Oxford Cognitive Approaches to Psychosis
Founded in 2011
22 team members
Over 800 citations of our paranoia model paper
We investigate why people experience hallucinations and delusions, and use that knowledge to develop truly effective treatments for these problems. The Oxford Cognitive Approaches to Psychosis (O-CAP) research group, set up in 2011 by Prof Daniel Freeman, is one of the largest clinical psychology research teams in the world. Notable achievements include the development of a new, powerful psychological treatment for persecutory delusions (the Feeling Safe Programme) and the pioneering of automated psychological treatment delivered in virtual reality (VR).
Our team comprises clinical psychologists, computer scientists, clinical trial co-ordinators, research assistants, DPhil students, trainee clinical psychologists, and administrative support. We work to understand why mental health problems happen and how they can be best treated.
Mental health problems are complex phenomena. To help us explain how hallucinations and delusions are caused and why they can persist, we follow best practice and focus on particular experiences – for example, feelings of paranoia. Drawing on a variety of approaches, including epidemiological studies, qualitative interviews, psychological experiments, and clinical trials, we use our theoretical knowledge to develop carefully tested treatments that will truly make a difference. We have a close collaboration with the McPin Foundation to ensure patients fully influence our work.
We have conducted new research showing the importance of sleep problems, worry, low self-confidence, reasoning biases, and defence behaviours to the occurrence of paranoia. When we treat these problems, paranoia lessens. The Feeling Safe Programme is a 20 session therapy that combines all our work. The initial clinical testing indicates it produces a large clinical effect, with successful treatment of 50% of cases of persecutory delusions that have not responded to medication.
We have pioneered the use of virtual reality (VR) in the assessment, understanding, and treatment of mental health conditions. Our team has two state-of-the-art VR labs. In recent years, we have developed new automated VR therapies and been testing these in randomised controlled trials.
Alongside these clinical interventions, we are committed to making our research - and especially therapeutic techniques - available to the widest possible audience, with several books for the general reader published and more in preparation.
We are also committed to helping develop a new generation of researchers and clinicians. In the past ten years, over twenty-five of our research assistants have gone on to clinical psychology training. We have a number of clinicians carrying our DPhils fellowships.
Our work is supported by the National Institute of Health Research (NIHR), Medical Research Council (MRC), and the Wellcome Trust.
Recent open access papers
- Treatable clinical intervention targets for patients with schizophrenia
- Automated virtual reality (VR) cognitive therapy for patients with psychosis: study protocol for a single-blind parallel group randomised controlled trial (gameChange)
- The weeks before 100 persecutory delusions: the presence of many potential contributory causal factors
- Suicidal ideation and behaviour in patients with persecutory delusions: Prevalence, symptom associations, and psychological correlates
- The comments of voices on the appearance of patients with psychosis: ‘the voices tell me that I am ugly’
- Automated psychological therapy using immersive virtual reality for treatment of fear of heights: a single-blind, parallel-group, randomised controlled trial
- The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis
- Disrupting sleep: the effects of sleep loss on psychotic experiences tested in an experimental study with mediation analysis
- Virtual reality in the assessment, understanding, and treatment of mental health disorders
- Persecutory delusions: a cognitive perspective on understanding and treatment [pdf]
- Virtual reality in the treatment of persecutory delusions: randomised controlled experimental study testing how to reduce delusional conviction
- The concomitants of conspiracy concerns
- Efficacy of cognitive behavioural therapy for sleep improvement in patients with persistent delusions and hallucinations (BEST): a prospective, assessor-blind, randomised controlled pilot trial
- Effects of cognitive behaviour therapy for worry on persecutory delusions in patients with psychosis (WIT): a parallel, single-blind, randomised controlled trial with a mediation analysis
- Targeting Recovery in Persistent Persecutory Delusions
- The role of sleep dysfunction in the occurrence of delusions and hallucinations: a systematic review
- Advances in understanding and treating persecutory delusions: a review
- An early Phase II randomised controlled trial testing the effect on persecutory delusions of using CBT to reduce negative cognitions about the self: The potential benefits of enhancing self confidence
- Height, social comparison, and paranoia: An immersive virtual reality experimental study
- Discussion of "Height, social comparison, and paranoia: An immersive virtual reality experimental study": Video 1
- Paranoia and post-traumatic stress disorder in the months after a physical assault: a longitudinal study examining shared and differential predictors
- How cannabis causes paranoia: Using the intravenous administration of ∆9-tetrahydrocannabinol (THC) to identify key cognitive mechanisms leading to paranoia
Funded by the Medical Research Council.