Developing a user-informed intervention study of a virtual reality therapy for social anxiety in autistic adolescents

Lucy Adams, Emily Simonoff, Kevin Tierney, Matthew Hollocks, Aylana Brewster, Jennifer Watson, Lucia Valmaggia

Research output: Contribution to journalArticlepeer-review


Social anxiety is prevalent in autistic adolescents. Using virtual reality to deliver exposure tasks in cognitive behavioural therapy (VRCBT) – the treatment-of-choice – may improve its accessibility in autism spectrum disorder (ASD). In preparation for testing this, service-providers (i.e. clinicians experienced with this patient group; n = 17), service-users (i.e. autistic adolescents diagnosed with social anxiety; n = 5), and their parents/guardians (n = 5), from local National Health Service (NHS) clinics specialized in working with ASD, were consulted. The aim was to develop user-informed case series, treatment, and VR design protocols for testing the intervention for the first time. Consultees indicated that the VRCBT exposure tasks ought to be self-paced, as individualizable as possible, viewable to the therapist, and provide a step towards real-life exposure. Consultees identified exposure tasks for simulating in VR: approaching and conversing with others, experiencing perceived injustice, the feeling of being the centre of attention, and situations involving novelty and/or lower predictability. Further implications for developing and testing VRCBT and conducting patient and public involvement (PPI) in autistic adolescents with social anxiety are discussed.
Original languageEnglish
JournalDesign for Health
Publication statusE-pub ahead of print - 24 Apr 2022


  • Virtual reality
  • Social anxiety
  • Autism spectrum disorder
  • Participatory design
  • Patient and public involvement
  • Clinician-advisory meeting


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