A virtual-reality programme called gameChange is showing that psychological therapy can be automated — no real therapist required. Here is how it works.

gameChange was built by the University of Oxford for people with psychosis whose intense fears about everyday situations have made them largely housebound. A virtual coach guides users through simulations of buses, shops and streets — the exact situations they avoid.

Treatment runs about six 30-minute sessions. A trained staff member is always present for support, but the therapy itself is delivered by the software. Patients can do it at home or at a clinic.

In the largest ever clinical trial of VR for mental health, across nine NHS Trusts, patients who got gameChange showed greater reductions in agoraphobia and distress than those on usual care. The biggest gains came in the most severely affected patients, and benefits lasted six months.

NICE has given the therapy a positive Early Value Assessment. The promise: consistent, scalable therapy for people therapist shortages leave behind.