Combining virtual reality-based positive mental imagery and dual tasking increases children's willingness to exposure.

This experiment aimed to test whether FutureMe, a VR-tool combining positive mental imagery and dual tasking, is efficacious in increasing willingness to exposure, and decreasing distress, emotionality, and vividness, of children's autobiographical fears, compared to an active VR control condition. Additionally, the moderating role of emotion regulation difficulties was investigated. Children (N = 557; 53.9% boys), with a mean age of 10.14 years (SD = 1.90), were randomly allocated to either the FutureMe (n = 281) or control (n = 276) condition. Willingness to exposure, distress, emotionality, and vividness were measured at pre- and posttest on a VAS from 0 (not at all) to 100 (very much). Parents (n = 437) filled out the Difficulties in Emotion Regulation Scale-Parent Report, assessing their child's emotion regulation difficulties. Willingness to exposure increased only in the FutureMe condition. Distress and emotionality decreased in both conditions. Vividness decreased only in the control condition. Emotion regulation difficulties moderated the pre-post change of distress and emotionality only within the control condition. This study shows that the FutureMe could improve children's willingness to exposure, which in clinical practice could lead to less drop-out in anxiety therapy for children. More research is needed on the separate effects of dual tasking and positive mental imagery.