Trial Results

gameChange Trial:

In the largest ever clinical trial of VR for mental health, gameChange was trialled with 346 patients with psychosis in nine NHS Trusts across five English regions: Bristol, Manchester, Newcastle, Nottingham, and Oxford.

The results were published in The Lancet Psychiatry in April 2022. The article is available to read online “Automated virtual reality therapy to treat agoraphobic avoidance and distress in patients with psychosis (gameChange): a multicentre, parallel-group, single-blind, randomised, controlled trial in England with mediation and moderation analyses.”

The trial showed that gameChange led to significant reductions in the agoraphobic avoidance of everyday situations and in distress. The patients who benefitted most were those who found it hardest to leave the house, and those with the most psychiatric symptoms, such as severe anxiety, depression, delusions, and hallucinations. These patients experienced large benefits – often being able to undertake activities they had previously found unthinkable. These benefits were maintained at the six-month follow-up. Patient feedback showed that the treatment was extremely popular, with very high up-take rates.

Publications:

THE TRIAL

Freeman, D., Lambe, S., Kabir, T., Petit, A., Rosebrock, L., Yu, L-M., Dudley, R., Chapman, K., Morrison, A., O’Regan, E., Aynsworth, C., Jones, J., Murphy, E., Powling, R., Galal, U., Grabey, J., Rovira, A., Martin, J., Hollis, C., Clark, D.M., Waite, F., & gameChange Trial Group (2022). Automated virtual reality therapy to treat agoraphobic avoidance and distress in patients with psychosis (gameChange): a multicentre, parallel-group, single-blind, randomised, controlled trial in England with mediation and moderation analyses. Lancet Psychiatry, 9, 375–388.

Freeman, D., Yu, L-M., Kabir, T., Martin, J., Craven, M., Leal, J., Lambe, S., Brown, S., Morrison, A., Chapman, K., Dudley, R., O’Regan, E., Rovira, A., Goodsell, A., Rosebrock, L., Bergin, A., Cryer, T., Robotham, D., Andleeb, H., Geddes, J., Hollis, C., Clark, D., & Waite, F. (2019). Automated virtual reality (VR) cognitive therapy for patients with psychosis: study protocol for a single-blind parallel group randomised controlled trial (gameChange). BMJ Open, 9:e031606. doi: 10.1136/bmjopen-2019-031606

 

AGORAPHOBIA IN PSYCHOSIS

Rosebrock, L., Lambe, S., Mulhall, S., Petit, A., Loe, B.S., Saidel, S., Mitchell, J., Aynsworth, C., Murphy, E., Jones, J., Powling, R., Chapman, K., Dudley, R., Morrison, A., O’Regan, E., Clark, D.M., Waite, F., & Freeman, D. (2022). Understanding Agoraphobic Avoidance Across Mental Health Disorders: The Development of the Oxford Cognitions and Defences Questionnaire (O-CDQ). Behavioural and Cognitive Psychotherapy.

Lambe, S., Bird, J., Loe, B., Rosebrock, L., Kabir, T., Petit, A., Mulhall, S., Jenner, L., Aynsworth, C., Murphy, E., Jones, J., Powling, R., Chapman, K., Dudley, R., Morrison, A., O’Regan, E., Yu, L-M., Clark, D., Waite, F., & Freeman, D. (2021). The Oxford Agoraphobic Avoidance Scale. Psychological Medicine, DOI: https://doi.org/10.1017/S0033291721002713

Freeman, D., Taylor, K., Molodynski, A., & Waite, F. (2019). Treatable clinical intervention targets for patients with schizophrenia. Schizophrenia Research, 21, 44-50.

 

THE DESIGN OF THE VR THERAPY

Knight, I., West, J., Matthews, E., Kabir, T., Lambe, S., Waite, F., & Freeman, D. (2021). Participatory design to create a VR therapy for psychosis. Design for Health, 5, 98-119.

Lambe, S., Knight, I., Kabir, T., West, J., Patel, R., Lister R., Rosebrock, L., Rovira, A., Garnish, B., Freeman, J., Clark, D., Waite, F., & Freeman, D. (2020). Developing an automated VR cognitive treatment for psychosis: gameChange VR therapy. Journal of Behavioural and Cognitive Therapy, 30, 33-40.

 

THE EXPERIENCE OF THE VR THERAPY

Brown, P., Waite, F., Lambe, S., Jones, J., Jenner, L., Diamond, D., & Freeman, D. (2022). Automated virtual reality cognitive therapy (gameChange) in inpatient psychiatric wards: qualitative study of staff and patient views using an implementation framework. JMIR Formative Research, 6, e34225

Freeman, D., Rosebrock, L., Waite, F., Loe, B.S., Kabir, T., Petit, A., Dudley, R., Chapman, K., Morrison, A., O’Regan, E., Aynsworth, C., Jones, J., Murphy, E., Powling, R., Peel, H., Walker, H., Bryne, R., Freeman, J., Rovira, A., Galal, U., Yu, L-M., Clark, D.M., & Lambe, S. (2022). Virtual reality (VR) therapy for patients with psychosis: satisfaction and side effects. Psychological Medicine.

Bond, J., Robotham, D., Kenny, A., Pinfold, V., Kabir, T., Andleeb, H., Larkin, M., Martin, J., Brown, S., Bergin, A., Petit, A., Rosebrock, L., Lambe, S., Freeman, D., & Waite, F. (2021). Automated virtual reality cognitive therapy for people with psychosis: protocol for a qualitative investigation using peer research methods. JMIR Research Protocols, 10(10):e31742.

Brown, P., Waite, F., Lambe, S., Rosebrock, L., & Freeman, D. (2020). Virtual Reality Cognitive Therapy in Inpatient Psychiatric Wards: Protocol for a Qualitative Investigation of Staff and Patient Views Across Multiple National Health Service Sites. JMIR Research Protocols, 9(8), e20300.

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Department of Psychiatry
University of Oxford
Warneford Hospital
Oxford, OX3 7JX

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