Slide
Centre Interdisciplinaire
de Recherche et d’Innovation
en Cybersécurité et Société
de Recherche et d’Innovation
en Cybersécurité et Société
1.
Delangle, M.; Moïse-Richard, A.; Leclercq, A. -L.; Labbé, D.; Bouchard, S.; Andrews, S.; Ménard, L.
Speaking face-to-face with a virtual avatar to reduce anxiety in students who stutter: Tool development and pilot study results Journal Article
In: Journal of Fluency Disorders, vol. 87, 2026, ISSN: 0094730X (ISSN).
Abstract | Links | BibTeX | Tags: Adolescent, adult, Anxiety, Arousal, article, Avatar, avoidance behavior, Canada, Child, clinical article, cognitive behavioral therapy, complication, controlled study, distance learning, ecological validity, electrocardiogram, electrodermal response, exposure, female, Heart Rate, heart rate variability, human, Humans, Liebowitz Social Anxiety Scale, Likert scale, male, nonverbal communication, physiological stress, Pilot Projects, pilot study, procedures, psychology, questionnaire, randomized controlled trial, role playing, School-age children, Self Concept, Self Efficacy, self report, Signal processing, skin conductance, social anxiety, speech, student, Students, Stuttering, Therapy, treatment outcome, virtual reality, virtual reality exposure therapy
@article{delangle_speaking_2026,
title = {Speaking face-to-face with a virtual avatar to reduce anxiety in students who stutter: Tool development and pilot study results},
author = {M. Delangle and A. Moïse-Richard and A. -L. Leclercq and D. Labbé and S. Bouchard and S. Andrews and L. Ménard},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-105028302364&doi=10.1016%2Fj.jfludis.2026.106194&partnerID=40&md5=af0d246f9187ee19796f36456887400b},
doi = {10.1016/j.jfludis.2026.106194},
issn = {0094730X (ISSN)},
year = {2026},
date = {2026-01-01},
journal = {Journal of Fluency Disorders},
volume = {87},
abstract = {Purpose Speaking in class is challenging for students who stutter. Cognitive-behavioral therapy (CBT) with exposure in virtual reality (VR) emerges as a promising intervention for treating speaking anxiety in pediatric populations. This pilot study tested if real-time avatar-based VR can elicit anxiety responses while remaining acceptable to youth who stutter. Method Twelve students who stutter (aged 9–18) were randomly assigned to a single training session conducted either (1) in VR with a realistic avatar controlled live by their SLP, or (2) in role-play with their SLP, before facing a real actor. We assessed system acceptability, anxiety levels and perceived self-efficacy. Results The VR system was well accepted and elicited physiological arousal comparable to real-life interactions. Although participants reported experiencing less anxiety during VR, skin conductance level showed higher arousal; suggesting a divergence between the subjective report and physiological response. Finally, one training session (either in VR or with the SLP) did not produce gains in self-efficacy or decrease in anxiety related to the final real-actor conversation. Conclusion This study demonstrates evidence that the potential use of immersive VR could represent an acceptable and viable complementary strategy for SLP treatment, that could control exposure parameters while evoking physiological responses similar to real-life contexts. The differences between subjective and physiological measures suggest that VR is inducing anxiety responses differently than it was perceived. Further research could investigate the use of VR as anxiety interventions for students who stutter and should be explored across multi-session studies to understand their therapeutic effect. © 2026 The Authors.},
keywords = {Adolescent, adult, Anxiety, Arousal, article, Avatar, avoidance behavior, Canada, Child, clinical article, cognitive behavioral therapy, complication, controlled study, distance learning, ecological validity, electrocardiogram, electrodermal response, exposure, female, Heart Rate, heart rate variability, human, Humans, Liebowitz Social Anxiety Scale, Likert scale, male, nonverbal communication, physiological stress, Pilot Projects, pilot study, procedures, psychology, questionnaire, randomized controlled trial, role playing, School-age children, Self Concept, Self Efficacy, self report, Signal processing, skin conductance, social anxiety, speech, student, Students, Stuttering, Therapy, treatment outcome, virtual reality, virtual reality exposure therapy},
pubstate = {published},
tppubtype = {article}
}
Purpose Speaking in class is challenging for students who stutter. Cognitive-behavioral therapy (CBT) with exposure in virtual reality (VR) emerges as a promising intervention for treating speaking anxiety in pediatric populations. This pilot study tested if real-time avatar-based VR can elicit anxiety responses while remaining acceptable to youth who stutter. Method Twelve students who stutter (aged 9–18) were randomly assigned to a single training session conducted either (1) in VR with a realistic avatar controlled live by their SLP, or (2) in role-play with their SLP, before facing a real actor. We assessed system acceptability, anxiety levels and perceived self-efficacy. Results The VR system was well accepted and elicited physiological arousal comparable to real-life interactions. Although participants reported experiencing less anxiety during VR, skin conductance level showed higher arousal; suggesting a divergence between the subjective report and physiological response. Finally, one training session (either in VR or with the SLP) did not produce gains in self-efficacy or decrease in anxiety related to the final real-actor conversation. Conclusion This study demonstrates evidence that the potential use of immersive VR could represent an acceptable and viable complementary strategy for SLP treatment, that could control exposure parameters while evoking physiological responses similar to real-life contexts. The differences between subjective and physiological measures suggest that VR is inducing anxiety responses differently than it was perceived. Further research could investigate the use of VR as anxiety interventions for students who stutter and should be explored across multi-session studies to understand their therapeutic effect. © 2026 The Authors.
2.
Delangle, M.; Moïse-Richard, A.; Leclercq, A. -L.; Labbé, D.; Bouchard, S.; Andrews, S.; Ménard, L.
Speaking face-to-face with a virtual avatar to reduce anxiety in students who stutter: Tool development and pilot study results Journal Article
In: Journal of Fluency Disorders, vol. 87, 2026, ISSN: 0094730X (ISSN).
Abstract | Links | BibTeX | Tags: Adolescent, adult, Anxiety, Arousal, article, Avatar, avoidance behavior, Canada, Child, clinical article, cognitive behavioral therapy, complication, controlled study, distance learning, ecological validity, electrocardiogram, electrodermal response, exposure, female, Heart Rate, heart rate variability, human, Humans, Liebowitz Social Anxiety Scale, Likert scale, male, nonverbal communication, physiological stress, Pilot Projects, pilot study, procedures, psychology, questionnaire, randomized controlled trial, role playing, School-age children, Self Concept, Self Efficacy, self report, Signal processing, skin conductance, social anxiety, speech, student, Students, Stuttering, Therapy, treatment outcome, virtual reality, virtual reality exposure therapy
@article{delangleSpeakingFacetofaceVirtual2026,
title = {Speaking face-to-face with a virtual avatar to reduce anxiety in students who stutter: Tool development and pilot study results},
author = {M. Delangle and A. Moïse-Richard and A. -L. Leclercq and D. Labbé and S. Bouchard and S. Andrews and L. Ménard},
url = {https://www.scopus.com/pages/publications/105028302364?origin=resultslist},
doi = {10.1016/j.jfludis.2026.106194},
issn = {0094730X (ISSN)},
year = {2026},
date = {2026-01-01},
journal = {Journal of Fluency Disorders},
volume = {87},
publisher = {Elsevier Inc.},
abstract = {Purpose Speaking in class is challenging for students who stutter. Cognitive-behavioral therapy (CBT) with exposure in virtual reality (VR) emerges as a promising intervention for treating speaking anxiety in pediatric populations. This pilot study tested if real-time avatar-based VR can elicit anxiety responses while remaining acceptable to youth who stutter. Method Twelve students who stutter (aged 9–18) were randomly assigned to a single training session conducted either (1) in VR with a realistic avatar controlled live by their SLP, or (2) in role-play with their SLP, before facing a real actor. We assessed system acceptability, anxiety levels and perceived self-efficacy. Results The VR system was well accepted and elicited physiological arousal comparable to real-life interactions. Although participants reported experiencing less anxiety during VR, skin conductance level showed higher arousal; suggesting a divergence between the subjective report and physiological response. Finally, one training session (either in VR or with the SLP) did not produce gains in self-efficacy or decrease in anxiety related to the final real-actor conversation. Conclusion This study demonstrates evidence that the potential use of immersive VR could represent an acceptable and viable complementary strategy for SLP treatment, that could control exposure parameters while evoking physiological responses similar to real-life contexts. The differences between subjective and physiological measures suggest that VR is inducing anxiety responses differently than it was perceived. Further research could investigate the use of VR as anxiety interventions for students who stutter and should be explored across multi-session studies to understand their therapeutic effect. © 2026 The Authors.},
keywords = {Adolescent, adult, Anxiety, Arousal, article, Avatar, avoidance behavior, Canada, Child, clinical article, cognitive behavioral therapy, complication, controlled study, distance learning, ecological validity, electrocardiogram, electrodermal response, exposure, female, Heart Rate, heart rate variability, human, Humans, Liebowitz Social Anxiety Scale, Likert scale, male, nonverbal communication, physiological stress, Pilot Projects, pilot study, procedures, psychology, questionnaire, randomized controlled trial, role playing, School-age children, Self Concept, Self Efficacy, self report, Signal processing, skin conductance, social anxiety, speech, student, Students, Stuttering, Therapy, treatment outcome, virtual reality, virtual reality exposure therapy},
pubstate = {published},
tppubtype = {article}
}
Purpose Speaking in class is challenging for students who stutter. Cognitive-behavioral therapy (CBT) with exposure in virtual reality (VR) emerges as a promising intervention for treating speaking anxiety in pediatric populations. This pilot study tested if real-time avatar-based VR can elicit anxiety responses while remaining acceptable to youth who stutter. Method Twelve students who stutter (aged 9–18) were randomly assigned to a single training session conducted either (1) in VR with a realistic avatar controlled live by their SLP, or (2) in role-play with their SLP, before facing a real actor. We assessed system acceptability, anxiety levels and perceived self-efficacy. Results The VR system was well accepted and elicited physiological arousal comparable to real-life interactions. Although participants reported experiencing less anxiety during VR, skin conductance level showed higher arousal; suggesting a divergence between the subjective report and physiological response. Finally, one training session (either in VR or with the SLP) did not produce gains in self-efficacy or decrease in anxiety related to the final real-actor conversation. Conclusion This study demonstrates evidence that the potential use of immersive VR could represent an acceptable and viable complementary strategy for SLP treatment, that could control exposure parameters while evoking physiological responses similar to real-life contexts. The differences between subjective and physiological measures suggest that VR is inducing anxiety responses differently than it was perceived. Further research could investigate the use of VR as anxiety interventions for students who stutter and should be explored across multi-session studies to understand their therapeutic effect. © 2026 The Authors.
3.
Delangle, M.; Moïse-Richard, A.; Leclercq, A. -L.; Labbé, D.; Bouchard, S.; Andrews, S.; Ménard, L.
Speaking face-to-face with a virtual avatar to reduce anxiety in students who stutter: Tool development and pilot study results Journal Article
In: Journal of Fluency Disorders, vol. 87, 2026, ISSN: 0094730X (ISSN).
Abstract | Links | BibTeX | Tags: Adolescent, adult, Anxiety, Arousal, article, Avatar, avoidance behavior, Canada, Child, clinical article, cognitive behavioral therapy, complication, controlled study, distance learning, ecological validity, electrocardiogram, electrodermal response, exposure, female, Heart Rate, heart rate variability, human, Humans, Liebowitz Social Anxiety Scale, Likert scale, male, nonverbal communication, physiological stress, Pilot Projects, pilot study, procedures, psychology, questionnaire, randomized controlled trial, role playing, School-age children, Self Concept, Self Efficacy, self report, Signal processing, skin conductance, social anxiety, speech, student, Students, Stuttering, Therapy, treatment outcome, virtual reality, virtual reality exposure therapy
@article{delangleSpeakingFacetofaceVirtual2026a,
title = {Speaking face-to-face with a virtual avatar to reduce anxiety in students who stutter: Tool development and pilot study results},
author = {M. Delangle and A. Moïse-Richard and A. -L. Leclercq and D. Labbé and S. Bouchard and S. Andrews and L. Ménard},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-105028302364&doi=10.1016%2Fj.jfludis.2026.106194&partnerID=40&md5=af0d246f9187ee19796f36456887400b},
doi = {10.1016/j.jfludis.2026.106194},
issn = {0094730X (ISSN)},
year = {2026},
date = {2026-01-01},
journal = {Journal of Fluency Disorders},
volume = {87},
abstract = {Purpose Speaking in class is challenging for students who stutter. Cognitive-behavioral therapy (CBT) with exposure in virtual reality (VR) emerges as a promising intervention for treating speaking anxiety in pediatric populations. This pilot study tested if real-time avatar-based VR can elicit anxiety responses while remaining acceptable to youth who stutter. Method Twelve students who stutter (aged 9–18) were randomly assigned to a single training session conducted either (1) in VR with a realistic avatar controlled live by their SLP, or (2) in role-play with their SLP, before facing a real actor. We assessed system acceptability, anxiety levels and perceived self-efficacy. Results The VR system was well accepted and elicited physiological arousal comparable to real-life interactions. Although participants reported experiencing less anxiety during VR, skin conductance level showed higher arousal; suggesting a divergence between the subjective report and physiological response. Finally, one training session (either in VR or with the SLP) did not produce gains in self-efficacy or decrease in anxiety related to the final real-actor conversation. Conclusion This study demonstrates evidence that the potential use of immersive VR could represent an acceptable and viable complementary strategy for SLP treatment, that could control exposure parameters while evoking physiological responses similar to real-life contexts. The differences between subjective and physiological measures suggest that VR is inducing anxiety responses differently than it was perceived. Further research could investigate the use of VR as anxiety interventions for students who stutter and should be explored across multi-session studies to understand their therapeutic effect. © 2026 The Authors.},
keywords = {Adolescent, adult, Anxiety, Arousal, article, Avatar, avoidance behavior, Canada, Child, clinical article, cognitive behavioral therapy, complication, controlled study, distance learning, ecological validity, electrocardiogram, electrodermal response, exposure, female, Heart Rate, heart rate variability, human, Humans, Liebowitz Social Anxiety Scale, Likert scale, male, nonverbal communication, physiological stress, Pilot Projects, pilot study, procedures, psychology, questionnaire, randomized controlled trial, role playing, School-age children, Self Concept, Self Efficacy, self report, Signal processing, skin conductance, social anxiety, speech, student, Students, Stuttering, Therapy, treatment outcome, virtual reality, virtual reality exposure therapy},
pubstate = {published},
tppubtype = {article}
}
Purpose Speaking in class is challenging for students who stutter. Cognitive-behavioral therapy (CBT) with exposure in virtual reality (VR) emerges as a promising intervention for treating speaking anxiety in pediatric populations. This pilot study tested if real-time avatar-based VR can elicit anxiety responses while remaining acceptable to youth who stutter. Method Twelve students who stutter (aged 9–18) were randomly assigned to a single training session conducted either (1) in VR with a realistic avatar controlled live by their SLP, or (2) in role-play with their SLP, before facing a real actor. We assessed system acceptability, anxiety levels and perceived self-efficacy. Results The VR system was well accepted and elicited physiological arousal comparable to real-life interactions. Although participants reported experiencing less anxiety during VR, skin conductance level showed higher arousal; suggesting a divergence between the subjective report and physiological response. Finally, one training session (either in VR or with the SLP) did not produce gains in self-efficacy or decrease in anxiety related to the final real-actor conversation. Conclusion This study demonstrates evidence that the potential use of immersive VR could represent an acceptable and viable complementary strategy for SLP treatment, that could control exposure parameters while evoking physiological responses similar to real-life contexts. The differences between subjective and physiological measures suggest that VR is inducing anxiety responses differently than it was perceived. Further research could investigate the use of VR as anxiety interventions for students who stutter and should be explored across multi-session studies to understand their therapeutic effect. © 2026 The Authors.
4.
Ørskov, P. T.; Runge, E.; Sainte-Marie, T. T. H.; Ernst, M. T.; Clemmensen, L.; Dalsgaard, C. H.; Lichtenstein, M. B.; Bouchard, S.
In: Frontiers in Virtual Reality, vol. 6, 2025, ISSN: 26734192 (ISSN), (Publisher: Frontiers Media SA).
Abstract | Links | BibTeX | Tags: 360° video, cognitive behavioral therapy, exposure, randomized controlled trial, social anxiety disorder, virtual reality
@article{orskov_virtual_2025,
title = {Virtual reality-based exposure with 360° video as part of cognitive behavioral therapy for social anxiety disorder: a three-arm randomized controlled trial},
author = {P. T. Ørskov and E. Runge and T. T. H. Sainte-Marie and M. T. Ernst and L. Clemmensen and C. H. Dalsgaard and M. B. Lichtenstein and S. Bouchard},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-105009844371&doi=10.3389%2Ffrvir.2025.1588181&partnerID=40&md5=eb28bc502f030b1af4bff5592815253b},
doi = {10.3389/frvir.2025.1588181},
issn = {26734192 (ISSN)},
year = {2025},
date = {2025-01-01},
journal = {Frontiers in Virtual Reality},
volume = {6},
abstract = {Background: Social anxiety disorder (SAD) has a high prevalence and an early onset. It often persists well into adulthood, turning into a chronic disorder. Cognitive behavioral therapy (CBT) is effective in treating SAD, but real-life exposure conducted as part of CBT is often costly and time-consuming, and imaginary exposure might lack realism and intensity. Virtual reality (VR)-based exposure using 360° video offers a promising way to deliver exposure therapy. Objective: To develop a complete psychotherapeutic treatment program including CBT with VR-based exposure using 360° videos (CBT-ExpVR) for adult patients with SAD and to test the treatment effect using the Social Interaction Anxiety Scale (SIAS) as the primary outcome. Methods: This three-arm randomized controlled trial involved 51 participants who were recruited through self-referral. The interventions took place at Center for Digital Psychiatry in Denmark. Participants were randomized via computer program to CBT-ExpVR, CBT with in vivo exposure (CBT-Exp), or an active control group offered VR relaxation (RlxVR). Afterwards, participants assigned to RlxVR were re-randomized to one of the two CBT interventions. Allocation was not blinded. Results: Intention-to-treat analysis showed that participants receiving CBT-ExpVR reported significantly fewer symptoms of social anxiety at post-treatment compared to pre-treatment, β = −14.89, 95% CI (−18.64, −11.14), p < 0.0001. At post-treatment, no difference in treatment effect was found between CBT-ExpVR and CBT-Exp, β = 3.643, 95% CI (−1.727, 9.013)},
note = {Publisher: Frontiers Media SA},
keywords = {360° video, cognitive behavioral therapy, exposure, randomized controlled trial, social anxiety disorder, virtual reality},
pubstate = {published},
tppubtype = {article}
}
Background: Social anxiety disorder (SAD) has a high prevalence and an early onset. It often persists well into adulthood, turning into a chronic disorder. Cognitive behavioral therapy (CBT) is effective in treating SAD, but real-life exposure conducted as part of CBT is often costly and time-consuming, and imaginary exposure might lack realism and intensity. Virtual reality (VR)-based exposure using 360° video offers a promising way to deliver exposure therapy. Objective: To develop a complete psychotherapeutic treatment program including CBT with VR-based exposure using 360° videos (CBT-ExpVR) for adult patients with SAD and to test the treatment effect using the Social Interaction Anxiety Scale (SIAS) as the primary outcome. Methods: This three-arm randomized controlled trial involved 51 participants who were recruited through self-referral. The interventions took place at Center for Digital Psychiatry in Denmark. Participants were randomized via computer program to CBT-ExpVR, CBT with in vivo exposure (CBT-Exp), or an active control group offered VR relaxation (RlxVR). Afterwards, participants assigned to RlxVR were re-randomized to one of the two CBT interventions. Allocation was not blinded. Results: Intention-to-treat analysis showed that participants receiving CBT-ExpVR reported significantly fewer symptoms of social anxiety at post-treatment compared to pre-treatment, β = −14.89, 95% CI (−18.64, −11.14), p < 0.0001. At post-treatment, no difference in treatment effect was found between CBT-ExpVR and CBT-Exp, β = 3.643, 95% CI (−1.727, 9.013)
5.
Bouchard, S.; Forget, H.
Conducting exposure in virtual reality for the treatment of social phobia does lead to change in dysfunctional beliefs Journal Article
In: Annual Review of CyberTherapy and Telemedicine, vol. 23, pp. 258–264, 2025, ISSN: 15548716 (ISSN).
Abstract | Links | BibTeX | Tags: adult, article, clinical article, cognitive behavioral therapy, controlled study, exposure, female, follow up, hospital admission, human, in vivo study, Liebowitz Social Anxiety Scale, male, multiple regression, predictors of outcome, randomized controlled trial, social anxiety disorder, social phobia, Social Phobia Scale, threat, treatment duration, Treatment mechanisms, treatment outcome, virtual reality
@article{bouchard_conducting_2025,
title = {Conducting exposure in virtual reality for the treatment of social phobia does lead to change in dysfunctional beliefs},
author = {S. Bouchard and H. Forget},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-105023856314&partnerID=40&md5=db4c4e86d7c32b544fe28c7fb6f9172b},
issn = {15548716 (ISSN)},
year = {2025},
date = {2025-01-01},
journal = {Annual Review of CyberTherapy and Telemedicine},
volume = {23},
pages = {258–264},
abstract = {This study used data from a randomized control trial on cognitive behavior therapy for social phobia testing the effectiveness of exposure conducted in virtual reality. Measures of cognitive mechanisms had been collected but never analyzed. The study was motivated by a recent publication mentioning that potential aversive outcomes of being judged in virtual reality and by virtual characters have no objective negative consequence in daily life. A sample of 51 adults completed outcome and cognitive mechanism measures at a pretreatment, after 14 weeks of treatment or being on a waiting list, and at a 6-month follow-up. Results demonstrate that conducting exposure in virtual reality led to reductions in dysfunctional beliefs about the perceived consequences of feared social threats, about the likelihood of these feared threats occurring, as well as an increase in perceived self-efficacy to face social situations. These changes were statistically significant when compared to the waiting list condition, remained stable at the 6-month follow-up, and were no less important than when exposure was conducted in vivo. All predictors significantly correlated (p < .001) with the two measures of treatment outcome. Further analyses of cognitive mechanism measures predicting treatment outcomes revealed that, when controlling for shared variance, changes in perceived likelihood and in self-efficacy contributed significantly to patients’ improvement, whereas the role of perceived consequences was only a predictor of self-efficacy. © 2025, Interactive Media Institute. All rights reserved.},
keywords = {adult, article, clinical article, cognitive behavioral therapy, controlled study, exposure, female, follow up, hospital admission, human, in vivo study, Liebowitz Social Anxiety Scale, male, multiple regression, predictors of outcome, randomized controlled trial, social anxiety disorder, social phobia, Social Phobia Scale, threat, treatment duration, Treatment mechanisms, treatment outcome, virtual reality},
pubstate = {published},
tppubtype = {article}
}
This study used data from a randomized control trial on cognitive behavior therapy for social phobia testing the effectiveness of exposure conducted in virtual reality. Measures of cognitive mechanisms had been collected but never analyzed. The study was motivated by a recent publication mentioning that potential aversive outcomes of being judged in virtual reality and by virtual characters have no objective negative consequence in daily life. A sample of 51 adults completed outcome and cognitive mechanism measures at a pretreatment, after 14 weeks of treatment or being on a waiting list, and at a 6-month follow-up. Results demonstrate that conducting exposure in virtual reality led to reductions in dysfunctional beliefs about the perceived consequences of feared social threats, about the likelihood of these feared threats occurring, as well as an increase in perceived self-efficacy to face social situations. These changes were statistically significant when compared to the waiting list condition, remained stable at the 6-month follow-up, and were no less important than when exposure was conducted in vivo. All predictors significantly correlated (p < .001) with the two measures of treatment outcome. Further analyses of cognitive mechanism measures predicting treatment outcomes revealed that, when controlling for shared variance, changes in perceived likelihood and in self-efficacy contributed significantly to patients’ improvement, whereas the role of perceived consequences was only a predictor of self-efficacy. © 2025, Interactive Media Institute. All rights reserved.
6.
Bouchard, S.; Forget, H.
Conducting exposure in virtual reality for the treatment of social phobia does lead to change in dysfunctional beliefs Journal Article
In: Annual Review of CyberTherapy and Telemedicine, vol. 23, pp. 258–264, 2025, ISSN: 15548716 (ISSN).
Abstract | Links | BibTeX | Tags: adult, article, clinical article, cognitive behavioral therapy, controlled study, exposure, female, follow up, hospital admission, human, in vivo study, Liebowitz Social Anxiety Scale, male, multiple regression, predictors of outcome, randomized controlled trial, social anxiety disorder, social phobia, Social Phobia Scale, threat, treatment duration, Treatment mechanisms, treatment outcome, virtual reality
@article{bouchardConductingExposureVirtual2025,
title = {Conducting exposure in virtual reality for the treatment of social phobia does lead to change in dysfunctional beliefs},
author = {S. Bouchard and H. Forget},
url = {https://www.scopus.com/pages/publications/105023856314?origin=resultslist},
issn = {15548716 (ISSN)},
year = {2025},
date = {2025-01-01},
journal = {Annual Review of CyberTherapy and Telemedicine},
volume = {23},
pages = {258–264},
publisher = {Interactive Media Institute},
abstract = {This study used data from a randomized control trial on cognitive behavior therapy for social phobia testing the effectiveness of exposure conducted in virtual reality. Measures of cognitive mechanisms had been collected but never analyzed. The study was motivated by a recent publication mentioning that potential aversive outcomes of being judged in virtual reality and by virtual characters have no objective negative consequence in daily life. A sample of 51 adults completed outcome and cognitive mechanism measures at a pretreatment, after 14 weeks of treatment or being on a waiting list, and at a 6-month follow-up. Results demonstrate that conducting exposure in virtual reality led to reductions in dysfunctional beliefs about the perceived consequences of feared social threats, about the likelihood of these feared threats occurring, as well as an increase in perceived self-efficacy to face social situations. These changes were statistically significant when compared to the waiting list condition, remained stable at the 6-month follow-up, and were no less important than when exposure was conducted in vivo. All predictors significantly correlated (p < .001) with the two measures of treatment outcome. Further analyses of cognitive mechanism measures predicting treatment outcomes revealed that, when controlling for shared variance, changes in perceived likelihood and in self-efficacy contributed significantly to patients’ improvement, whereas the role of perceived consequences was only a predictor of self-efficacy. © 2025, Interactive Media Institute. All rights reserved.},
keywords = {adult, article, clinical article, cognitive behavioral therapy, controlled study, exposure, female, follow up, hospital admission, human, in vivo study, Liebowitz Social Anxiety Scale, male, multiple regression, predictors of outcome, randomized controlled trial, social anxiety disorder, social phobia, Social Phobia Scale, threat, treatment duration, Treatment mechanisms, treatment outcome, virtual reality},
pubstate = {published},
tppubtype = {article}
}
This study used data from a randomized control trial on cognitive behavior therapy for social phobia testing the effectiveness of exposure conducted in virtual reality. Measures of cognitive mechanisms had been collected but never analyzed. The study was motivated by a recent publication mentioning that potential aversive outcomes of being judged in virtual reality and by virtual characters have no objective negative consequence in daily life. A sample of 51 adults completed outcome and cognitive mechanism measures at a pretreatment, after 14 weeks of treatment or being on a waiting list, and at a 6-month follow-up. Results demonstrate that conducting exposure in virtual reality led to reductions in dysfunctional beliefs about the perceived consequences of feared social threats, about the likelihood of these feared threats occurring, as well as an increase in perceived self-efficacy to face social situations. These changes were statistically significant when compared to the waiting list condition, remained stable at the 6-month follow-up, and were no less important than when exposure was conducted in vivo. All predictors significantly correlated (p < .001) with the two measures of treatment outcome. Further analyses of cognitive mechanism measures predicting treatment outcomes revealed that, when controlling for shared variance, changes in perceived likelihood and in self-efficacy contributed significantly to patients’ improvement, whereas the role of perceived consequences was only a predictor of self-efficacy. © 2025, Interactive Media Institute. All rights reserved.
7.
Ørskov, P. T.; Runge, E.; Sainte-Marie, T. T. H.; Ernst, M. T.; Clemmensen, L.; Dalsgaard, C. H.; Lichtenstein, M. B.; Bouchard, S.
In: Frontiers in Virtual Reality, vol. 6, 2025, ISSN: 26734192 (ISSN).
Abstract | Links | BibTeX | Tags: 360° video, cognitive behavioral therapy, exposure, randomized controlled trial, social anxiety disorder, virtual reality
@article{orskovVirtualRealitybasedExposure2025,
title = {Virtual reality-based exposure with 360° video as part of cognitive behavioral therapy for social anxiety disorder: a three-arm randomized controlled trial},
author = {P. T. Ørskov and E. Runge and T. T. H. Sainte-Marie and M. T. Ernst and L. Clemmensen and C. H. Dalsgaard and M. B. Lichtenstein and S. Bouchard},
url = {https://www.scopus.com/pages/publications/105009844371?origin=resultslist},
doi = {10.3389/frvir.2025.1588181},
issn = {26734192 (ISSN)},
year = {2025},
date = {2025-01-01},
journal = {Frontiers in Virtual Reality},
volume = {6},
publisher = {Frontiers Media SA},
abstract = {Background: Social anxiety disorder (SAD) has a high prevalence and an early onset. It often persists well into adulthood, turning into a chronic disorder. Cognitive behavioral therapy (CBT) is effective in treating SAD, but real-life exposure conducted as part of CBT is often costly and time-consuming, and imaginary exposure might lack realism and intensity. Virtual reality (VR)-based exposure using 360° video offers a promising way to deliver exposure therapy. Objective: To develop a complete psychotherapeutic treatment program including CBT with VR-based exposure using 360° videos (CBT-ExpVR) for adult patients with SAD and to test the treatment effect using the Social Interaction Anxiety Scale (SIAS) as the primary outcome. Methods: This three-arm randomized controlled trial involved 51 participants who were recruited through self-referral. The interventions took place at Center for Digital Psychiatry in Denmark. Participants were randomized via computer program to CBT-ExpVR, CBT with in vivo exposure (CBT-Exp), or an active control group offered VR relaxation (RlxVR). Afterwards, participants assigned to RlxVR were re-randomized to one of the two CBT interventions. Allocation was not blinded. Results: Intention-to-treat analysis showed that participants receiving CBT-ExpVR reported significantly fewer symptoms of social anxiety at post-treatment compared to pre-treatment, β = −14.89, 95% CI (−18.64, −11.14), p < 0.0001. At post-treatment, no difference in treatment effect was found between CBT-ExpVR and CBT-Exp, β = 3.643, 95% CI (−1.727, 9.013)},
keywords = {360° video, cognitive behavioral therapy, exposure, randomized controlled trial, social anxiety disorder, virtual reality},
pubstate = {published},
tppubtype = {article}
}
Background: Social anxiety disorder (SAD) has a high prevalence and an early onset. It often persists well into adulthood, turning into a chronic disorder. Cognitive behavioral therapy (CBT) is effective in treating SAD, but real-life exposure conducted as part of CBT is often costly and time-consuming, and imaginary exposure might lack realism and intensity. Virtual reality (VR)-based exposure using 360° video offers a promising way to deliver exposure therapy. Objective: To develop a complete psychotherapeutic treatment program including CBT with VR-based exposure using 360° videos (CBT-ExpVR) for adult patients with SAD and to test the treatment effect using the Social Interaction Anxiety Scale (SIAS) as the primary outcome. Methods: This three-arm randomized controlled trial involved 51 participants who were recruited through self-referral. The interventions took place at Center for Digital Psychiatry in Denmark. Participants were randomized via computer program to CBT-ExpVR, CBT with in vivo exposure (CBT-Exp), or an active control group offered VR relaxation (RlxVR). Afterwards, participants assigned to RlxVR were re-randomized to one of the two CBT interventions. Allocation was not blinded. Results: Intention-to-treat analysis showed that participants receiving CBT-ExpVR reported significantly fewer symptoms of social anxiety at post-treatment compared to pre-treatment, β = −14.89, 95% CI (−18.64, −11.14), p < 0.0001. At post-treatment, no difference in treatment effect was found between CBT-ExpVR and CBT-Exp, β = 3.643, 95% CI (−1.727, 9.013)
8.
Ørskov, P. T.; Runge, E.; Sainte-Marie, T. T. H.; Ernst, M. T.; Clemmensen, L.; Dalsgaard, C. H.; Lichtenstein, M. B.; Bouchard, S.
In: Frontiers in Virtual Reality, vol. 6, 2025, ISSN: 26734192 (ISSN).
Abstract | Links | BibTeX | Tags: 360° video, cognitive behavioral therapy, exposure, randomized controlled trial, social anxiety disorder, virtual reality
@article{orskovVirtualRealitybasedExposure2025a,
title = {Virtual reality-based exposure with 360° video as part of cognitive behavioral therapy for social anxiety disorder: a three-arm randomized controlled trial},
author = {P. T. Ørskov and E. Runge and T. T. H. Sainte-Marie and M. T. Ernst and L. Clemmensen and C. H. Dalsgaard and M. B. Lichtenstein and S. Bouchard},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-105009844371&doi=10.3389%2Ffrvir.2025.1588181&partnerID=40&md5=eb28bc502f030b1af4bff5592815253b},
doi = {10.3389/frvir.2025.1588181},
issn = {26734192 (ISSN)},
year = {2025},
date = {2025-01-01},
journal = {Frontiers in Virtual Reality},
volume = {6},
abstract = {Background: Social anxiety disorder (SAD) has a high prevalence and an early onset. It often persists well into adulthood, turning into a chronic disorder. Cognitive behavioral therapy (CBT) is effective in treating SAD, but real-life exposure conducted as part of CBT is often costly and time-consuming, and imaginary exposure might lack realism and intensity. Virtual reality (VR)-based exposure using 360° video offers a promising way to deliver exposure therapy. Objective: To develop a complete psychotherapeutic treatment program including CBT with VR-based exposure using 360° videos (CBT-ExpVR) for adult patients with SAD and to test the treatment effect using the Social Interaction Anxiety Scale (SIAS) as the primary outcome. Methods: This three-arm randomized controlled trial involved 51 participants who were recruited through self-referral. The interventions took place at Center for Digital Psychiatry in Denmark. Participants were randomized via computer program to CBT-ExpVR, CBT with in vivo exposure (CBT-Exp), or an active control group offered VR relaxation (RlxVR). Afterwards, participants assigned to RlxVR were re-randomized to one of the two CBT interventions. Allocation was not blinded. Results: Intention-to-treat analysis showed that participants receiving CBT-ExpVR reported significantly fewer symptoms of social anxiety at post-treatment compared to pre-treatment, β = −14.89, 95% CI (−18.64, −11.14), p < 0.0001. At post-treatment, no difference in treatment effect was found between CBT-ExpVR and CBT-Exp, β = 3.643, 95% CI (−1.727, 9.013)},
keywords = {360° video, cognitive behavioral therapy, exposure, randomized controlled trial, social anxiety disorder, virtual reality},
pubstate = {published},
tppubtype = {article}
}
Background: Social anxiety disorder (SAD) has a high prevalence and an early onset. It often persists well into adulthood, turning into a chronic disorder. Cognitive behavioral therapy (CBT) is effective in treating SAD, but real-life exposure conducted as part of CBT is often costly and time-consuming, and imaginary exposure might lack realism and intensity. Virtual reality (VR)-based exposure using 360° video offers a promising way to deliver exposure therapy. Objective: To develop a complete psychotherapeutic treatment program including CBT with VR-based exposure using 360° videos (CBT-ExpVR) for adult patients with SAD and to test the treatment effect using the Social Interaction Anxiety Scale (SIAS) as the primary outcome. Methods: This three-arm randomized controlled trial involved 51 participants who were recruited through self-referral. The interventions took place at Center for Digital Psychiatry in Denmark. Participants were randomized via computer program to CBT-ExpVR, CBT with in vivo exposure (CBT-Exp), or an active control group offered VR relaxation (RlxVR). Afterwards, participants assigned to RlxVR were re-randomized to one of the two CBT interventions. Allocation was not blinded. Results: Intention-to-treat analysis showed that participants receiving CBT-ExpVR reported significantly fewer symptoms of social anxiety at post-treatment compared to pre-treatment, β = −14.89, 95% CI (−18.64, −11.14), p < 0.0001. At post-treatment, no difference in treatment effect was found between CBT-ExpVR and CBT-Exp, β = 3.643, 95% CI (−1.727, 9.013)
9.
Bouchard, S.; Forget, H.
Conducting exposure in virtual reality for the treatment of social phobia does lead to change in dysfunctional beliefs Journal Article
In: Annual Review of CyberTherapy and Telemedicine, vol. 23, pp. 258–264, 2025, ISSN: 15548716 (ISSN).
Abstract | Links | BibTeX | Tags: adult, article, clinical article, cognitive behavioral therapy, controlled study, exposure, female, follow up, hospital admission, human, in vivo study, Liebowitz Social Anxiety Scale, male, multiple regression, predictors of outcome, randomized controlled trial, social anxiety disorder, social phobia, Social Phobia Scale, threat, treatment duration, Treatment mechanisms, treatment outcome, virtual reality
@article{bouchardConductingExposureVirtual2025a,
title = {Conducting exposure in virtual reality for the treatment of social phobia does lead to change in dysfunctional beliefs},
author = {S. Bouchard and H. Forget},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-105023856314&partnerID=40&md5=db4c4e86d7c32b544fe28c7fb6f9172b},
issn = {15548716 (ISSN)},
year = {2025},
date = {2025-01-01},
journal = {Annual Review of CyberTherapy and Telemedicine},
volume = {23},
pages = {258–264},
abstract = {This study used data from a randomized control trial on cognitive behavior therapy for social phobia testing the effectiveness of exposure conducted in virtual reality. Measures of cognitive mechanisms had been collected but never analyzed. The study was motivated by a recent publication mentioning that potential aversive outcomes of being judged in virtual reality and by virtual characters have no objective negative consequence in daily life. A sample of 51 adults completed outcome and cognitive mechanism measures at a pretreatment, after 14 weeks of treatment or being on a waiting list, and at a 6-month follow-up. Results demonstrate that conducting exposure in virtual reality led to reductions in dysfunctional beliefs about the perceived consequences of feared social threats, about the likelihood of these feared threats occurring, as well as an increase in perceived self-efficacy to face social situations. These changes were statistically significant when compared to the waiting list condition, remained stable at the 6-month follow-up, and were no less important than when exposure was conducted in vivo. All predictors significantly correlated (p < .001) with the two measures of treatment outcome. Further analyses of cognitive mechanism measures predicting treatment outcomes revealed that, when controlling for shared variance, changes in perceived likelihood and in self-efficacy contributed significantly to patients’ improvement, whereas the role of perceived consequences was only a predictor of self-efficacy. © 2025, Interactive Media Institute. All rights reserved.},
keywords = {adult, article, clinical article, cognitive behavioral therapy, controlled study, exposure, female, follow up, hospital admission, human, in vivo study, Liebowitz Social Anxiety Scale, male, multiple regression, predictors of outcome, randomized controlled trial, social anxiety disorder, social phobia, Social Phobia Scale, threat, treatment duration, Treatment mechanisms, treatment outcome, virtual reality},
pubstate = {published},
tppubtype = {article}
}
This study used data from a randomized control trial on cognitive behavior therapy for social phobia testing the effectiveness of exposure conducted in virtual reality. Measures of cognitive mechanisms had been collected but never analyzed. The study was motivated by a recent publication mentioning that potential aversive outcomes of being judged in virtual reality and by virtual characters have no objective negative consequence in daily life. A sample of 51 adults completed outcome and cognitive mechanism measures at a pretreatment, after 14 weeks of treatment or being on a waiting list, and at a 6-month follow-up. Results demonstrate that conducting exposure in virtual reality led to reductions in dysfunctional beliefs about the perceived consequences of feared social threats, about the likelihood of these feared threats occurring, as well as an increase in perceived self-efficacy to face social situations. These changes were statistically significant when compared to the waiting list condition, remained stable at the 6-month follow-up, and were no less important than when exposure was conducted in vivo. All predictors significantly correlated (p < .001) with the two measures of treatment outcome. Further analyses of cognitive mechanism measures predicting treatment outcomes revealed that, when controlling for shared variance, changes in perceived likelihood and in self-efficacy contributed significantly to patients’ improvement, whereas the role of perceived consequences was only a predictor of self-efficacy. © 2025, Interactive Media Institute. All rights reserved.
10.
Quintana, P.; Bouchard, S.; Botella, C.; Robillard, G.; Serrano, B.; Rodriguez-Ortega, A.; Ernst, M. Torp; Rey, B.; Berthiaume, M.; Corno, G.
In: Journal of Clinical Medicine, vol. 12, no. 13, 2023, ISSN: 20770383 (ISSN), (Publisher: Multidisciplinary Digital Publishing Institute (MDPI)).
Abstract | Links | BibTeX | Tags: adult, anxiety assessment, article, Canada, clinical article, controlled study, cultural differences, ecological validity, exposure, female, generalized social anxiety, human, immersion, male, multicenter study, psychotherapy, self report, social anxiety, social interaction, social phobia, Spain, virtual reality, virtual reality exposure therapy
@article{quintana_engaging_2023,
title = {Engaging in Awkward Social Interactions in a Virtual Environment Designed for Exposure-Based Psychotherapy for People with Generalized Social Anxiety Disorder: An International Multisite Study},
author = {P. Quintana and S. Bouchard and C. Botella and G. Robillard and B. Serrano and A. Rodriguez-Ortega and M. Torp Ernst and B. Rey and M. Berthiaume and G. Corno},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85165033932&doi=10.3390%2fjcm12134525&partnerID=40&md5=7b0f59b46ff7680611d5a64e18909651},
doi = {10.3390/jcm12134525},
issn = {20770383 (ISSN)},
year = {2023},
date = {2023-01-01},
journal = {Journal of Clinical Medicine},
volume = {12},
number = {13},
publisher = {Multidisciplinary Digital Publishing Institute (MDPI)},
abstract = {The effectiveness of in virtuo exposure-based treatment of performance-only social anxiety disorder (SAD) has been demonstrated in several studies. However, few studies have validated virtual environments with participants suffering from generalized SAD. The goal of this study is to confirm the potential of a virtual environment in inducing anxiety in adults suffering from generalized SAD, compared to adults without SAD, when engaged in awkward social interactions. Differences between participants from two different countries were also explored. The sample consisted of 15 participants with SAD from Canada, 17 participants without SAD from Canada, 16 participants with SAD from Spain, and 21 participants without SAD from Spain. All participants were immersed in a control virtual environment and in an experimental virtual environment considered potentially anxiety-inducing for individuals with generalized SAD. As hypothesized, results showed that the experimental virtual environment induced a higher level of anxiety than the control environment among participants with SAD compared to those without SAD. The impact on anxiety of each socially threatening task performed during the experimental immersion was statistically significant. In terms of anxiety responses, no significant differences were found between participants from Canada and Spain. However, spatial presence and ecological validity were higher in Canadians than in Spaniards. Unwanted negative side effects induced by immersions in virtual reality were higher in the SAD group. This study highlights the importance for therapists to engage people with SAD in clinically relevant tasks while immersed in VR psychotherapeutic applications. © 2023 by the authors.},
note = {Publisher: Multidisciplinary Digital Publishing Institute (MDPI)},
keywords = {adult, anxiety assessment, article, Canada, clinical article, controlled study, cultural differences, ecological validity, exposure, female, generalized social anxiety, human, immersion, male, multicenter study, psychotherapy, self report, social anxiety, social interaction, social phobia, Spain, virtual reality, virtual reality exposure therapy},
pubstate = {published},
tppubtype = {article}
}
The effectiveness of in virtuo exposure-based treatment of performance-only social anxiety disorder (SAD) has been demonstrated in several studies. However, few studies have validated virtual environments with participants suffering from generalized SAD. The goal of this study is to confirm the potential of a virtual environment in inducing anxiety in adults suffering from generalized SAD, compared to adults without SAD, when engaged in awkward social interactions. Differences between participants from two different countries were also explored. The sample consisted of 15 participants with SAD from Canada, 17 participants without SAD from Canada, 16 participants with SAD from Spain, and 21 participants without SAD from Spain. All participants were immersed in a control virtual environment and in an experimental virtual environment considered potentially anxiety-inducing for individuals with generalized SAD. As hypothesized, results showed that the experimental virtual environment induced a higher level of anxiety than the control environment among participants with SAD compared to those without SAD. The impact on anxiety of each socially threatening task performed during the experimental immersion was statistically significant. In terms of anxiety responses, no significant differences were found between participants from Canada and Spain. However, spatial presence and ecological validity were higher in Canadians than in Spaniards. Unwanted negative side effects induced by immersions in virtual reality were higher in the SAD group. This study highlights the importance for therapists to engage people with SAD in clinically relevant tasks while immersed in VR psychotherapeutic applications. © 2023 by the authors.