Improving Social Functioning in Youth at Clinical High Risk for Psychotic Disorders With a Virtual Reality Based Cognitive Behavioural Therapy: The Feasibility and Acceptability of REVIVE

Abstract

Introduction

Adolescence is when mental disorders such as psychosis frequently emerge, with long-term impacts on social functioning if left untreated. Early intervention, including cognitive behavioural therapy (CBT) and innovative approaches like virtual reality (VR)-assisted therapy, can help young people in their social recovery.

Method

During the development phase of REVIVE therapy, input was gathered through group consultations with 10 youth advisors aged 16–25 who had lived experience. Their insights informed the design of the virtual social environments. A feasibility and acceptability study was conducted with eight participants at clinical high risk (CHR) for psychosis. Participants received up to 10 VR-assisted CBT sessions focused on enhancing social recovery. Feasibility and acceptability were assessed through structured evaluations.

Results

Out of the 13 eligible service users with clinical high risk for psychosis (CHR) status, 10 expressed interest in enrolling in the REVIVE study, leading to eight participants being included. The recruitment conversion rate was 77%, while retention rates showed 38% for therapy and 63% for the study. Therapy completers achieved an average of 74% toward their personal social goal by the end of treatment. Participants reported overall positive experiences with the VR therapy and suggested improvements for program flexibility, personalisation, and content variety.

Discussion

While the REVIVE VR-CBT therapy is deemed moderately feasible and acceptable for young people with clinical high risk (CHR) status, significant barriers underscore existing challenges and the necessity for a personalised and supportive approach. The small sample size restricts the ability to generalise findings and precludes robust statistical analyses.