Professor Daniel Freeman, and colleagues, Professors David Clark (Experimental Psychology, Oxford), Mel Slater (University of Barcelona) and Graham Dunn (University of Manchester) will use a grant from the Medical Research Council Developmental Pathways Funding Scheme to develop an extended Virtual Reality Cognitive Treatment VRCT.
The grant enables them to use the latest consumer equipment, and test it in a clinical trial. Based on patient feedback, VRCT scenarios for four treatment sessions will be developed, each scenario having different levels of difficulty, and with a virtual coach present to help encourage the patient. A shared manual for patients and mental health staff will be written. Patients will then go on to test VRCT in an early Phase II clinical trial. Ninety patients with persecutory delusions will either have VRCT or spend identical time in relaxing VR environments. Patients will be assessed over six months.
It is an exciting time to be working on virtual reality treatments. The technology is starting to move out of specialist labs into clinics and homes. We are delighted that the MRC is supporting this next stage of our clinical research developing and testing immersive virtual reality for patients with psychosis. We believe that the technology, combined with the right psychological science, has the potential to transform lives. - Professor Daniel Freeman
Persecutory delusions are a key problem for patients with severe mental disorders such as schizophrenia. Examples include: ‘People are trying to cause me physical, mental, and emotional harm’; ‘When I go out the devil and other people persecute me’; ‘People know what I'm thinking and want to kill me’. These strongly held, unfounded beliefs are associated with many negative outcomes, including isolation, depression, disrupted education and employment, and hospital admission. The main treatment is medication but this is inadequate for too many patients. Patients want psychological help, but rarely get such help, and the effectiveness of standard intervention needs significant improvement. A treatment is needed, targeted for this problem, that is much more effective, and that can be accessed by a greater number of patients.
How can VR tackle the fundamental fear that underlies paranoia: the sense of danger from other people?
- By helping patients drop their defences, go into the situations that they fear, and relearn that they are safe. VR is a powerful means to make new learning.
- By providing interactive, three-dimensional worlds. Although you know what you’re seeing isn’t real, your mind and body behave as if it were. It's much easier to enter feared situations in VR, but you still make important learning that transfers to everyday life.
- By allowing patients to try the same situation many times, and be instantly transported from one challenging situation to another, meaning that progress can be fast.
- As the feeling of safety increases, so the delusion diminishes.
VR has successfully been used to treat the fears in anxiety disorders, and Daniel Freeman and his team believe it can do the same for persecutory delusions. VR is emerging into the mainstream, with affordable equipment that can take it from specialist labs into clinics and homes.