Feasibility and acceptability of SOCIAbLE: A novel social cognition intervention for adults with a history of childhood trauma.

BACKGROUND: Adults with a history of childhood trauma often experience impairments in social cognition, but these difficulties are rarely therapeutically targeted. We designed 'SOCIAbLE' as a novel virtual reality (VR)-assisted intervention to improve social cognitive functioning and real-world social function in adults with childhood trauma histories. METHODS: This single-arm proof-of-concept study evaluated the feasibility, acceptability, and preliminary outcomes of the SOCIAbLE intervention. Adults with a history of early-life adversity and ongoing social difficulties completed eight weekly one-hour intervention sessions combining psychoeducation, cognitive-behavioral strategies, and immersive VR role-play, targeting social cognition. Outcome assessments were conducted at baseline, 6, 12 (end of treatment), and 18 weeks. Acceptability was assessed based on post-intervention qualitative interviews. RESULTS: Of 32 participants who completed baseline, n = 25 completed the full 8-week intervention; n = 23 completed the 12-week intervention, and n = 24 completed the 18-week follow-up assessments. Improvements relative to baseline were observed at 12 weeks on both our primary (BLERT emotional recognition: g = 1.04) and secondary outcome measures, which persisted at 18 weeks. Data from qualitative interviews (n = 24) indicated a high level of intervention acceptability to participants, highlighting perceived gains in confidence, self-awareness, and real-world social functioning. CONCLUSIONS: In this pilot study, SOCIAbLE was observed to be feasible and acceptable and showed preliminary evidence of benefits to social cognition, clinical symptoms, and social functioning. These data suggest that immersive VR-assisted interventions warrant further investigation in a full randomized controlled trial as a potentially effective, engaging way to target social cognitive difficulties in adults with a history of CT.