gameChange VR
gameChange VR is a virtual reality therapy designed to help people with psychosis overcome severe anxiety about everyday situations. Using immersive simulations of real-world environments, users practise activities such as going to the shops or travelling on public transport, guided by a virtual therapist and supported by a mental health worker.
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The therapy has been shown to significantly reduce fear and avoidance, particularly for those with the most severe difficulties, and has now been recommended for wider use within the NHS following NICE approval.
My contributions to gameChangeVR
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Supported and managed the delivery of the first VR-based therapy to be implemented within the NHS.
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Evaluated and selected the Meta Quest 3S platform, balancing performance, cost, and suitability for large-scale NHS deployment.
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Worked with Meta and ArborXR to remotely manage and deploy over 50 headsets across seven NHS sites.
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Collaborated with multiple NHS Trusts to design and implement deployment workflows that met varied organisational requirements.
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Created training materials, documentation, and onboarding resources to support clinicians and staff.
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Provided ongoing technical support and communication to ensure smooth implementation across sites.
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Kept workflows up to date in response to an evolving hardware and software landscape.
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Conducted QA testing and worked closely with the development team to identify issues, reduce barriers, and implement fixes.
Challenges & Solutions
Remote Device Management at Scale
Shortly before rolling out gameChange to NHS sites, Meta introduced changes that required devices to be enrolled in Horizon Managed Services (HMS) for Education in order to be managed remotely. As the project spanned multiple NHS Trusts across England, on-site device management was not a viable option.
After researching available solutions, I identified ArborXR as the most suitable platform for remote device management. ArborXR allowed us to remotely configure and lock down headsets so that therapists only needed to power on the device for gameChange to launch automatically. This significantly reduced onboarding complexity, particularly for staff with little or no prior experience using VR.
Following Meta’s announcement of HMS, I held multiple discussions with both Meta and ArborXR to determine the most robust long-term solution. Given the study’s estimated two-year duration, which aligned with Meta’s free HMS trial period and a discounted ArborXR licence, I decided to enrol devices in both systems. This provided us with redundancy, flexibility, and strong value for money over the lifetime of the trial.
Hardware Reliability and Battery Management
During the trial, we identified an issue where controller batteries were frequently arriving at sites uncharged or losing power while stored for extended periods. Due to the complexities of procuring headset supplies through NHS systems, we opted to supply batteries directly to sites.
After confirming with Meta that the issue was known but unresolved, I communicated clear guidance to all participating sites, advising that controller batteries be removed during long-term storage. Training materials and documentation were updated accordingly to prevent further disruption.
Preventing Data Loss During Therapy Sessions
A critical challenge emerged around Meta’s requirement for session passcodes. Selecting the “End Session” option, which was prominently displayed in-headset, resulted in all app data being wiped. This posed a serious risk, as therapists could unintentionally erase participant progress.
As an immediate mitigation, I advised all sites to avoid ending sessions and to use a neutral passcode configuration while a longer-term solution was explored. In parallel, I maintained ongoing communication with Meta and ArborXR to resolve the issue at a platform level.
Subsequent updates from Meta removed the requirement for session passcodes, replacing them with automatic timeouts after inactivity. ArborXR later introduced persistent app data across sessions. Together, these changes eliminated the risk of accidental data loss and allowed us to remove any risks associated with sessions entirely.
Reflection
gameChange is the first VR therapy to be approved for use within the NHS, and I feel incredibly fortunate to have been responsible for managing headset deployment during this critical implementation trial. Being involved at this stage of a nationally significant clinical study was both a privilege and a responsibility.
The project has been especially meaningful due to its real-world impact. gameChange offers a genuinely accessible treatment option for people who may otherwise have no effective support, and contributing to a therapy with the potential to improve so many lives has been deeply rewarding. For a deeper understanding of the study, I would encourage reading the study protocol published in the BMJ.
As the trial is ongoing, the full results will not be known for another two to three years. Nevertheless, being part of the early stages of this journey and helping to translate the research into a practical, scalable deployment within the NHS has been an invaluable experience, and one I am extremely grateful to have been involved in.
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