Automated virtual reality therapy to treat agoraphobic avoidance and distress in patients with psychosis (gameChange): a multicentre, parallel-group, single-blind, randomised, controlled trial in England with mediation and moderation analyses

Freeman, Daniel; Lambe, Sinéad; Kabir, Thomas; Petit, Ariane; Rosebrock, Laina; Yu, Ly-Mee; Dudley, Robert; Chapman, Kate; Morrison, Anthony P.; O’Regan, Eileen; Aynsworth, Charlotte; Jones, Julia; Murphy, Elizabeth; Powling, Rosie; Galal, Ushma; Grabey, Jenna; Rovira, Aitor; Martin, Jennifer; Hollis, Chris; Clark, David M.; Waite, Felicity

doi:10.1016/s2215-0366(22)00060-8

Cited by 67 publications

(71 citation statements)

References 31 publications

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“…The objectives are 3-fold: first, to obtain initial expectations of patients and staff about using VR headsets and, especially, VR psychological therapy; second, to gain patient and staff views of an automated VR therapy (gameChange). gameChange, which has a user-centered design [ 5 , 6 ], was evaluated in a randomized controlled trial with 346 patients with psychosis [ 7 , 8 ]. Almost all patients were attending outpatient services.…”

Section: Introductionmentioning

confidence: 99%

Automated Virtual Reality Cognitive Therapy (gameChange) in Inpatient Psychiatric Wards: Qualitative Study of Staff and Patient Views Using an Implementation Framework

Brown¹,

Lambe²,

Jones³

et al. 2022

JMIR Form Res

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Background Automated virtual reality (VR) therapy could allow a greater number of patients to receive evidence-based psychological therapy. The aim of the gameChange VR therapy is to help patients overcome anxious avoidance of everyday social situations. gameChange has been evaluated with outpatients, but it may also help inpatients prepare for discharge from psychiatric hospital. Objective The aim of this study is to explore the views of patients and staff on the provision of VR therapy on psychiatric wards. Methods Focus groups or individual interviews were conducted with patients (n=19) and National Health Service staff (n=22) in acute psychiatric wards. Questions were derived from the nonadoption, abandonment, and challenges to the scale-up, spread, and sustainability framework. Expectations of VR therapy were discussed, and participants were then given the opportunity to try out the gameChange VR therapy before they were asked questions that focused on opinions about the therapy and feasibility of adoption. Results There was great enthusiasm for the use of gameChange VR therapy on psychiatric wards. It was considered that gameChange could help build confidence, reduce anxiety, and “bridge that gap” between the differences of being in hospital and being discharged to the community. However, it was reflected that the VR therapy may not suit everyone, especially if they are acutely unwell. VR on hospital wards for entertainment and relaxation was also viewed positively. Participants were particularly impressed by the immersive quality of gameChange and the virtual coach. It was considered that a range of staff groups could support VR therapy delivery. The staff thought that implementation would be facilitated by having a lead staff member, having ongoing training accessible, and involving the multidisciplinary team in decision-making for VR therapy use. The most significant barrier to implementation identified by patients and staff was a practical one: access to sufficient, private space to provide the therapy. Conclusions Patients and staff were keen for VR to be used on psychiatric wards. In general, patients and staff viewed automated VR therapy as possible to implement within current care provision, with few significant barriers other than constraints of space. Patients and staff thought of many further uses of VR on psychiatric wards. The value of VR therapy on psychiatric wards now requires systematic evaluation. International Registered Report Identifier (IRRID) RR2-10.2196/20300

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Section: Introductionmentioning

confidence: 99%

Automated Virtual Reality Cognitive Therapy (gameChange) in Inpatient Psychiatric Wards: Qualitative Study of Staff and Patient Views Using an Implementation Framework

Brown¹,

Lambe²,

Jones³

et al. 2022

JMIR Form Res

Self Cite

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“…The findings of a randomised controlled trial evaluating the efficacy of VR-based cognitive therapy in lowering experiences of vulnerability and anxiety in individuals with psychosis were recently published. According to the findings, symptoms of agoraphobia improved after 6 weeks of VR therapy; the greater the intensity of symptoms, the greater the efficacy of this treatment 24…”

Section: Projected Benefits Of the Metaverse On Mental Healthmentioning

confidence: 94%

“…According to the findings, symptoms of agoraphobia improved after 6 weeks of VR therapy; the greater the intensity of symptoms, the greater the efficacy of this treatment. 24 In another study, 15 individuals with severe major depression were immersed in 3-8 min virtual simulations in which they practised comforting a crying avatar with words of compassion and then later switched roles and received the compassionate response themselves from another virtual body. This intervention led to significant reductions in depression severity, as well as to significant increases in self-compassion.…”

Section: Current Applications Of Vr and Ar In Mental Healthmentioning

confidence: 99%

Future of mental health in the metaverse

2022

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The metaverse and non-fungible tokens (NFTs) were some of the hottest tech terms in 2021, according to a Google Trends search. Our review aims to describe the metaverse and NFTs in the context of their potential application in the treatment of mental health disorders. Advancements in technology have been changing human lives at an ever-increasing pace. Metaverse, also known as the three-dimensional (3D) internet, is the convergence of virtual reality (VR) and physical reality in a digital space. It could potentially change the internet as we know it, with NFTs as the key building blocks in the new expansive virtual ecosystem. This immersive 3D virtual world boasts the features of the real world with the added ability to change the surrounding environment according to individual needs and requirements. VR, augmented reality (AR) and mixed reality (MR) have been employed as tools in the treatment of various mental health disorders for the past decade. Studies have reported positive results on their effectiveness in the diagnosis and treatment of mental health disorders. VR/AR/MR have been hailed as a solution to the acute shortage of mental health professionals and the lack of access to mental healthcare. But, on the flip side, young adults tend to spend a significant amount of time playing 3D immersive games and using social media, which can lead to insecurity, anxiety, depression, and behavioural addiction. Additionally, endless scrolling through social media platforms negatively affects individuals' attention span as well as aggravating the symptoms of adolescents with attention deficit hyperactivity disorder.We aimed to explore the ramifications of expanding applications of the metaverse on mental health. So far, no other review has explored the future of mental health in the context of the metaverse.

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“…These scenarios depicted a dentist's workstation with multiple instruments surrounding the patient's chair, a virtual dentist sitting beside the patient's right hand within the 3D scene, picking up the dentist's mirror from the tray to examine the oral cavity and approaching the patient's oral cavity, and the virtual dentist injecting the patient by picking up the syringe from the tray and approaching the patient's oral cavity. 5) gameChange, a VR application programmed by Oxford VR, is used for automated VR therapy to treat agoraphobic avoidance and distress in patients with psychosis who are anxious about everyday social situations [142]. Agoraphobia refers to a type of anxiety disorder in which the victims fear and avoid places or situations that might cause them to panic and feel trapped, helpless, or embarrassed.…”

Section: Mental Wellnessmentioning

confidence: 99%

Healthcare in Metaverse: A Survey on Current Metaverse Applications in Healthcare

et al. 2022

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The COVID-19 pandemic has revealed several limitations of existing healthcare systems. Thus, there is a surge in healthcare innovation and new business models using computer-mediated virtual environments to provide an alternative healthcare system. Today, digital transformation is not limited to virtual communication alone but encompasses digitalizing the network of social connections in the healthcare industry using metaverse technology. The metaverse is a universal and immersive virtual world facilitated by virtual reality (VR) and augmented reality (AR). This paper presents the first effort to offer a comprehensive survey that examines the latest metaverse developments in the healthcare industry, which covers seven domains: telemedicine, clinical care, education, mental health, physical fitness, veterinary, and pharmaceuticals. We review metaverse applications and deeply discuss technical issues and available solutions in each domain that can help develop a self-sustaining, persistent, and future-proof solution for medical healthcare systems. Finally, we highlight the challenges that must be tackled before fully embracing the metaverse for the healthcare industry.

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Automated virtual reality therapy to treat agoraphobic avoidance and distress in patients with psychosis (gameChange): a multicentre, parallel-group, single-blind, randomised, controlled trial in England with mediation and moderation analyses

Cited by 67 publications

References 31 publications

Automated Virtual Reality Cognitive Therapy (gameChange) in Inpatient Psychiatric Wards: Qualitative Study of Staff and Patient Views Using an Implementation Framework

Automated Virtual Reality Cognitive Therapy (gameChange) in Inpatient Psychiatric Wards: Qualitative Study of Staff and Patient Views Using an Implementation Framework

Future of mental health in the metaverse

Healthcare in Metaverse: A Survey on Current Metaverse Applications in Healthcare

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