Virtual reality intervention for psychotic disorders using 360-degree video - agile development of an easy to implement protocol

Abstract Background Virtual reality technologies have been utilized in the treatment of psychiatric disorders by offering means to practice challenging situations in a safe environment. In this case report, we describe the development of a novel and easy to implement virtual reality-based intervention protocol to treat paranoid ideations of individuals with psychotic disorders. Method 360-degree videos were filmed with a head-mounted camera, simulating everyday social situations which people with paranoid delusions often find threatening. These situations included for example walking in a crowded street or visiting a grocery store. Five weekly sessions with a clinician were included in the treatment protocol, following a treatment manual and individualized case formulation. The patients were exposed to the simulations using a virtual reality-headset. Results The intervention was found feasible by the clinicians and was positively received by the first pilot patients. The only observed disadvantage was nausea and dizziness caused by specific video clips. 360-degree videos as stimuli for exposure were deemed suitable. Conclusions Developing novel forms of treatment which are easy to pilot and to implement in day-to-day clinical environment may bridge the gap between controlled studies and standard practice. As far as we know, 360-degree videos have not been previously used in the context of psychotic disorders and their utility in the treatment paranoid ideation appears promising. Based on this pilot, creating virtual reality treatment protocols is possible without excessive resources and without any specific technical know-how. The process of development and implementation is carefully laid out so this paper can be used as a manual for similar protocols. Trial registration: not applicable