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Currently submitted to: JMIR Research Protocols

Date Submitted: May 15, 2020
(currently open for review)

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Virtual reality cognitive therapy on inpatient psychiatric wards: protocol for a qualitative investigation of staff and patient views across multiple NHS sites.

  • Poppy Brown; 
  • Felicity Waite; 
  • Sinead Lambe; 
  • Laina Rosebrock; 
  • Daniel Freeman; 



Patients on psychiatric wards typically have very limited access to individual psychological therapy. Inpatients often have significant time available – and an important transition back to everyday life to prepare for – but historically there have been few trained therapists available on wards for the delivery of evidence-based therapy. Automated virtual reality (VR) therapy may be one route to increase the provision of powerful psychological treatments in psychiatric hospitals. The gameChange automated VR cognitive therapy is targeted at helping patients overcome anxious avoidance and re-engage in everyday situations (e.g. walking down the street, taking a bus, going to a shop). This treatment target may fit well for many patients preparing for discharge. However, little is known about how VR therapy may be viewed in this setting.


The objectives of the study are to: explore psychiatric hospital staff and patients’ initial expectations of VR therapy; gather patient and staff views of an automated VR cognitive therapy (gameChange) after briefly experiencing it; and identify potential differences across NHS mental health trusts for implementation. Guided by an implementation framework, the knowledge gained will be used to assess the feasibility of adoption of VR treatment into psychiatric hospitals.


Focus groups will be conducted with NHS staff and patients on acute psychiatric wards at five NHS mental health trusts across England. Staff and patients will be interviewed in separate groups. Individual interviews will also be conducted when preferred by a participant. One to two wards will be visited within each of the five trusts. A total of 8-15 staff and patients per ward will be recruited, with a minimum total of 50 staff and patients recruited across all sites. Focus group questions have been derived from the Nonadoption, Abandonment, and Challenges to the Scale-Up, Spread, and Sustainability (NASSS) framework. Focus groups will firstly discuss expectations of VR therapy, before giving participants the opportunity to briefly try the gameChange VR therapy. Questions will then focus on opinions about the therapy and investigate feasibility of adoption, with particular consideration given to site specific issues. A thematic analysis will be conducted.


As of May 15th 2020 one patient focus group has been conducted.


The study will provide a unique insight from patients and staff into the potential for implementing automated VR therapy on psychiatric wards. Perspectives will be captured both on the use of immersive technology hardware and therapy-specific issues in such settings.


Please cite as:

Brown P, Waite F, Lambe S, Rosebrock L, Freeman D

Virtual reality cognitive therapy on inpatient psychiatric wards: protocol for a qualitative investigation of staff and patient views across multiple NHS sites.

JMIR Preprints. 15/05/2020:20300

DOI: 10.2196/preprints.20300


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