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. 2025 Apr 18;25:401. doi: 10.1186/s12888-025-06756-w

Table 1.

Overview of inclusion criteria per screening phase

Included if: Assessment
Screening phase 1
 Elevated levels of social anxiety SPIN questionnaire = total score ≥ 19 as a cut-off score
 Fluency in Dutch Able to complete the SPIN questionnaire + further assessed during the 2nd screening stage
 Adolescents are 12–16 years old (they must be at least in their second semester of 1st grade of secondary school up until 5th grade) Demographic questions during the SPIN administration

 (Online) informed consent

from adolescent and one of their legal guardians

Presence of the required informed assent and consent
Screening phase 2 
 No severe SAD  SAD diagnosis (SCID-5 Junior, Module 6D) + significant level of functional impairment (e.g., refusal to attend school) with ADIS-CSR = 8 (judged by the assessor)
 No severe depression  Mood disorder diagnosis (SCID-5 Junior; Module 3B) + significant level of functional impairment with ADIS-CSR = 8 (judged by the assessor)
 No severe substance use  Severe substance use based on the SCID-5 Junior (≥ 6 symptoms); Module 13
 No presence of psychotic symptoms (regardless of severity) Based on the screening questions of an adapted version of the SCID-5 Junior & ADIS-C / assessor’s judgment

 No severe suicidal thoughts

and / or self-harm

SCID-5 Junior screening questions + MINI-KID Module B on suicidality and self-harm / suicidality: severity rating of ≥ 9 and self-harm: (1) there is danger due to very serious injuries (e.g. deep cutting, which requires medical care) and/or (2) when one’s self harm behavior is combined with suicidal ideation

 No other urgent psychopathologies and/or mismatch between

participants’ clinical presentation and the offered training

Based on assessor’s judgment and then discussed during supervision

 No use of psychoactive

medication that has not been stabilized; use of benzodiazepines

Stabilized = (a) same type and dosage for at least the last 4 weeks; (b) must remain unchanged throughout the study
 No autism spectrum disorder (ASD)  Pre-existing diagnosis of ASD
 No current ongoing psychological treatment (or on a waiting list) for anxiety disorders and/or depression Asked during assessment interview
 No exposure therapy for SAD in the past two years Asked during assessment interview 

 Not eligible for the use of virtual reality (VR)

- History of severe motion sickness and / or experiencing symptoms of motion sickness during 3D movies Lack of stereoscopic vision or a balance problem that would hinder the VR experience;

- History of seizures, seizure disorder or epilepsy

Asked during assessment interview 
 Not a member of the same household as another participant in the study Asked during assessment interview 
 No missing (online) informed consent/assent from adolescent and one of his / her legal guardians