The Preliminary Efficacy of Cognitive Behavioral Therapy Virtual Reality Job Interview and Workplace Communication Training Program for Autistic Adults

Abstract

Background:

The majority of autistic adults experience social communication differences that may lead to frustrations during the job application process, even among those with strong work-related skills or histories. Compared with traditional lecture or role-play training, virtual reality (VR) technology generates more realistic and immersive simulated environments, which is crucial for autistic adults who often have difficulties envisioning real-world situations. The study developed a Cognitive Behavioral Therapy (CBT) VR Job Interview and Workplace Communication Training (CBT-VR-JIWCT) program, considering the features of autistic adults, and examined its feasibility and preliminary efficacy.

Methods:

The eight-session program contained various VR scenarios delivered via head-mounted displays as a highly immersive training environment for practicing job interviewing and communication skills. We examined the feasibility and efficacy of the program through the interviewer-rated Mandarin Chinese Version of the Adapted Mock Interview Rating Scale (adapted MIRS-Chinese), speech analysis, and content analysis. Eighty autistic adults were randomized into the intervention group (n = 40) and the control group (n = 40). Among them, 30 from the intervention group eventually completed the training program, whereas 36 from the control group completed pre- and post-tests without intervention.

Results:

Overall, autistic adults reported minimal simulator sickness symptoms. The attendance rate was high. Compared with the controls, the intervention group had significantly better interview performance, as rated by significant group-by-time interactions on the total adapted MIRS-Chinese scores (p < .001), speech volume (p = .006), as well as a nonsignificant larger group-by-time interaction observed on the frequency of achievement words (p = .056).

Conclusion:

CBT-VR-JIWCT is feasible and effective in enhancing job interview skills among autistic adults. Speech and content analyses demonstrated value in objectively assessing improvements in interview performance, such as word choice and presentation styles, within this population. Overall, this study underscores the potential of VR technology as a promising tool for enhancing employment opportunities among autistic adults.

Community Brief

Why is this an important issue?

Autistic adults frequently face challenges in the context of job applications that primarily stem from inadequate interviewing skills and social communication difficulties. The recurrently experienced frustration can foster conditioned anxiety, diminish self-confidence, and curtail motivation to seek employment opportunities, leading to high unemployment rates within the autistic population.

What was the purpose of this study?

This study developed a unique virtual reality (VR) training program. It integrated a highly immersive VR environment, generated through a head-mounted display, with cognitive behavioral therapy (CBT)-based coaching lessons tailored for autistic adults. This study examined both the feasibility of a using VR technology with autistic adults and the preliminary efficacy of this innovative program.

What did we do?

We recruited 80 autistic adults. We then randomly assigned them to the VR group (n = 40) who underwent our VR training program or the control group (n = 40) who did not receive the training. The VR training program included coaching on job interviewing and communication skills for various workplace situations based on VR simulated environment. We collected the adverse effects when they used the VR platform. To evaluate the preliminary efficacy of the VR training program, we assessed their interview performance on the rating scale, as well as content and prosodic features by speech analysis methods, to compare the performance before and after the training.

What were the results of the study?

Overall, autistic adults reported minimal discomfort when viewing VR materials. The attendance rate for the VR training program was good. Compared with the controls, the VR group demonstrated significantly improved interview performance. Moreover, they exhibited a greater increase in speech volume, total word count, total phrase count, and the use of achievement-related words compared with the control group.

What do these findings add to what was already known?

Previous studies have demonstrated the effectiveness of using computer screens for job interview training; however, empirical evidence on using highly immersive VR equipment in job training remains limited. Our randomized controlled trial further confirmed the efficacy of using head-mounted displays (HMDs) in enhancing job interview skills. Also, in addition to traditional assessment on rating scales, speech and content analyses may help decompose objective improvement in interview performance, including word choosing and ways of presentation.

What are the potential weaknesses in the study?

The relatively small sample size may potentially limit the study's ability to detect small-effect differences after training. Additionally, the study assessed outcomes in a laboratory environment, which may not capture the complexities and nuances of real-life job interviews and employment scenarios.

How will these findings help autistic adults now or in the future?

The results suggest that our VR training program is both feasible and effective in enhancing job interview skills among autistic adults, demonstrating its potential as a valuable tool for addressing the unique challenges faced by this population in the employment context. With the incorporation of innovative technology, our program successfully engaged and motivated unemployed autistic adults who had previously given up searching for jobs. This study paves the way for continued advancements in technology-driven interventions and support services for autistic adults in the job market.