Feasibility trial of the virtual reality application gameChange in a Norwegian psychosis participant group

Individuals with psychosis often experience levels of anxious avoidance comparable to patients with agoraphobia, causing detrimental effects on quality of life and functional outcomes. Automated virtual reality delivered cognitive behavioural therapy (CBT) may represent a promising treatment approach for addressing agoraphobic avoidance in patients with psychosis. We sought to evaluate the feasibility of using the virtual reality application gameChange as a treatment option for agoraphobic avoidance in people with psychosis in psychosis treatment units in Oslo, Norway.

This study was conducted as a two arm non-randomized site-based feasibility trial (gameChange plus CBTp and standard care or gameChange plus standard care) across 3 treatment units for patients diagnosed with psychosis. Participants were allocated to intervention arm based on the type of CBTp available at their respective treatment units. It was aimed to recruit thirty patients with psychosis. Outcomes were assessed at baseline and post-treatment (13 weeks). Outcomes were recruitment-, retention-, and adherence-rates as well as patient satisfaction and a range of self-reported symptom measures.

A total of 32 patients were referred: 28 patients were eligible, and 27 participated. 22 patients (81%) received an adherent dose of gameChange. 21 patients (77.7%) completed the post-treatment assessment. Participants reported high satisfaction with the intervention. gameChange was associated with improvements in symptomatology, most notably in the domains of functioning and depression.

Findings suggest that incorporating virtual reality delivered cognitive behavioural therapy interventions in a Norwegian health care setting is feasible. Randomised controlled trials are warranted to assess treatment efficacy.