VRET
avoidance behaviors, anxiety
At the end of the pre assessment (T0) in the CAVE (computer assisted virtual environment) the subjects are given a psychoeducational manual in preparation for the VRET. They are instructed to read the manual at home and to complete short written exercises included in the manual. Contents of the manual are extracted from standardized CBT manuals and include the function and components of fear as well as their interplay (vicious circle of fear), information about MPA in discrimination to non-pathological stage fright and its treatment due to exposure therapy. Exercises concerning individual components of MPA, individual safety- and avoidance behaviors, and an individual The first training session (VRET 1) starts with discussing the contents of the manual with the patients to make sure they understand the key points and mechanisms of behavioral exposure therapy. Sessions two to four (VRET 2–4) start with discussing the practice experience at home since the last session, reinforcing therapy compliant behavior and supporting the patient in case of difficulties with the exposure concept. The VR scenario for the exposure training is selected in every training session (VRET 1–4) and with every patient individually using the anxiety hierarchy. The selection criteria for the first scenario in VRET 1 is a moderate level of fear (approx. 60), which is considered high enough to elicit a fear reaction as suggested by Neudeck [The virtual environment is generated using the programs 