy offers comparable clinical efficacy to traditional in-person exposure, supporting its use as a scalable and practical alternative that overcomes logistical barriers associated with live audience exposure.
Limits
The total sample size was modest (508 participants across 11 studies). The abstract does not detail specific control conditions (waitlist vs. active), exact effect size metrics used (e.g., Cohen's d or Hedges' g), participant clinical severity, or long-term durability of symptom reduction.
Cited by
- context Exposure therapy requiring individuals to engage in real-world social interactions is more effective at overcoming social anxiety than simulated or imagined interactions.