Automated Virtual Reality Cognitive Therapy for People With Psychosis: Protocol for a Qualitative Investigation Using Peer Research Methods


Many people with psychosis experience difficulties in everyday social situations. Anxiety can make life challenging, leading to withdrawal. Cognitive therapy, using active in vivo learning, enables people to overcome fears. These treatments are not readily available to people with psychosis. Automated virtual reality (VR) therapy is a potential route to increase accessibility. The gameChange automated VR cognitive therapy is designed to help people overcome anxious avoidance and build confidence in everyday social situations. A virtual coach guides the person through the treatment. Understanding user experience is key to facilitating future implementation. Peer research methods, in which people with lived experience of the issues being studied are involved in collecting and analyzing data, may be useful in developing this understanding. This encourages researchers to draw on their lived experience to explore participant perspectives and co-create knowledge. The primary objective is to use a peer research approach to explore the participant experience of a novel automated VR therapy for anxious social avoidance. This includes understanding (1) the experience of anxious social avoidance in people with psychosis, (2) the experience of the gameChange automated VR cognitive therapy, and (3) any potential impact of the therapy in people's lives. This will inform future implementation strategies. The secondary objective is to explore how peer research can be used to co-create knowledge. Semistructured interviews will be conducted with approximately 25 people with psychosis participating in the gameChange trial (ISRCTN17308399). Participants will be recruited from the five trial centers based in National Health Service mental health trusts across England. Interviews will be conducted by two researchers. One is a peer researcher with similar lived experience to the trial participants. The other has lived experiences of mental health issues that do not directly overlap with those of the trial participants. Interview questions will focus on an individual's experience of anxious social avoidance, experiences of participating in the gameChange VR therapy, and any changes or impact following therapy. The interview schedule was developed in collaboration with the gameChange Lived Experience Advisory Panel (LEAP), comprising 10 project advisors with lived experience of psychosis. Interpretative phenomenological analysis and template analysis will be used to explore individual accounts. The LEAP will contribute to the analysis. Data collection will be conducted from April to September 2021, and analysis will be conducted from June to October 2021. As of September 28, 2021, 20 participants had been interviewed, and coding is underway. The study, employing a peer research approach, may provide a unique insight into the experiences of anxious social avoidance in people with psychosis and its treatment using automated VR therapy. This will inform potential future implementation of VR automated therapies in mental health services. DERR1-10.2196/31742. [Abstract copyright: ©Jessica Bond, Dan Robotham, Alexandra Kenny, Vanessa Pinfold, Thomas Kabir, Humma Andleeb, Michael Larkin, Jennifer L Martin, Susan Brown, Aislinn D Bergin, Ariane Petit, Laina Rosebrock, Sinéad Lambe, Daniel Freeman, Felicity Waite. Originally published in JMIR Research Protocols (, 25.10.2021.]

Publication DOI:
Divisions: College of Health & Life Sciences > School of Psychology
College of Health & Life Sciences > Aston Institute of Health & Neurodevelopment (AIHN)
College of Health & Life Sciences
Additional Information: ©Jessica Bond, Dan Robotham, Alexandra Kenny, Vanessa Pinfold, Thomas Kabir, Humma Andleeb, Michael Larkin, Jennifer L Martin, Susan Brown, Aislinn D Bergin, Ariane Petit, Laina Rosebrock, Sinéad Lambe, Daniel Freeman, Felicity Waite. Originally published in JMIR Research Protocols (, 25.10.2021. This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on, as well as this copyright and license information must be included. Funding: National Health Service (NHS) National Institute for Health Research (NIHR) invention for innovation (i4i) program (Project II-C7-0117-20001). The work is also supported by the NIHR Oxford Health Biomedical Research Centre (BRC-1215-20005), NIHR Nottingham Biomedical Research Centre (BRC-1215-20003), and NIHR Mindtech Co-operative (MIC-2016-003). FW is supported by a Wellcome Trust Clinical Doctoral Fellowship (102176/B/13/Z). This research was funded in whole or in part by the Wellcome Trust (102176/B/13/Z).
Uncontrolled Keywords: Agoraphobia,Cognitive therapy,Implementation,Mental health,Peer research,Psychosis,Qualitative methods,Schizophrenia,Therapy,Virtual reality,Medicine(all)
Publication ISSN: 1929-0748
Last Modified: 09 Apr 2024 16:02
Date Deposited: 08 Nov 2021 11:46
Full Text Link:
Related URLs: https://www.res ... /2021/10/e31742 (Publisher URL)
https://preprin ... /preprint/31742 (Author URL)
http://www.scop ... tnerID=8YFLogxK (Scopus URL)
PURE Output Type: Article
Published Date: 2021-10-25
Accepted Date: 2021-08-03
Submitted Date: 2021-07-02
Authors: Bond, Jessica
Robotham, Dan
Kenny, Alexandra
Pinfold, Vanessa
Kabir, Thomas
Andleeb, Humma
Larkin, Michael (ORCID Profile 0000-0003-3304-7000)
Martin, Jennifer L
Brown, Susan
Bergin, Aislinn D
Petit, Ariane
Rosebrock, Laina
Lambe, Sinéad
Freeman, Daniel
Waite, Felicity



Version: Published Version

License: Creative Commons Attribution

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