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

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.