CareVR, a Virtual Reality assisted communication training programme to support informal carers of people with psychosis: a feasibility study

BMC Psychiatry. 2026 Jun 1. doi: 10.1186/s12888-026-08203-w. Online ahead of print.

ABSTRACT

BACKGROUND: Family (informal) carers play a vital role in providing care and support to relatives living with a psychotic disorder. Carers, however, often face challenges in communicating effectively with care recipients, particularly in the presence of psychosis symptoms such as delusions and hallucinations. Immersive technologies such as virtual reality have a growing evidence base in mental health treatments in patient groups, but their application to support carers has yet to be established. This study sought to evaluate the feasibility of CareVR, a therapist-facilitated virtual reality (VR) communication skills training programme for informal carers in psychosis. CareVR comprised four individual sessions designed to enhance carers’ confidence and effectiveness in their conversations with a care recipient experiencing psychosis symptoms.

METHODS: An uncontrolled study design was conducted to ascertain the feasibility and acceptability of CareVR. The VR programme comprised two conversation scenarios between an adult avatar carer and an adult avatar relative (care recipient) with psychosis. Scenarios were delivered from both a third-person (observer) and a first-person (carer) perspective. In each scenario, participants selected how the avatar carer responded to communications from the avatar relative with psychosis. Following each training scenario, participants, supported by a facilitator, reflected on their experiences within the VR environment and their own lived experiences. They were also given opportunities to revisit and revise their choices. The final session focused on integrating learning across the training programme. Feasibility was assessed through recruitment, retention, session attendance, and completion of outcome measures. Acceptability was evaluated using participant feedback, including session satisfaction scores, and achievement of individualised goals.

RESULTS: The sample comprised twelve participants with diverse caregiving relationships and socio-demographic backgrounds. Recruitment targets were achieved, and all participants attended and completed the full training and assessment measures. Participants reported high levels of satisfaction for individual sessions, the intervention, overall, and goal achievement.

CONCLUSION: Preliminary findings from our small and uncontrolled study suggest CareVR might be both feasible and acceptable to informal carers of individuals in psychosis. The study, however, was not designed to evaluate efficacy. Thus, any reports and conclusions of clinical benefits of CareVR require further investigation in a future adequately powered controlled trial.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:42219466 | DOI:10.1186/s12888-026-08203-w