Oxford University researchers have used virtual reality simulations to teach patients with severe paranoia that the situations they fear most are actually safe.

The study, funded by the Medical Research Council, wanted to test whether patients could relearn that situations were safe, by experiencing them first hand.

Patients were also encouraged to stop using defence behaviours such as reducing eye contact or limiting social interactions.

“Paranoia all too often leads to isolation, unhappiness, and profound distress. But the exceptionally positive immediate results for the patients in this study show a new route forward in treatment. In just a thirty minute session, those who used the right psychological techniques showed major reductions in paranoia,” said the study’s head researcher, Professor Daniel Freeman.

“It’s not easy work for patients, since lowering defences takes courage. But as they relearned that being around other people was safe we saw their paranoia begin to melt away. They were then able to go into real social situations and cope far better. This has the potential to be transformative.”

Thirty patients attending treatment services at Oxford Health NHS Foundation Trust were split into two groups.

While half the group were allowed to maintain some of their defence behaviours, the other half were encouraged to drop their defences completely and try to learn that they were safe by approaching the virtual characters and interacting with them.

“There is growing evidence that psychological treatments can have a major beneficial impact on the lives of people suffering from psychosis,” said study team member, Professor David Clark.

“Virtual reality assisted treatment has great potential because, as the price of the equipment makes it more accessible, much treatment could be delivered in people’s homes.”

Patients who fully tested out their fears in virtual reality by lowering their defences completely showed very substantial reductions in their paranoid delusions.

After the virtual reality therapy session, over 50% of these patients no longer had severe paranoia at the end of the test day, compared with the 20% of patients who no longer exhibited signs of severe paranoia having maintained some of their defences.

“Virtual reality is proving extremely effective in the assessment and treatment of mental health problems. This study shows the potential of its application to a major psychiatric problem. There is a lot of work to do be done in testing the approach in treating delusions but this study shows a new way forward,” said head of Neurosciences and Mental Health at the Medical Research Council, Dr Kathryn Adcock.

The researchers’ findings are available in the British Journal of Psychiatry.