Accepted for/Published in: JMIR Serious Games
Date Submitted: Aug 18, 2023
Date Accepted: May 31, 2024
Developing an Automated VR Therapy for Improving Positive Self-beliefs and Psychological Well-being: Phoenix VR Self-Confidence Therapy
ABSTRACT
Virtual Reality (VR) is an immersive technology in which delivery of psychological therapy techniques can be automated. Techniques can be implemented similarly to real-world delivery or in ways that are not possible in the real world to enhance efficacy. The potential is for greater access for patients to effective therapy. Despite an increase in the use of VR for mental health, there are few descriptions of how to build and design automated VR therapies. We describe the development of Phoenix VR Self-Confidence Therapy, designed to increase positive self-beliefs in young patients diagnosed with psychosis in order to improve psychological well-being. A double-diamond, user-centered design process, conducted over the course of 18 months, was used involving stakeholders from multiple areas: individuals with lived experience of psychosis, clinical psychologists, treatment designers, and VR software developers. Thirteen meetings were held with young patients diagnosed with psychosis to increase the understanding and improve the assessment of positive self-beliefs, help design the scenarios for implementing therapeutic techniques, and conduct user testing. The resulting Phoenix therapy is a class I UKCA certified medical device designed to be used on the standalone Meta Quest 2 headset. Phoenix aims to build up three types of positive self-beliefs that are connected to psychological well-being. In a community garden area tasks are designed to increase a sense of mastery and achievement (“I can make a difference”); in a TV studio, users complete an activity with graded levels of difficulty to promote success in the face of a challenge (“I can do this”); and in a forest by a lake, activities are designed to encourage feelings of pleasure and enjoyment (“I can enjoy things”). Phoenix is delivered over the course of approximately 6 weekly sessions supported by a mental health provider. Patients can take the headsets home to use in between sessions. Usability testing with individuals with lived experience of psychosis as well as patients in the NHS demonstrated that Phoenix is engaging, easy to use, and has high levels of satisfaction.
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