Third-wave therapy with virtual reality exposure: Transdiagnostic proof of concept for the treatment of social anxiety.

Third-wave therapies and Virtual Reality (VR) exposure are two promising interventions for Social Anxiety (SA) disorder. These interventions are not new, but what is innovative is the combination of them. The main objective of this study was to evaluate the preliminary efficacy of a treatment for SA that combines the best of third-wave therapies with the advantages of immersive VR exposure. Three experimental groups with SA disorder were recruited: SA only, SA with comorbidity, and SA with psychosis (n = 50; 64 % female; mean age 22.98). A control group was also recruited: SA with and without comorbidities (n = 25; 84 % female; mean age 24.88). Experimental participants received eight weekly treatment sessions of about 60 min each. At the end of the study, the control group was provided with a list of telephone helplines and clinics for the treatment of SA. The results suggest that the intervention was effective in reducing SA symptoms with large effect sizes, irrespective of the presence or absence of comorbid disorders. The impact of the intervention was also observed on other clinical variables: general anxiety, depression, intolerance of uncertainty, cognitive distortions, mindfulness skills, and non-adaptative emotional regulation. Significant predictors of treatment change were linked to improvements in intolerance of uncertainty, experiential avoidance, and the frequency of exposure exercises. The results support the combined use of VR exposure and third-wave therapy for the treatment of SA. Further studies are needed to confirm the efficacy and investigate the implementation considerations of combining these interventions for SA disorder.