Virtual reality (VR) therapy for patients with psychosis: satisfaction and side effects

Abstract

Background Automated virtual reality therapies are being developed to increase access to psychological interventions. We assessed the experience with one such therapy of patients diagnosed with psychosis, including satisfaction, side effects, and positive experiences of access to the technology. We tested whether side effects affected therapy. Methods In a clinical trial 122 patients diagnosed with psychosis completed baseline measures of psychiatric symptoms, received gameChange VR therapy, and then completed a satisfaction questionnaire, the Oxford-VR Side Effects Checklist, and outcome measures. Results 79 (65.8%) patients were very satisfied with VR therapy, 37 (30.8%) were mostly satisfied, 3 (2.5%) were indifferent/mildly dissatisfied, and 1 (0.8%) person was quite dissatisfied. The most common side effects were: difficulties concentrating because of thinking about what might be happening in the room (n = 17, 14.2%); lasting headache (n = 10, 8.3%); and the headset causing feelings of panic (n = 9, 7.4%). Side effects formed three factors: difficulties concentrating when wearing a headset, feelings of panic using VR, and worries following VR. The occurrence of side effects was not associated with number of VR sessions, therapy outcomes, or psychiatric symptoms. Difficulties concentrating in VR were associated with slightly lower satisfaction. VR therapy provision and engagement made patients feel: proud (n = 99, 81.8%); valued (n = 97, 80.2%); and optimistic (n = 96, 79.3%). Conclusions Patients with psychosis were generally very positive towards the VR therapy, valued having the opportunity to try the technology, and experienced few adverse effects. Side effects did not significantly impact VR therapy. Patient experience of VR is likely to facilitate widespread adoption.

Randomised controlled trial of automated VR therapy to improve positive self-beliefs and psychological well-being in young people diagnosed with psychosis: a study protocol for the Phoenix VR self-confidence therapy trial

“…32 For patients in the Phoenix VR therapy arm, the staff member will collect end-of-treatment assessments of satisfaction, using the Modified Client Satisfaction Questionnaire, 33 34 and side effects, via the Oxford-VR Side Effects Scale. 35 A summary of the measures is provided in table 1 .…”

Automated VR therapy for improving positive self-beliefs and psychological well-being in young patients with psychosis: a proof of concept evaluation of Phoenix VR self-confidence therapy

“…Oxford-VR Side Effects Checklist (O-VRSE; Freeman et al, 2023b) Participants are asked to report whether they had any of the 33 experiences listed in the checklist during the provision of VR therapy (see Table 3 for all items). 'No' is coded as 0, and 'Yes' is coded as 1.…”

Correspondence to Freeman et al. (2023)'s virtual reality (VR) therapy for patients with psychosis: satisfaction and side effects

“…Against this backdrop, a mounting research preoccupation has emerged, centering on the deployment of technology, specifically virtual reality (VR), as a therapeutic modality for addressing severe mental health conditions like psychosis. A seminal contribution in this arena was published recently, authored by Freeman et al (2023), which scrutinizes patient satisfaction and the collateral side effects of VR-based therapy for psychosis. Freeman's study is distinctive, offering a pioneering analysis of patient satisfaction.…”

“…This methodological approach, while ostensibly apt, harbors substantial risk factors (Dunning, Heath, & Suls, 2004). Initially, this appears to be a fitting reporting method as patients are guided through a number of private therapy sessions and then report back on questions like: 'Using the headset gave me a lasting headache', 'While using VR, I felt so sick that I had to stop', and 'After using VR, the everyday world felt very unreal' (Freeman, et al, 2023). However, this modality of self-assessment is not devoid of inherent limitations, often fraught with susceptibility to biases.…”

“…A conspicuous factor impinging on the veracity of research outcomes is the issue of conflict of interest. Freeman and his team are implicated in the creation and deployment of the gameChange therapy program, courtesy of their affiliation with Oxford VR (Freeman et al, 2023). The disclosure of Freeman's multifarious roles – Scientific Founder, non-executive director, and advisor to Oxford VR – in the study's denouement is mentioned.…”