A Safe Place to Learn: Peer Research Qualitative Investigation of gameChange Virtual Reality Therapy

Abstract

BACKGROUND: Automated virtual reality (VR) therapy has the potential to substantially increase access to evidence-based psychological treatments. The results of a multicenter randomized controlled trial showed that gameChange VR cognitive therapy reduces the agoraphobic avoidance of people diagnosed with psychosis, especially for those with severe avoidance. OBJECTIVE: We set out to use a peer research approach to explore participants' experiences with gameChange VR therapy. This in-depth experiential exploration of user experience may inform the implementation in clinical services and future VR therapy development. METHODS: Peer-led semistructured remote interviews were conducted with 20 people with a diagnosis of psychosis who had received gameChange as part of the clinical trial (ISRCTN17308399). Data were analyzed using interpretative phenomenological analysis and template analyses. A multiperspectival approach was taken to explore subgroups. Credibility checks were conducted with the study Lived Experience Advisory Panel. RESULTS: Participants reported the substantial impact of anxious avoidance on their lives before the VR intervention, leaving some of them housebound and isolated. Those who were struggling the most with agoraphobic avoidance expressed the most appreciation for, and gains from, the gameChange therapy. The VR scenarios provided "a place to practise." Immersion within the VR scenarios triggered anxiety, yet participants were able to observe this and respond in different ways than usual. The "security of knowing the VR scenarios are not real" created a safe place to learn about fears. The "balance of safety and anxiety" could be calibrated to the individual. The new learning made in VR was "taken into the real world" through practice and distilling key messages with support from the delivery staff member. CONCLUSIONS: Automated VR can provide a therapeutic simulation that allows people diagnosed with psychosis to learn and embed new ways of responding to the situations that challenge them. An important process in anxiety reduction is enabling the presentation of stimuli that induce the original anxious fears yet allow for learning of safety. In gameChange, the interaction of anxiety and safety could be calibrated to provide a safe place to learn about fears and build confidence. This navigation of therapeutic learning can be successfully managed by patients themselves in an automated therapy, with staff support, that provides users with personalized control. The clinical improvements for people with severe anxious avoidance, the positive experience of VR, and the maintenance of a sense of control are likely to facilitate implementation.

Publication DOI: https://doi.org/10.2196/38065
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
Funding Information: The authors thank the study participants and other people who worked on this study. They are grateful to the gameChange Lived Experience Advisory Panel for their valuable contribution to the study design, materials, and analysis. Members include Debbie Bu
Additional Information: Copyright © Jessica Bond, Alexandra Kenny, Vanessa Pinfold, Lisa Couperthwaite, The gameChange Lived Experience Advisory Panel, Thomas Kabir, Michael Larkin, Ariane Beckley, Laina Rosebrock, Sinéad Lambe, Daniel Freeman, Felicity Waite, Dan Robotham. Originally published in JMIR Serious Games (https://games.jmir.org), 16.01.2023. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Serious Games, is properly cited. The complete bibliographic information, a link to the original publication on https://games.jmir.org, as well as this copyright and license information must be included.
Uncontrolled Keywords: virtual reality,VR,automated,interpretative phenomenological analysis,IPA,implementation,qualitative methods,lived experience,anxiety,psychosis,cognitive therapy,peer research
Publication ISSN: 2291-9279
Last Modified: 23 May 2024 07:19
Date Deposited: 30 Jan 2023 13:36
Full Text Link:
Related URLs: https://games.j ... g/2023/1/e38065 (Publisher URL)
http://www.scop ... tnerID=8YFLogxK (Scopus URL)
PURE Output Type: Article
Published Date: 2023-01-16
Published Online Date: 2023-01-16
Accepted Date: 2022-10-11
Submitted Date: 2022-03-18
Authors: , gameChange Lived Experience Advisory Panel

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