The thought of talking in front of a large crowd can cause even business professionals to tremble. The stares of a waiting audience can evoke sweaty hands, shortness of breath and memory loss for people who suffer from this most common social anxiety; fear of public speaking is common in up to 88 percent of individuals with social phobia and 34 percent of people overall.

A new pilot study is exploring the first attempt at virtual reality therapy (VRT) for people with a fear of public speaking. The computer-based self-help program is based on the research of Barbara Rothbaum, associate professor of psychiatry and behavioral sciences in the School of Medicine and director of the Trauma and Anxiety Recovery Program; and Larry Hodges, former associate director of the Graphics, Visualization and Usability Center at Georgia Tech and now professor and chair of computer science at the University of North Carolina at Charlotte.

Rothbaum’s and Hodges’ work involves using virtual reality as a medium for exposure therapy for people with anxiety disorders. They first used VRT in 1995 to treat patients with a fear of heights. Since then, they also have conducted studies for persons with fears of flying, thunderstorms and post-traumatic stress disorder for Vietnam veterans. In 1996, the pair formed the startup company Virtually Better Inc. to market their virtual reality systems.

“Using [VRT] is an easier way to treat the fear of public speaking for logistical reasons,” Rothbaum said. “It’s difficult for most therapists to assemble enough people on a regular basis, and at a specific time, to use a real audience for someone with fear of public speaking. But with VRT, participants give a speech to their virtual audience and tape themselves to use it for feedback.”

Therapists at Virtually Better are looking to enroll participants in the first phase of the pilot study. To be considered, participants must be between the ages of 18–65, read and speak English, and public speaking must be their primary fear.

If accepted into the study, participants will complete eight sessions. The first four, facilitated by a therapist, will introduce anxiety-management techniques, such as breathing relaxation, speaking tips, cognitive therapy (ability to identify and analyze anxious thoughts) and a videotaped speech performed by the participant in front of the center’s staff.

During the following four sessions, called exposure therapy, the participants will use the self-help module that features different computer-generated environments which appear on a computer monitor.

The programs are designed to allow participants to slowly get used to public speaking. Depending on their levels of anxiety, participants can choose different situations, such as speaking to different audience sizes, using different delivery styles for their speech and responding to different audience reactions.

Elana Zimand, director of clinical services at Virtually Better, will work with Libby Tannenbaum, an Emory postdoctoral fellow, to conduct the pilot study.

“We advise the participants to first choose the situations that produce the least anxiety, and then gradually build up to more anxiety-producing situations,” Zimand said. “This approach allows for a more therapeutic exposure to the environment.”

Currently the therapy is conducted by viewing a computer screen, but in the near future, Zimand said, a three-dimensional component will be introduced. With the use of a head-mounted display that covers the eyes and ears, the therapy will create a sense of immersion into the environment. Virtual reality integrates real-time computer graphics, body-tracking devices, visual displays and other sensory input technology to assist the patient in making the experience as close to real life as possible.

People interested in the study may call at 404-634-3400 for more information. Under an agreement between Virtually Better and the University, Rothbaum is entitled to a share of sales royalty received by the University from the company. Under that agreement, Emory and Rothbaum have received Virtually Better equity interests. The terms of this arrangement have been approved by the University in accordance with its conflict of interest policies.