A case series in using virtual-reality assisted CBTp for social difficulties in psychosis

Intro People with psychosis often experience social difficulties associated with psychological processes, such as fear of harm or negative evaluation from others. Virtual reality presents a unique opportunity to use social environments in therapy. This study presents a case-series of virtual-reality assisted cognitive behavioural therapy (VR-CBTp) for people with first episode psychosis (FEP) who are experiencing social difficulties. It aimed to evaluate the feasibility and acceptability of this novel therapy in real-world clinical settings. Methods Eight eligible participants were recruited and received a course of 10 sessions of individual formulation-driven VR-CBTp with a focus on improving social functioning. A novel VR environment and therapy package were piloted for the use of the assessment, formulation and treatment of social difficulties. Psychometric assessments were conducted pre- and post-therapy, and participants provided qualitative feedback about their experiences. Results The results provided preliminary information to suggest that the therapy was feasible and acceptable, recruiting to target and with good participant retention. Pre-post comparison of treatment outcomes revealed a reliable change on some of the assessed domains, indicating participants experienced clinical benefits from the therapy. Conclusion The inclusion of VR into a course of CBTp for people with psychosis who experience social difficulties was found to be feasible and acceptable with potential therapeutic benefits. A number of challenges to implementation in real-world clinical settings and future directions were identified.