Enhancing Virtual Reality Exposure Therapy (VRET) for the Treatment of Speech Anxiety: The Influence of Positive Affect Induction and Mental Health Self-Efficacy

Abstract Speech anxiety is one of the most common and impairing forms of social anxiety. This has led to increased interest in innovative treatment methods, with virtual reality exposure therapy (VRET) emerging as a cost-efficient and highly replicable alternative to in vivo exposure. However, the role of affective states and self-efficacy in VRET outcomes remains unclear. The present study examined whether inducing positive affect prior to VRET would enhance reductions in speech anxiety compared to negative affect induction, and whether baseline self-efficacy predicted short-term treatment outcomes. Thirty-one participants with moderate to high levels of speech anxiety completed a single VRET session following either a positive or negative affect induction. Speech anxiety levels were assessed before, immediately after, and one week following the intervention using the Personal Report of Communication Apprehension - Public Speaking Subscale (PRCA-PS). Baseline self-efficacy was measured using the Mental Health Self-Efficacy Scale (MHSES). Results showed the presence of a significant reduction in speech anxiety from pre- to post-intervention, which was maintained at the one-week follow-up. The affect induction condition did not significantly influence treatment outcomes, despite successfully altering participants’ mood. Baseline self-efficacy was not significantly associated with short-term reductions in speech anxiety. Together, these findings suggest that a single session of VRET is effective in reducing speech anxiety, while positive affect induction and baseline self-efficacy may not provide additional benefits in this context. Future research should aim to assess multi-session interventions and the dynamic nature of self-efficacy to better understand individual differences in exposure outcomes.