Accepted for/Published in: JMIR Research Protocols
Date Submitted: Nov 1, 2025
Date Accepted: Jun 30, 2026
Therapist Facilitated Virtual Reality Intervention for Social Anxiety among Youths: Protocol for a Randomized Controlled Trial
ABSTRACT
Background:
Youth social anxiety is rising, yet evidence for therapist-guided virtual-reality exposure remains sparse.
Objective:
This RCT will test whether such a VR program can effectively reduce social-anxiety symptoms in 15- to 25-year-olds.
Methods:
Participants will be recruited from schools, tertiary institutions, and community centers in Hong Kong and screened for eligibility. Youths aged 15 to 25 years who score ≥25 on the Social Phobia Inventory (SPIN) will be randomly allocated to either the VR intervention group or the waitlist control group in a 1:1 ratio. The VR group will receive a six-session therapist-facilitated VR intervention, focusing on exposure to realistic social scenarios, real-time physiological monitoring, and AI-driven adaptive support. The control group will receive routine support sessions at scheduled intervals but no VR treatment. Both groups will be assessed at baseline, 1 month (post-intervention), and 3 months for the primary outcome of social anxiety (SPIN) and the secondary outcome of depression (PHQ-9). Cost-effectiveness will also be evaluated, providing an estimate of the cost per unit reduction in SPIN scores.
Results:
A total of 90 participants (45 in each group) will be recruited. Participant enrollment will begin in March 2026, and data collection will continue until the required sample size is reached. Outcome analyses will use a linear mixed-effects model under the intention-to-treat principle, with missing data accounted for under the assumption of missing-at-random.
Conclusions:
This trial will determine whether a therapist-guided VR program can provide an immersive, monitored, and cost-effective way to reduce social anxiety in youths. Clinical Trial: NCT06876779
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