Boosting Reward Processing to Improve Anxiety Treatment

This trial is testing whether helping people feel more pleasure and motivation (called reward processing) before starting exposure therapy can make that therapy work better for social anxiety and fear of public speaking. Many people don't get full relief from exposure therapy alone, and researchers think that difficulty experiencing pleasure and motivation might be part of the problem. This study will test whether a behavioral program designed to boost positive feelings can help.

Exposure therapy—where people gradually face feared situations like public speaking—helps many people with anxiety, but not everyone gets better, and some people's fears come back. Research suggests that when people struggle to feel pleasure and motivation, they also struggle to overcome their fears during exposure therapy. This trial wants to see if improving reward processing first will make the exposure therapy more effective.