Cognitive-behavioral Processes Research Articles

Coaching Generation Z: Necessity, challenges and opportunities

Individuals are shaped by the values, pressures, and constraints of the time and place in which they grew up – each of us is a child of our time. Generation Z are the first generation to grow up with the internet, smart phones, and social media consistently available during adolescence. These technological advances have been accompanied by increased prevalence of mental-health issues and related challenges. Alongside the putative effects of such technologies, Generation Z have also grown up in cultures much more focussed on safety. During their formative years, the concept of safety was expanded to include emotional safety, which is to say a felt need that one must never be upset, and that one should believe one’s own emotional reactions unquestioningly. Such a conception of human emotion runs directly counter to the evidence base behind Cognitive Behavioural Therapy and Coaching. Demand for mental health services is at an all-time high in many countries, however many of the challenges Generation Z are facing are not clinical and may ethically be supported by a sufficiently trained coaching professional. There are a number of cognitive-behavioural processes, such as psychological flexibility, that seem to fit well with some of the challenges most commonly experienced by members of Generation Z, and which coaching psychologists would be well-placed to employ with this population. With this paper we hope to start a broader conversation about the potential contribution of coaching psychology in this context.

“How Can I Get Out of This?”: A Qualitative Study of the Phenomenology and Functional Impact of Misophonia in Youth and Families

Introduction: Misophonia is an increasingly recognized disorder characterized by negative emotional and sensory reactions to specific noises. Although misophonia most often begins in childhood, there has been minimal research on its clinical presentation in youth. This qualitative study explored cognitive behavioral processes that are involved in misophonia and its associated functional impairment in young people and their families. Methods: Focused interviews were conducted with 20 youth with misophonia (ages 10–17) and their parents. Thematic analyses of these interviews using a cognitive behavioral theoretical framework were conducted. Results: A number of themes were identified, which included internalizing and externalizing cognitive behavioral processes at the individual level (e.g., hypervigilance, anticipatory anxiety, escape, automatic negative attributions), secondary emotional and functional consequences (e.g., negative perception of self, guilt, anxiety, depression, emotional exhaustion, concentration difficulties at school), as well as significant impacts to school, social life, and particularly to family life (e.g., conflict/tension, anger and resentment, family accommodation). These themes are integrated in a proposed theoretical model. Discussion: Misophonia is characterized by several transdiagnostic cognitive behavioral processes, including avoidance, maladaptive cognitions, emotional reactivity, and family communication difficulties, as well as significant functional impairment. Developing treatments that target these processes has the potential to help youth overcome misophonia and improve the quality of life of youth and their families.

Cognitive-behavioural processes during route previewing in bouldering

IntroductionIn the Olympic climbing discipline of bouldering, climbers can preview boulders before actually climbing them. Whilst such pre-climbing route previewing is considered as central to subsequent climbing performance, research on cognitive-behavioural processes during the preparatory phase in the modality of bouldering is lacking. The present study aimed at extending existing findings on neural efficiency processes associated with advanced skill level during motor activity preparation by examining cognitive-behavioural processes during the previewing of boulders. MethodsIntermediate (n = 20), advanced (n = 20), and elite (n = 20) climbers were asked to preview first, and then attempt two boulders of different difficulty levels (boulder 1: advanced difficulty; boulder 2: elite difficulty). During previewing, climbers’ gaze behaviour was gathered using a portable eye-tracker. ResultsLinear regression revealed for both boulders a significant relation between participants’ skill levels and both preview duration and number of scans during previewing. Elite climbers more commonly used a superficial scan path than advanced and intermediate climbers. In the more difficult boulder, both elite and advanced climbers showed longer preview durations, performed more scans, and applied less often a superficial scan path than in the easier boulder. ConclusionFindings revealed that cognitive-behavioural processes during route previewing are associated with climbing expertise and boulder difficulty. Superior domain-specific cognitive proficiency seems to account for the expertise-processing-paradigm in boulder previewing, contributing to faster and more conscious acquisition of perceptual cues, more efficient visual search strategies, and better identification of representative patterns among experts.

A Single-Session Process-Based Cognitive-Behavioral Intervention Combined with Multimodal Rehabilitation Treatment for Chronic Pain Associated with Emotional Disorders.

Defined by chronic pain, rheumatic diseases are often co-occurring with anxiety and depression. Among the available psychological interventions, cognitive-behavioral therapies have an already-proven efficiency in these cases. However, the need to adjust their structure became ubiquitous during the post-pandemic period. Hence, the objective of this study was to investigate the impact of a single-session, process-based cognitive-behavioral intervention for patients with rheumatic conditions within an in-patient setting. A total of 31 participants (mean age 58.9 years) completed the single-session intervention. Assessments were conducted prior to the intervention, post-intervention and after one month. Pearson's correlations, paired samples T tests and a covariance analysis based on the Linear Mixed Model were performed for exploring the relations between baseline variables and evaluating the impact of the SSI intervention. Immediately after the intervention, a significant reduction in cognitive fusion (p = 0.001, d = 1.78), experiential avoidance (p = 0.001, d = 1.4) and dysfunctional behavioral processes was observed. At the one-month evaluation, participants reported decreased pain (p = 0.001, d = 1.11), anxiety (p = 0.004, d = 0.55) and depression (p = 0.001, d = 0.72). The single-session, process-based approach represents a promising intervention in healthcare contexts, as an integrative part of a multimodal rehabilitation treatment in patients with rheumatic conditions.

Investigating the Factors Related to the Reduction of Salt Consumption in Women in Southern Iran: Application of ،ranstheoretical Model

Introduction: Reducing salt consumption in population is one of the easiest, most efficient and cost-effective ways to reduce the burden of cardiovascular diseases. The present study was conducted with the aim of investigating the factors related to the reduction of salt consumption using transtheoretical model among women in southern Iran.
 Methods: This was a cross-sectional study (descriptive-analytical) conducted from November 2022 to February 2023 on women of 18-59 who visited comprehensive health centers in Bastak city. A total number of 452 subjects were selected using convenient sampling method. Data were collected using a questionnaire with three sections: demographic information, a researcher-made questionnaire based on transtheoretical model constructs, and salt consumption reduction questionnaire. Data were analyzed using Kruskal-Wallis tests, Pearson's correlation and regression analysis with SPSS software (v. 22).
 Results: The results showed that participants were between 18 and52 with a mean of 35/51±10/13. 23/5% of the participants were in pre-contemplation stage, 21/7% in the contemplation stage, 20/8% in preparation stage, 11/3% in action stage, and 22/8% in maintenance stage. Pearson correlation analysis results indicated that there were significant positive relationships between cognitive processes (r= 0/44, p<0/01), behavioral processes (r= 0/54, p<0/01), self-efficacy (r=0/43, p<0/01) , decision balance (r= 0/37, p<0/01), and salt consumption reduction behavior; but, there was a significant negative correlation between temptation and salt consumption reduction behavior (r=-0.34, p<0/01). Moreover, regression analysis results revealed that age, counter conditioning, self-efficacy, raising awareness, decision balance, helping relationships, and temptation can predict 38/1% of the total variance in salt consumption reduction behavior (p<0/05).
 Conclusion: According to the findings, self-efficacy, temptation, cognitive and behavioral change processes, and advantages and disadvantages of salt reduction play a major role in salt consumption reduction behavior. It is suggested that these variables be taken into account in developing and implementing educational interventions.

Brief scales for the measurement of target variables and processes of change in cognitive behaviour therapy for major depression, panic disorder and social anxiety disorder.

The measurement of process variables derived from cognitive behavioural theory can aid treatment development and support the clinician in following treatment progress. Self-report process measures are ideally brief, which reduces the burden on patients and facilitates the implementation of repeated measurements. To develop 13 brief versions (3-6 items) of existing cognitive behavioural process scales for three common mental disorders: major depression, panic disorder, and social anxiety disorder. Using data from a real-world teaching clinic offering internet-delivered cognitive behavior therapy (n=370), we drafted brief process scales and then validated these scales in later cohorts (n=293). In the validation data, change in the brief process scales significantly mediated change in the corresponding domain outcomes, with standardized coefficient point estimates in the range of -0.53 to -0.21. Correlations with the original process scales were substantial (r=.83-.96), internal consistency was mostly adequate (α=0.65-0.86), and change scores were moderate to large (|d|=0.51-1.18). For depression, the brief Behavioral Activation for Depression Scale-Activation subscale was especially promising. For panic disorder, the brief Agoraphobic Cognitions Questionnaire-Physical Consequences subscale was especially promising. For social anxiety disorder, the Social Cognitions Questionnaire, the Social Probability and Cost Questionnaire, and the Social Behavior Questionnaire-Avoidance and Impression Management subscales were all promising. Several brief process scales showed promise as measures of treatment processes in cognitive behaviour therapy. There is a need for replication and further evaluation using experimental designs, in other clinical settings, and preferably in larger samples.

Perfectionism and cognitive-behavioural processes in daily work: Implications for self-related perceptions and emotions

ABSTRACT Work-related perfectionism is widespread among employees. Nevertheless, it is largely unclear how perfectionism might impact employees in their daily work. In line with whole trait theory, we took a dynamic perspective to investigate how daily fluctuations in both dimensions of work-related perfectionism (i.e., perfectionistic strivings and concerns) relate to an employee’s daily planning, procrastination, and self-blaming at work. We also examined relationships between these cognitions and behaviours and employees’ work-related self-efficacy and feelings of shame and guilt. During two workweeks, 78 employees completed daily surveys that assessed perfectionistic strivings and concerns as well as planning, procrastination, and self-blaming during work, and work-related self-efficacy, shame, and guilt at the end of the workday. Multilevel path modelling of data from 514 workdays showed that daily work-related perfectionistic strivings related positively to planning and daily work-related perfectionistic concerns related positively to self-blaming. Self-blaming served as a mechanism linking perfectionistic concerns with shame and guilt. Our findings show that both perfectionism dimensions relate differently to employees’ cognitions, behaviours, and emotions in their daily work. Thereby, our study helps to better understand why perfectionism can be both beneficial and detrimental for employees.

Identifying interactions between determinants of intention for civic engagement against transportation noise exposure – a theory-driven classification tree analysis with cross-sectional data from the KORA study in Germany

The European Environmental Noise Directive highlights public participation in the development and review of noise action plans. Considering unequal participation opportunities, determinants of public civic engagement are crucial. We conceptualised these determinants to arise from four components: (1) noise exposure, (2) environmental resources, (3) engagement-specific cognitions, and (4) general cognitions and emotions. We aimed to classify intention for civic engagement in a population-based sample from the German KORA study in the Augsburg region by using Conditional Inference Trees (CIT) with variables attributed to the four components (N = 3,743, 43–92 years). The “engagement-specific cognitions”-CIT showed the highest prevalence of civic engagement intention resulting from interactions between subjective norm (expecting positive feedback from significant others), self-efficacy (having confidence to engage), and knowledge of noise abatement planning (70.6% as compared to the sample average (11.2%)). To promote equitable decision-making, participation might benefit from focusing on residents’ cognitive-behavioural processes.

Development of a psychotherapy process prototype for the Real Relationship

Objective The Real Relationship (RR) describes the aspect of the psychotherapy relationship that is based on a genuine connection and a realistic view between patient and therapist. In the current study, we aimed to develop a Psychotherapy Process Q-set (PQS) prototype of the RR to facilitate post-hoc assessment of the RR in psychotherapy session recordings. We also aimed to measure the association between the RR-PQS and current PQS measures of theoretical treatment principles and the working alliance. Method We developed an RR-PQS prototype based on ratings of an ideal RR session by eight RR experts. We assessed the associations between the RR-PQS and existing cognitive behavioral and psychodynamic process prototypes, and seven PQS items known to predict the working alliance. Results RR experts agreed on the ideal RR session ratings to a high degree (ICC = 0.89). The RR-PQS was moderately related to both cognitive behavioral (r = 0.66, p < 0.01), and psychodynamic prototypes (r = 0.56, p < 0.01). PQS items predictive of the working alliance were characteristic of the RR-PQS. Conclusion The RR-PQS prototype appears to behave in theoretically predicted ways and may be a valid measure of the RR.

Cognitive-behavioral factors in tinnitus-related insomnia.

A significant proportion of individuals with distressing tinnitus also report insomnia. Limited, but emerging, evidence suggests that tinnitus-related insomnia cannot be explained only by the presence of tinnitus and that sleep-related cognitive-behavioral processes may play a key role in exacerbating tinnitus-related insomnia. This study aimed to assess whether sleep-related cognitions and behaviors believed to maintain insomnia disorder are present in individuals with tinnitus-related insomnia. This between-groups study recruited 180 participants online for four groups: tinnitus-related insomnia (N = 49), insomnia disorder without tinnitus (N = 34), tinnitus sufferers who are good sleepers (N = 38), and controls (N = 59). They completed questionnaires assessing insomnia severity, sleep-related cognitions and behaviors, sleep quality, anxiety, and depression. People with tinnitus completed a measure of tinnitus severity and rated the loudness of their tinnitus on a subjective measure. Linear regression demonstrated that group significantly predicted sleep related thoughts and behaviors, and sleep quality. Pairwise comparisons showed that the tinnitus-related insomnia group had significantly greater insomnia-related thoughts and behaviors and significantly worse sleep quality than tinnitus-good sleepers. No differences were seen between the tinnitus-related insomnia and the insomnia groups. The tinnitus-related insomnia group had significantly higher depression, anxiety, and tinnitus distress than tinnitus-good sleepers. Findings suggest that tinnitus-related insomnia may be maintained by cognitive-behavioral processes similar to those found in insomnia disorder. Such processes are more important than tinnitus severity when understanding sleep disturbance. People with tinnitus-related insomnia may benefit from treatments such as cognitive-behavioral therapy for insomnia.

A reinforcement learning approach to explore the role of social expectations in altruistic behavior

While altruism has been studied from a variety of standpoints, none of them has proven sufficient to explain the richness of nuances detected in experimentally observed altruistic behavior. On the other hand, the recent success of behavioral economics in linking expectation formation to key behaviors in complex societies hints to social expectations having a key role in the emergence of altruism. This paper proposes an agent-based model based upon the Bush–Mosteller reinforcement learning algorithm in which agents, subject to stimuli derived from empirical and normative expectations, update their aspirations (and, consequently, their future cooperative behavior) after playing successive rounds of the Dictator Game. The results of the model are compared with experimental results. Such comparison suggests that a stimuli model based on empirical and normative expectations, such as the one presented in this work, has considerable potential for capturing the cognitive-behavioral processes that shape decision-making in contexts where cooperative behavior is relevant.

Acceptance and commitment therapy (ACT) for post-stroke adjustment difficulties via telerehabilitation in a working-age man

Abstract Adjustment difficulties following a stroke are common and associated with poorer outcomes. Current systematic reviews suggest insufficient evidence for the efficacy of psychological interventions for post-stroke anxiety and/or depression. However, a recent randomised controlled trial (Majumdar and Morris, 2019) of group-based acceptance and commitment therapy (ACT) showed promise in reducing depression and increasing hopefulness and perceived health status in stroke survivors. The present case study describes the assessment, formulation, treatment and outcomes of post-stroke adjustment difficulties in a working-aged man using ACT delivered via telerehabilitation. At the end of treatment (six sessions over 2 months), the client no longer met clinical cut-off for psychological distress and depression. Furthermore, reported levels of psychological flexibility were comparable to non-clinical norms. These gains were maintained at 3- and 6-month follow-up. Outcomes from this case study support emerging evidence indicating that ACT may be an efficacious intervention for post-stroke adjustment difficulties, even when delivered via telerehabilitation. Further research investigating the mediating and moderating effects of different cognitive behavioural processes such as values and acceptance on psychological adjustment to stroke is recommended. Key learning aims (1) Current evidence on the efficacy of psychological interventions for stroke survivors is limited. (2) This case study describes the assessment, treatment and outcomes of post-stroke adjustment difficulties in a working-aged man using an ACT approach. (3) Following six sessions of ACT delivered via telerehabilitation, the client no longer met clinical cut-off for psychological distress and depression. Moreover, his levels of psychological flexibility were comparable to non-clinical norms. (4) Further exploration of psychological processes that facilitate post-stroke adjustment difficulties is recommended.

Intervention strategy for children victims of bullying and school violence

The present work "Intervention strategy in children victims of bullying and school violence", was designed to evaluate and intervene, based on the scales of psychological damage found, with cognitive behavioral therapy techniques, exposure therapy, cognitive processing, physical care, self-knowledge, self-acceptance and learning to see memories as a tool. Objective: To develop and apply an intervention strategy in children victims of violence and bullying. Methodology: This research was experimental and mixed, combining qualitative and quantitative approaches. Both approaches were used in this work because when evaluating the children with the AVE test it was done by means of percentiles, when describing the concepts of the scales it was done in a qualitative way, as well as when registering the progress of the patients in the Anecdotal Record. The program provides a series of techniques for dealing with bullying and school violence.

An Integrative Model for Understanding Obsessive-Compulsive Disorder: Merging Cognitive Behavioral Theory with Insights from Clinical Neuroscience.

Several models have been proposed for the emergence and maintenance of obsessive-compulsive disorder (OCD). Although these models have provided important insights and inspired treatment development, no single model has yet sufficiently accounted for the complexed phenotype of the disorder. In the current paper, we propose a novel model that integrates elements from cognitive behavioral models of OCD with neurocognitive approaches to the disorder. This Reciprocal Interaction Model (RIM) for OCD is based on two assumptions: (a) similar observed symptoms can stem from different etiological processes; and (b) neuropsychological deficits (such as reduced response inhibition and overreliance on the habit formation system) and cognitive behavioral processes (such as temporary reduction in anxiety after engaging in compulsive behaviors) mutually affect each other such that abnormalities in one system influence the second system and vice-versa-creating a vicious cycle of pathological processes. Indeed, the bidirectional inhibitory connection between anxiety/obsessions and executive control is at the heart of the model. We begin by briefly reviewing the current models for OCD. We then move on to describe the RIM, the supporting evidence for the model, the model's predictions, and potential clinical implications.

Different cognitive behavioural processes underpinning reassurance seeking in depression and obsessive-compulsive disorder

Background and objectivesIt has been suggested that reassurance seeking may play an important role in the development and maintenance of common mental health problems such as OCD and depression. We considered the extent of reassurance seeking in depression and OCD relative to a healthy comparison group and tested the hypothesis that reassurance seeking is primarily motivated by threat in those suffering from OCD and by interpersonal concerns in those suffering from depression. MethodsThe frequency and intensity of reassurance seeking and the motivation for seeking reassurance was measured using the reassurance seeking questionnaire in 28 people with OCD, 18 people with depression and 29 healthy controls. ResultsThe OCD group sought reassurance more and at a higher intensity than both the depression group and healthy controls. For the OCD group, reassurance seeking was found to be linked to threat concern motivation. The depression group were not motivated by threat or interpersonal concerns. LimitationsThe OCD group did not significantly differ from the depression group on the measure of depression, most likely due to secondary depression in the OCD group. ConclusionsFor people suffering from OCD, reassurance is motivated by threat concern. For the depression group, levels of reassurance seeking were not substantially increased relative to controls, and the motivation to seek reassurance is less clear but interpersonal concern may not be a distinct motivational factor.

A network analysis of social problem-solving and anxiety/depression in adolescents.

Social problem-solving (SPS) involves the cognitive-behavioral processes through which an individual identifies and copes with everyday problems; it is considered to contribute to anxiety and depression. The Social Problem-Solving Inventory Revised is a popular tool measuring SPS problem orientations and problem-solving styles. Only a negative problem orientation (NPO) is considered strongly related to anxiety and depression. In the present study, we investigated the detailed connections among the five components of SPS and 14 anxiety-depression symptoms and specified the role of NPO and other components in the anxiety-depression network. We employed network analysis, constructed circular and multi-dimensional scaling (MDS) networks, and calculated the network centrality, bridge centrality, and stability of centrality indices. The results were as follows: (1) the MDS network showed a clustering of anxiety and depression symptoms, with NPO and avoidance style components from SPS being close to the anxiety-depression network (demonstrated by large bridge betweenness and bridge closeness); (2) the NPO and positive problem orientation from SPS were most influential on the whole network, though with an opposite effect; (3) strength was the most stable index [correlation stability (CS) coefficient = 0.516] among the centrality indices with case-dropping bootstraps. We also discussed this network from various perspectives and commented on the clinical implications and limitations of this study.

Developing A Smartphone-Based Application for the Behavioral Cognitive Therapy of Panic Disorder

IntroductionEven though cognitive behavior therapy is proven to be an effective treatment for panic disorder, the scarcity of psychiatrists cause many patients not to get a sufficient therapy. E-mental health applications are being developed to address this shortage, especially after the COVID-19 pandemic. However, none of the e-mental health applications developed so far has offered a structured cognitive behavioral therapy.ObjectivesWe are developing a mobile application which will integrate with psychiatric interventions that aims to make cognitive behavioral therapy more accessible.MethodsOur algorithm consists of multiple choice questions and answers to determine the progression of the algorithm. The first three sessions consist of psycho-education of the application and the cognitive therapy model of panic mostly. During the psycho-education sessions, patients’ symptoms during panic attacks and their catastrophic thoughts will be questioned to be used in following sessions. After the panic log has been introduced in the third session, patients will enter the details of their panic attacks right after they experience it and this information will be investigated in the following sessions. Progress for the cognitive restructuring will be monitored as the sessions proceed. Later session will also include in-session symptom induction exercises.Results We are still on the development phase of the mobile application. Hence we do not have any data to present at the moment.ConclusionsOur main purpose is to develop a mobile application which will integrate with structured cognitive behavioral therapy process, reduce the workload of the therapist and is easily accessible through the smart phones.DisclosureNo significant relationships.

My Grief App for Prolonged Grief in Bereaved Parents: A Pilot Study.

The death of a child is a devastating experience for most parents. Consequently, bereaved parents are at risk to develop physical and mental health problems, including prolonged grief disorder. Nevertheless, there is a lack of evaluated psychosocial interventions for bereaved parents. The primary aim of this study was to examine the feasibility of the My Grief app for bereaved parents. The secondary aim was to evaluate the potential reduction of symptoms of prolonged grief, depression and post-traumatic stress, and cognitive-behavioral processes proposed to prolong grief reactions. The study was a mixed-method open trial design, using pre- and post-intervention surveys and post-intervention interviews. Thirteen parents had access to the app for 4 weeks, eight parents participated in interviews and 10 parents answered the follow-up survey. The study provided evidence for the app's feasibility and acceptability, with participants reporting satisfaction with the app and stating that they would recommend it to parents in similar situations. According to the participants, the app was easy to use, the content gave a feeling of not being alone or weird in how one grieves, and the app gave a valuable overview of information, knowledge and further support. In addition, all parents expressed that an app like My Grief is needed and would be particularly useful to access early in the grieving process. Significant reductions of prolonged grief symptoms (dwithin = 0.86) and grief-related rumination (dwithin = 0.72), loss avoidance (dwithin = 0.95) and negative cognitions (dwithin = 1.36) from pre- to post-assessment were found. In conclusion, the app appears acceptable and feasible to use and will be evaluated in a larger randomized controlled trial (Trial registration number: NCT04552717, https://clinicaltrials.gov/ct2/show/NCT04552717).

Trainee therapist personality and the rating of cognitive behavioural and dynamic interpersonal therapy processes.

Therapist factors are generally thought to be important predictors of the capacity to understand and respond to clinical material. The current study aims to identify which features of personality and clinical symptomatology predict a trainee therapist's rating of cognitive behavioural (CB) and psychodynamic interpersonal (PI) processes in video recordings of these therapies. Eighty psychology trainees completed the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) and watched two video recordings of therapy sessions showing prototypical examples of CB and PI psychotherapy, rating the processes they could identify using the Comparative Psychotherapy Process Scale (CPPS). Trainees accurately differentiated CB from PI process while viewing the CB session but rated the CB video higher in PI processes than the PI video itself. Bayesian regression models showed that the most consistent MMPI-2-RF scale that predicted variance in ratings was hypomanic activation (RC9) predicting higher ratings of all psychotherapy processes in both conditions, while clinical scale factors such as Aggressiveness-Revised (AGGR-r) and personality scale factors of Psychoticism-Revised (PSYC-r) and Negative Emotionality/Neuroticism-Revised (NEGE-r) showed some notable but less consistent predictions. The variances in psychotherapy process ratings accounted for by MMPI-2-RF scales ranged from 15% to 51%. The study suggests that some clinical symptoms and personality factors do influence the rating of psychotherapy processes by psychology trainees, but further studies would be required to substantiate such findings. These findings have relevance to therapist training and selection for clinical training and therapist mental health.

Virtual Reality Exposure Therapy for Treating Social Anxiety: A Scoping Review of Treatment Designs and Adaptation to Stuttering.

Virtual Reality Exposure Therapy (VRET) has been shown to be an effective technique for reducing social anxiety. People who stutter are at greater risk of developing heightened social anxiety. Cognitive behavior therapy protocols have shown promise in reducing social anxiety in people who stutter, but no studies have investigated VRET targeting social anxiety associated with stuttering. The aim of the current review is to provide an overview of VRET techniques used to treat social anxiety and insights into how these techniques might be adopted in the case of comorbid stuttering and social anxiety. Twelve studies were reviewed to understand key distinctions in VRET protocols used to treat social anxiety. Distinctions include exercises targeting public speaking vs. general social anxiety, computer-generated virtual environments vs. 360° video, and therapist guided vs. automated VRET. Based on the review findings, we propose how certain features could be applied in the case of stuttering. Virtual therapists, inhibitory learning techniques and integration into speech therapy may be suitable ways to tailor VRET. Regardless of these different techniques, VRET should consider the situations and cognitive-behavioral processes that underlie the experience of social anxiety amongst people who stutter.