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Landmark clinical trial shows benefits of virtual reality treatment for severe psychological problems

Person using a virtual reality headset in living room

Published: 07 April 2022

The largest ever clinical trial of virtual reality (VR) therapy for mental health, funded by NIHR, has shown that automated VR treatment works well for patients diagnosed with psychosis. The biggest benefits were experienced by those with the most challenging psychological problems.

The trial, published in the Lancet Psychiatry, investigated the benefits of the gameChange VR program, which uses a VR headset with a built-in treatment program that patients can use in their own home and other settings. 346 patients with psychosis were involved across nine NHS trusts.

The gameChange VR program was developed by a multi-partner team led by researchers at the University of Oxford and Oxford Health NHS Foundation Trust, and funded by NIHR’s Invention for Innovation programme (i4i). It targets a problem that is common in people diagnosed with psychosis: intense fears about being outside in everyday situations. 

For many patients, these fears become so bad that they avoid leaving the home, severely disrupting relationships with family and friends, their education, and careers. The gameChange program is designed to help patients re-engage with day-to-day activities, taking them from a housebound existence to life back in the world outside. Patients use VR headsets to practise everyday situations such as being in a cafe, shop, pub, street, doctor’s surgery and on a bus. The treatment is personalised, allowing patients to choose what they work on and when. 

gameChange led to significant reductions in the avoidance of everyday situations and in distress. The patients who benefited most were those who found it hardest to leave the house, and those with most psychiatric symptoms, such as severe anxiety, depression, delusions, and hallucinations. These patients experienced large benefits – for example, being able to undertake activities they had previously found unthinkable. These benefits were maintained at the six-month follow-up. 

One trial participant commented: “If anyone has the opportunity to do the virtual reality treatment, I really would recommend it because it’s made a lot of difference to me. After seven years of illness, I do feel so much better. I’ve been able to make eye contact with people more, without feeling really anxious, I’ve been able to walk down a street without worrying about anyone walking towards me. I’m now able to go into a café. I feel much more confident about going on a bus. I just feel so much more confident than I was.”

Professor Daniel Freeman, lead researcher, Department of Psychiatry, University of Oxford and NIHR Senior Investigator, said: “Virtual reality psychological therapy has come of age with gameChange. Over the past 25 years VR has been used in a small number of specialist mental healthcare clinics. It has supported in-person therapy delivered by a clinician. However, with gameChange, the therapy is built in, so it can be overseen by a range of staff. And it can be delivered in a variety of settings, including patients’ homes.”

“We are delighted that gameChange has produced excellent results for people with some of the most challenging mental health problems. Individuals who were largely housebound have got back outside. Using today’s affordable and easy-to-use consumer VR equipment, we think gameChange will lead a transformation in the digital provision of evidence-based psychological therapy, with deployment at scale for treatments that really work.”

Professor Mike Lewis, i4i Programme Director, said: "This impressive research exemplifies what NIHR aims to achieve through its i4i funding scheme - truly transformational technology that can change people's lives for the better. We're really excited about the potential for gameChange to bring the benefits of psychological therapy to many more people in their own homes through the medium of virtual reality."

Read more about gameChange on the University of Oxford Department of Psychiatry website

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