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Virtual Reality (VR) creates an immersive experience by using a headset that lets you explore a world that looks and feels like the real world. In VR, you can interact with virtual objects, characters, and other users. In this study, the VR environments have been co-designed by researchers with young people who use early psychosis services.

Symptoms vary for different individuals, but can include feeling low in mood, feeling paranoid or seeing things, or people hearing voices that they know aren’t there. Some people might worry that their thoughts are being heard, may not feel right in themselves, or might be having more difficulty than usual coping with work, school or relationships. Other people may not experience any of these early symptoms, but have a family member with a psychotic disorder.

The VISOR research study will evaluate whether VR therapy focused on strengthening social functioning in everyday situations is effective for young people experiencing early psychosis and others symptoms of mental ill-health. While traditional therapies like CBT and talk therapy are an important part of a regular mental health care, these methods may not meet the needs of every young person. Our aim is to determine if introducing VR therapy as an additional treatment option in early psychosis services offers benefits for young people. At every stage of the research study, The VISOR team is committed to hearing young people’s lived experiences to develop digital mental health services and evaluate the efficacy of VR therapy treatments in early psychosis. 

Social functioning refers to how we interact with others and navigate social situations in our everyday lives. During or after periods of mental ill-health, experiences with early psychosis, depression or anxiety can make social functioning more challenging. Everyday situations like hanging out with friends, catching public transport, or going to class or work, might feel overwhelming or difficult.  

Social functioning includes: 

• Communication: Expressing and understanding thoughts and feelings 

• Forming relationships: Building and maintaining connections with others 

• Participating in activities: Navigating environments like class, work, and social events 

Improving social functioning helps build confidence and the ability to engage in meaningful social interactions. In this study, VR therapy sessions focus on helping young people practice these skills in a safe and supportive virtual environment. 

The study involves 12 VR therapy sessions, each lasting for 60-90 minutes. There are 1-2 sessions per week, occurring over three months. Your participation will be alongside regular care with your early psychosis service. You will also participate in four 2-hour research interviews, either online or in person, where you will be asked questions about your experiences, challenges with social functioning, feelings of loneliness, and general health and wellbeing.  In VR therapy sessions, participants will experience various virtual scenarios that resemble daily experiences, such as ordering a coffee at a cafe or completing group work at university. You will be guided through simulations of real-life situations in a safe, controlled environment with the support of a therapist.  

No, the VISOR study will supply VR hardware and software. The VR hardware and software will be set up by a VR clinician before the start of the session. For this study, VR therapy will take place in-person at participating early psychosis service providers. 

A qualified virtual reality clinician will conduct the VR therapy, guiding you through VR simulations using a headset. The sessions will take place in a regular therapy room at your service. You and your VR therapist will work one-on-one during your sessions, and you will have regular contact with your case manager throughout the study. 

Participating in this study offers a unique opportunity to be part of a world-first clinical trial evaluating VR therapy in early psychosis services. While we are optimistic about the potential of the VISOR study and we anticipate benefits to participants, we cannot guarantee individual outcomes. Your involvement in this clinical trial will help us better understand and develop advanced digital mental health care treatments. You will receive 12 free VR therapy sessions as part of the study. In addition, you will be reimbursed $125 for each of the four research interviews with a member of the VISOR team, totalling $500. You can also earn an additional $200 for completing a series of brief smartphone questionnaires. 

Your VR clinician can help you to manage any feelings of discomfort you may experience, and tailor the VR therapy sessions to your needs. There are supports available, and your comfort and safety will be our priority throughout the study. If you choose to stop participating at any point during the study, the care you receive at your early psychosis service will not be impacted. 

The information collected from you will be de-identified, which means that your data will be anonymous and not identifiable to you. Instead, your data will be represented by a unique code number to identify you in the research findings instead of your name or any other identifying features.

After you finish participating in the study, you can continue to receive care from your early psychosis service. As part of VISOR, the research team is working to create a toolkit for using VR therapy in mental health services. You may be invited to take part in an optional interviews or workshops to assist the development of this toolkit. The results of the study will be shared with young people, carers, families, researchers, clinicians, and the wider community. If you’re interested, you can choose to receive these findings. If you would like to learn more about the VISOR research study or share your thoughts on VR therapy, we encourage you to reach out to our team. Through our findings, we hope to make VR therapy a valuable tool for young people accessing mental health services both in Australia and around the world. 

ORYGEN, Melbourne, VIC: Professor Andrew Thompson, Dr Roos Pot-Kolder, Professor Patrick McGorry, Professor Mario Alvarez, Professor Kelly Allott, Prof Cathy Mihalopoulos, Dr Cali Bartholomeusz, Dr Caroline Gao, Dr Jen Nicholas, Dr Isabel Zbukvic, Dr Imogen Bell, Jessica Spark, Carli Ellinghaus, Kate Reynolds, Shona Louis, Dr Michelle Tennant, Professor David Penn, Dr Amity Watson, Professor Eóin Killackey, Martin Reinoso, Yang Liu, Gráinne Carthy, James Reeves, Daniel Metcalfe, Rachel Hines and Brooke McLean.

ALFRED HEALTH, Frankston, VIC: Dr Iain Macmillan, Dr Liza Hopkins, Sarcia Stills-Blott. 

THE KIDS INSTITUTE, Perth, WA: A/Professor Yael Perry, Jacinta Freeman, Azriel Lo, Sam Wilkinson.