The Effectiveness of Virtual Reality Exposure Therapy and Mindfulness-Based Cognitive Therapy on Meta Emotional Dimensions in Adolescents with Social Anxiety

Document Type : Original Article

Authors

Department of Psychology, Ahv.C., Islamic Azad University, Ahvaz, Iran

10.30476/jhmi.2025.108549.1312

Abstract

Introduction: Social anxiety disorder is a prevalent and debilitating condition among
adolescents, often maintained by dysfunctional meta-emotional beliefs. The present
study aimed to compare the effectiveness of Virtual Reality Exposure Therapy (VRET)
and Mindfulness-Based Cognitive Therapy (MBCT) on meta-emotional dimensions in
adolescents with social anxiety in Ahvaz, Iran.
Methods: This study utilized a pre-test, post-test, and follow-up design with a control group.
The statistical population included all adolescents with social anxiety disorder who sought
treatment at counseling centers in Ahvaz between March and June 2024. A convenience
sample of 45 participants was selected and then randomly assigned to two experimental
groups (VRET, n=15; MBCT, n=15) and a control group (n=15). VRET consisted of eight
weekly 45-minute sessions, while MBCT consisted of eight weekly 90-minute sessions. Data
were collected using diagnostic interviews and the Meta-Emotion Questionnaire (MEQ), and
analyzed using a repeated-measures ANOVA.
Results: Both the VRET and MBCT groups showed significant improvement in metaemotional
dimensions compared with the control group. Furthermore, VRET demonstrated
a slightly greater improvement, although both therapies maintained their positive effects at
the three-month follow-up.
Conclusion: The results indicate that both VRET and MBCT are effective interventions for
improving meta-emotional dimensions in adolescents with social anxiety. These findings
highlight the potential for integrating technology-based and mindfulness-based approaches
into clinical practice to enhance therapeutic outcomes.

Highlights

Solmaz Choheili: Google Scholar

Fatemeh Sadat Marashian: Google Scholar

Keywords

Main Subjects

References

  1. Karki R, Timsina A, Kaphe M, Sah R. Prevalence and factors of social anxiety disorder among health science students in Kathmandu. Iran J Health Sci. 2024;12(2):89. doi: 10.32598/ijhs.12.2.1029.1.

  2. Asher M, Asnaani A, Aderka IM. Gender differences in social anxiety disorder: a review. Clin Psychol Rev. 2017;56:1-12. doi: 10.1016/j.cpr.2017.05.004.

  3. Gao W, Li Y, Yuan J, He Q. The shared and distinct mechanisms underlying fear of evaluation in social anxiety: the roles of negative and positive evaluation. Depress Anxiety. 2025;2025:9559056. doi: 10.1155/da/9559056.

  4. Orben A, Tomova L, Blakemore SJ. The effects of social deprivation on adolescent development and mental health. Lancet Child Adolesc Health. 2020;4(8):634-40. doi: 10.1016/s2352-4642(20)30186-3.

  5. Leigh E, Clark DM. Understanding social anxiety disorder in adolescents and improving treatment outcomes: applying the cognitive model of Clark and Wells (1995). Clin Child Fam Psychol Rev. 2018;21(3):388-414. doi: 10.1007/s10567-018-0258-5.

  6. O'Toole MS, Hougaard E, Mennin DS. Social anxiety and emotion knowledge: a meta-analysis. J Anxiety Disord. 2013;27(1):98-108. doi: 10.1016/j.janxdis.2012.09.005.

  7. Sadati C, Namvar H, Nasrolahi B. Association of the meta-emotion structure with the dimensions of emerging adulthood identity mediated by mental health in university students. J Health Rep Technol. 2021;8(1):e119942. doi: 10.5812/jhrt.119942.

  8. Hur J, Tillman RM, Kim HC, Didier P, Anderson AS, Islam S, et al. Adolescent social anxiety is associated with diminished discrimination of anticipated threat and safety in the bed nucleus of the stria terminalis. J Psychopathol Clin Sci. 2025;134(1):41-56. doi: 10.1037/abn0000940.

  9. Leigh E, Clark DM. Cognitive therapy for social anxiety disorder in adolescents: a development case series. Behav Cogn Psychother. 2016;44(1):1-17. doi: 10.1017/s1352465815000715.

  10. Molazamani F, Bavi S, Jayervand H. Effectiveness of virtual reality intervention for impulsivity, sustained attention, and divided attention in children with attention-deficit hyperactivity disorder. Health Manag Inf Sci. 2023;10(2):93-9. doi: 10.30476/jhmi.2024.101736.1207.

  11. Chard I, van Zalk N. Virtual reality exposure therapy for treating social anxiety: a scoping review of treatment designs and adaptation to stuttering. Front Digit Health. 2022;4:842460. doi: 10.3389/fdgth.2022.842460.

  12. Seuling PD, Czernin NS, Schiele MA. Virtual reality exposure therapy in the treatment of public speaking anxiety and social anxiety disorder. Neurosci Appl. 2024;3:104074. doi: 10.1016/j.nsa.2024.104074.

  13. Wray TB, Kemp JJ, Larsen MA. Virtual reality (VR) treatments for anxiety disorders are unambiguously successful, so why are so few therapists using them? Barriers to adoption and potential solutions. Cogn Behav Ther. 2023;52(6):603-24. doi: 10.1080/16506073.2023.2229017.

  14. Soltani M, Farhadi H, Manshaeeg M, Mehdad A. Effectiveness of virtual reality therapy on emotional exhaustion and quality of work life of employees with occupational stress. (مشخصات کامل نشریه در فایل ارائه شده موجود نیست)

  15. Tuckell A, Ball S, Bernard P, Kuyken W, Marx R, Pack S, et al. The effectiveness of mindfulness-based cognitive therapy (MBCT) in real-world healthcare services. Mindfulness (N Y). 2020;11(2):279-90. doi: 10.1007/s12671-018-1087-9.

  16. Musa ZA, Kim Lam S, Binti Mamat Mukhtar F, Kwong Yan S, Tajudeen Olalekan O, Kim Geok S. Effectiveness of mindfulness-based cognitive therapy on the management of depressive disorder: systematic review. Int J Afr Nurs Sci. 2020;12:100200. doi: 10.1016/j.ijans.2020.100200.

  17. Kashefinishabouri J, Eftekhar Saadi Z, Pasha R, Heidari A, Makvandi B. The effect of mindfulness-based cognitive therapy and emotion-regulation training on rumination and social anxiety in teenagers prone to addiction. J Occup Health Epidemiol. 2021;10(1):1. doi: 10.52547/johle.10.1.1.

  18. Shokri A, Kazemi R, Narimani M, Taklavi S. Comparison of the effectiveness of mother's mindfulness-based cognitive therapy and cognitive emotion regulation training on externalizing disorder and self-efficacy of aggressive children. Pract Clin Psychol. 2020;8(2):85. doi: 10.32598/jpcp.8.2.677.1.

  19. Shahsavari Googhari Z, Hafezi F, Asgari P, Heidari A. The effectiveness of mindfulness-based cognitive therapy and acceptance and commitment therapy on medical science students' subjective well-being, psychological distress, and emotion regulation. J Shahrekord Univ Med Sci. 2022;24(1):35-41. doi: 10.34172/jsums.2022.07.

  20. Mitmansgruber H, Beck TN, Hofer S, Schussler G. When you don't like what you feel: experiential avoidance, mindfulness and meta-emotion in emotion regulation. Pers Individ Dif. 2009;46(4):448-53. doi: 10.1016/j.paid.2008.11.013.

  21. Parsaei I, Sadipour E, Dortaj F, Asadzaeh H. Evaluation of the structural model of achievement motivation based on the school climate and values related to study with the mediation of meta-emotion in students. Q J Child Ment Health. 2019;5(4):110-21.

  22. Meyerbroeker K, Morina N. The use of virtual reality in assessment and treatment of anxiety and related disorders. Clin Psychol Psychother. 2021;28(3):466-76. doi: 10.1002/cpp.2623.

  23. Tan YL, Chang VYX, Ang WHD, Ang WW, Lau Y. Virtual reality exposure therapy for social anxiety disorders: a meta-analysis and meta-regression of randomized controlled trials. Anxiety Stress Coping. 2025;38(2):141-60. doi: 10.1080/10615806.2024.2392195.

  24. Sharma N, Agrawal M, Rushi, Ayyub S, Rai D. Mindfulness-based interventions for emotional dysregulation in adolescents: a systematic review. Ann Neurosci. 2025;09727531251355311. doi: 10.1177/09727531251355311.

  25. Strege MV, Swain D, Bochicchio L, Valdespino A, Richey JA. A pilot study of the effects of mindfulness-based cognitive therapy on positive affect and social anxiety symptoms. Front Psychol. 2018;9:866. doi: 10.3389/fpsyg.2018.00866.

  26. Graham WM, Drinkwater R, Kelson J, Kabir MA. Self-guided virtual reality therapy for anxiety: a systematic review. Int J Med Inform. 2025;200:105902. doi: 10.1016/j.ijmedinf.2025.105902.

  27. Remskar M, Western MJ, Osborne EL, Maynard OM, Ainsworth B. Effects of combining physical activity with mindfulness on mental health and wellbeing: systematic review of complex interventions. Ment Health Phys Act. 2024;26:100575. doi: 10.1016/j.mhpa.2023.100575.

Health Management & Information Science
Volume 13, Issue 1
January 2026
Pages 13-21

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