Imagery-enhanced virtual reality exposure to broaden public speaking confidence.

Enhancing Generalization of Virtual Reality Exposure for Public Speaking Anxiety Via Imagery-Based Extinction Memory Updating: A Randomized Controlled Trial

Not applicable Interventional Philipps University Marburg · NCT07323498

This trial will see if adding guided imagery after a single VR public-speaking session helps adults with high public-speaking anxiety feel less anxious in new speaking situations.

Quick facts

PhaseNot applicable
Study typeInterventional
Enrollment48 (estimated)
Ages18 Years to 70 Years
SexAll
SponsorPhilipps University Marburg Academic / other
Locations1 site (Marburg, Hesse)
Trial IDNCT07323498 on ClinicalTrials.gov

What this trial studies

Participants with elevated public speaking anxiety complete a single standardized virtual reality speech exposure and are then randomized to either standard mental rehearsal or mental rehearsal plus guided imagery designed to update the extinction memory with novel non-exposed contexts. The guided imagery intervention aims to integrate new contextual information into the recently formed extinction memory to increase its accessibility and applicability across situations. Generalization of fear reduction is measured 7–14 days later using a multi-context behavioral approach test conducted both in vivo and in VR. The trial translates laboratory findings on imagery-based extinction updating into a clinically feasible, single-session adjunct to exposure therapy.

Who should consider this trial

Good fit: Adults aged 18–70 with elevated public-speaking anxiety (PRCA-PS score ≥ 18) who can attend in-person visits at the study site are ideal candidates.

Not a fit: People with low public-speaking fear, those outside the 18–70 age range, or individuals whose symptoms are driven primarily by other psychiatric conditions may not benefit from this single-session intervention.

Why it matters

Potential benefit: If successful, this approach could help exposure gains from a single VR session carry over to new real-world speaking situations, reducing relapse and the need for longer or more intensive therapy.

How similar studies have performed: Experimental laboratory studies have shown that imagery-based extinction updating can enhance generalization of fear reduction, but randomized clinical translations remain limited.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* speech anxiety scale score of ≥ 18 on the Personal Report of Communication Apprehension, Public Speaking Subscale (PRCA-PS)
* Self-report of 18 - 70 years of age

Exclusion Criteria:

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Where this trial is running

Marburg, Hesse

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Public Speaking AnxietyPublic Speaking Fearvirtual reality exposureextinction generalizationfear extinctionexposure therapy
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.