Comparison of the effectiveness of cognitive - behavioral therapy and virtual reality exposure therapy on fear of negative evaluative among adolescents with social anxiety disorder

Social anxiety disorder is one of the most common anxiety disorders. Fear of negative evaluation by others is one of the most important features of social anxiety disorder. In various studies, the effectiveness of cognitive-behavioral treatments and virtual reality exposure therapy on the symptoms of anxiety disorders such as social anxiety disorder has been investigated and confirmed, But so far, no study has been conducted on the comparison of the effectiveness of these two types of treatment methods on the fear of negative evaluation of students with social anxiety disorder.

The present study was conducted with the aim of comparing the effectiveness of cognitive-behavioral therapy and virtual reality exposure therapy on the fear of negative evaluation of students with social anxiety disorder.

The current research method was a semi-experimental pre-test-post-test type with a control group and a one-month follow-up. The statistical population of the research included all second-year high school students studying in the schools of Qaem Shahr city in the academic year of 2022-2023. 51 students were included in the study with available sampling method and were randomly placed in two experimental groups and one control group (17 people in each group). The first and second experimental groups were subjected to cognitive-behavioral intervention and virtual reality exposure therapy during 12 and 8 60-minute sessions, respectively. The data collection tools in this research included the Social Phobia Inventory (Connor et al., 2000) and the short form of the Brief Fear of Negative Evaluation Scale (Leary, 1983). Data analysis was done by variance analysis method with repeated measurement and using SPSS-24 software.

The findings of this research showed that both cognitive-behavioral therapy interventions and virtual reality exposure therapy significantly reduced the fear of negative evaluation compared to the control group (P<0.01). And the effect of both intervention methods was maintained until the one-month follow-up phase. Also, the findings indicated that cognitive-behavioral therapy was more effective compared to virtual reality exposure therapy (P<0.01).

According to the obtained results, it is suggested that child and adolescent counselors and therapists as well as school counselors of the two interventional methods, cognitive-behavioral therapy and virtual reality exposure therapy, with the priority of cognitive-behavioral therapy in particular use to reduce the fear of negative evaluation and in general to reduce the symptoms of social anxiety of students.