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Virtual Reality (VR)\u2013based interventions combined with Cognitive Behavioral Therapy (CBT) represent a promising approach for treating PSA, as they enable gradual and controlled exposure to feared social situations by simulating realistic audiences and environments. The primary aim of this study is to evaluate whether the use of VR as a support to standard psychotherapy is effective in managing anxiety and PSA in university students who access the University Psychological Counseling Service (UPCS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This article outlines the study protocol for a randomized controlled trial (RCT). Participants will be divided into two groups: (1) a control group receiving psychological counseling, and (2) an experimental group that receives psychological counseling integrated with VR interventions based on 360\u00b0 video scenarios. The intervention will include two VR-based modules: a VR\u2013Exposure and Response Prevention (ERP) module, designed to provide graded immersive exposure to anxiety-provoking scenarios, and a VR\u2013Acceptance and Commitment Training (ACT) module, aimed at enhancing mindfulness and psychological flexibility through guided experiential practice. Psychological and physiological data collected during the sessions will be analyzed to compare the effectiveness of VR-integrated psychotherapy with traditional counseling alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This study will introduce a novel VR-based ERP and ACT training protocol designed to reduce public speaking anxiety in university students by integrating innovative, immersive VR scenarios within a psychological counseling context. The proposed approach may be particularly relevant for university settings, as it offers a scalable, standardized, and controllable VR-supported counseling protocol aimed at reducing PSA, enhancing students\u2019 academic functioning (e.g., oral exams and presentations), and strengthening the overall effectiveness of university psychological counseling services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>This protocol was registered at the Clinical Trials.gov (Identifier: NCT07351409) on January 16, 2026.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40359-026-04418-4","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T01:55:04Z","timestamp":1774230904000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Immersive virtual reality for reducing public speaking anxiety in students accessing a university psychological counseling service: protocol for a randomized controlled trial"],"prefix":"10.1186","volume":"14","author":[{"given":"Gianluca Mariano","family":"Colella","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Silvestro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Cosentino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Capparelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Gravina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loris","family":"Barbieri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Costabile","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Bruno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Craig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"issue":"1","key":"4418_CR1","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1080\/03634520903443849","volume":"59","author":"GD Bodie","year":"2010","unstructured":"Bodie GD. 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J Behav Cogn Ther. 2022;32(4):271\u201389. https:\/\/doi.org\/10.1016\/j.jbct.2022.05.002.","journal-title":"J Behav Cogn Ther"}],"container-title":["BMC Psychology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40359-026-04418-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40359-026-04418-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40359-026-04418-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T20:40:04Z","timestamp":1781642404000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s40359-026-04418-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,23]]},"references-count":41,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["4418"],"URL":"https:\/\/doi.org\/10.1186\/s40359-026-04418-4","relation":{},"ISSN":["2050-7283"],"issn-type":[{"value":"2050-7283","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,23]]},"assertion":[{"value":"16 February 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study received ethical approval (No. 112518\/2025) from the Institutional Review Board Committee (IRBC) of the University of Calabria and is registered with the ClinicalTrials.gov (NCT07351409) on January 16, 2026. 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