Virtual Reality Schema Therapy Exercises With Parent and Child Modes

VR-STEM: Virtual Reality Schema Therapy Exercises With Parent and Child Modes

The goal of this clinical trial is to develop a Virtual Reality version of a Schema Therapy exercise and test its feasibility, acceptability and potential usefulness in people with psychiatric disorders (age 18-65). The main questions the investigators aim to answer are:

1. Are dialogue exercises with virtual reality mode avatars feasible, acceptable and useful?
2. How do patients experience VR schema therapy exercises (in terms of immersion, elicited emotions, therapeutic relationship or subjective efficacy) and are the exercises potentially effective (in terms of schema mode scores, self-criticism, self-compassion and self-esteem)?
3. In case of a potential 'effect', is this moderated by mental imagery ability?

The investigators hypothesize that 1) dialogue exercises with virtual reality mode avatars are feasible, ac-ceptable and useful according the Technology Acceptance Model (TAM; Davis, 1989); 2) patients experience high levels of immersion, elicited emotions and subjective efficacy, a strong therapeutic relationship, and show effects on schema mode scores and self-compassion and self-esteem scores; and 3) these effects are moderated by patients' mental imagery ability in such a way that patients with less mental imagery abilities benefit most.

The development of the VR version of the exercise will be done in collaboration with patients and therapists.

To test its feasibility, acceptability and potential usefulness, participants will be invited to receive one session of the exercise. During this session, they will complete some questionnaires before and after the exercise, and they will be asked about their opinions about and experiences of the exercise.

Inclusion Criteria:

• 18-65 years of age
• In treatment at a tertiary treatment facility (UCP, UMCG)
• Whose current psychological distress is related to early life experiences as indicated by a clinician
• Score of >3 on one of three schema modes on the SMI (Lobbestael et al., 2010)

Exclusion Criteria:

• Insufficient command of the Dutch language
• Primary diagnosis of a substance use disorder, or organic brain disease (such as dementia)
• Unable to provide informed consent