Smartphone-based self-help virtual reality exposure therapy for college students’ social anxiety: a randomized controlled study

Abstract

Social anxiety disorder (SAD) is marked by intense fear of social scrutiny, significantly impairing functioning among university students. This randomized controlled trial evaluated a 14-day, fully self-guided smartphone-based virtual reality exposure therapy (VRET) to reduce SAD symptoms, addressing the gap in existing self-guided VRET studies, which often involve therapist participation and require 4–6 weeks. Using immersive exposure and autonomy-driven engagement, the intervention employed affordable smartphone-based VR devices for scalability and accessibility. Sixty-one university students with elevated SAD symptoms (Social Phobia Inventory ≥ 31; Liebowitz Social Anxiety Scale ≥ 35) were randomized to an intervention group (n = 31) receiving daily VRET sessions via a mobile application with locked progression and reminders or a waitlist control group (n = 30). A mixed ANOVA showed a significant Time × Group interaction for SAD symptoms and negative emotions. The intervention group exhibited significant reductions in SAD symptoms, negative emotions, and mental health distress from pre- to post-intervention, sustained at 1-month follow-up, with no changes in the control group. This brief, self-administered VRET protocol offers a cost-effective, time-efficient solution for university students, advancing fully self-guided interventions.