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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 and Care Research (NIHR), Medical Research Council (MRC), and the Wellcome Trust.



Paranoid Thoughts website

Follow Daniel Freeman on Twitter


BBC Radio 4 Series: A History of Delusions 

Feeling Safe Illustration Module

Our team

Selected publications

Related research themes