Social CommunicationAcceptability

Qualitative study of patient and therapist experiences with immersive VR-assisted therapy for distressing auditory hallucinations (voices) in psychosis - from the Danish Challenge Trial multi-site collaboration

Christensen MJ et al. · 2025 · JMIR Mental Health · Qualitative 0 · Adults with psychotic disorders and distressing voices, plus therapists · DOI
Evidence certainty: Moderate certainty
How this was rated

Qualitative study within an established multi-site clinical trial (the Challenge Trial). Multi-country authorship: Denmark (Aalborg, Copenhagen), Australia (Orygen, Swinburne), UK (Institute of Psychiatry London). Peer-reviewed in JMIR Mental Health (JMIR Publications, established peer-reviewed mental-health-tech venue). Strengths: multi-site, multi-stakeholder (participants + therapists) perspectives. Limitations: qualitative work cannot establish efficacy; psychotic-disorder population is outside the typical SLP/communication-disorder scope (included here for cross-disciplinary completeness and high-quality venue).

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A qualitative study of participants' and therapists' experiences with Immersive VR-Assisted Therapy for distressing voices in psychosis, conducted within the Challenge Trial. Multi-site Danish + Australian + UK collaboration (Aalborg University Hospital, Copenhagen Mental Health Services, Orygen Melbourne, Swinburne University, Institute of Psychiatry London). Examines how patients with psychotic disorders experiencing distressing auditory hallucinations relate to immersive VR therapy and how therapists deliver it. Complements Pot-Kolder 2018 (VR-CBT for paranoid ideation in psychosis) with a focused qualitative lens on the distressing-voices subtype of psychosis.

Clinical bottom line

A qualitative deep-dive into participant and therapist experience with immersive VR-assisted therapy for distressing voices in psychosis. Multi-site Danish+Australian+UK collaboration. Companion to Pot-Kolder 2018 (in our Hub) for the psychosis-VR-CBT branch. For SLPs the relevance is conceptual: distressing voices is auditory hallucination, which intersects with auditory-perceptual phenomena studied in voice and hearing research. Not directly applicable to typical SLP caseloads but adds depth to our cross-disciplinary psychosis-VR coverage.

Key findings

  • Qualitative companion study to the Challenge Trial - a multi-site clinical trial of Immersive VR-Assisted Therapy for distressing voices (auditory hallucinations) in psychosis
  • Multi-country authorship: Aalborg University Hospital (Denmark), Copenhagen University Hospital, Orygen Melbourne, Swinburne University Australia, Alfred Hospital Melbourne, Institute of Psychiatry London - diversified clinical context
  • Examines BOTH participant and therapist experiences - dual-perspective qualitative depth rare in psychosis-VR research
  • Distressing voices (auditory verbal hallucinations) is a specific psychotic-spectrum symptom; the VR-assisted therapy approach gives patients structured exposure to and dialogue with their voices in a clinician-controlled virtual context
  • Companion to Pot-Kolder 2018 (Lancet Psychiatry - in our Hub) which focused on paranoid ideation + social avoidance in psychosis; Christensen 2025 focuses on distressing-voices subtype
  • Published 2025 in JMIR Mental Health (peer-reviewed, open access)

Background

Distressing auditory hallucinations (voices) are a common and disabling psychotic-spectrum symptom. Immersive VR-assisted therapy offers a structured way for patients to engage with their voices in a clinician-controlled context. The Challenge Trial is a multi-site clinical evaluation of this approach; Christensen 2025 reports the qualitative companion study.

What they did and found

Qualitative study of participants and therapists in the Challenge Trial. Multi-country authorship (Denmark, Australia, UK). Specific qualitative methodology (thematic analysis, interview structure) reported in published article.

Why it matters

Companion to Pot-Kolder 2018 for the psychosis-VR-CBT branch. Qualitative dual-perspective depth (participants + therapists).

Limitations

Psychosis is outside typical SLP scope - included for cross-disciplinary completeness. Qualitative work cannot establish efficacy.

Implications for practice

For SLPs working with mainstream communication-disorder caseloads, this paper's clinical relevance is limited - distressing voices is a psychotic-spectrum symptom not typically addressed in SLP practice. For cross-disciplinary teams or for SLPs working in psychiatric hospital settings where they may encounter clients with comorbid psychotic-spectrum presentations, this paper adds qualitative depth on VR-assisted therapy acceptability. For our Hub, Christensen 2025 strengthens the cross-disciplinary psychosis-VR-CBT branch alongside Pot-Kolder 2018.

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Cite this study

If you reference this study in your work, the canonical citation formats are:

APA 7th
Christensen, M. J., Rydborg, M. P., Jørgensen, R., Nielsen, C. D., Mainz, J., Bell, I. H., Thomas, N., Smith, L. C., Mariegaard, L. S., Ward, T., Nordentoft, M., Glenthøj, L. B., & Vernal, D. L. (2025). Immersive Virtual Reality–Assisted Therapy for Distressing Voices in Psychosis: Qualitative Study of Participants' and Therapists' Experiences in the Challenge Trial. JMIR Mental Health. https://doi.org/10.2196/74519.
AMA 11th
Christensen MJ, Rydborg MP, Jørgensen R, Nielsen CD, Mainz J, Bell IH, Thomas N, Smith LC, Mariegaard LS, Ward T, Nordentoft M, Glenthøj LB, Vernal DL. Immersive Virtual Reality–Assisted Therapy for Distressing Voices in Psychosis: Qualitative Study of Participants' and Therapists' Experiences in the Challenge Trial. JMIR Mental Health. 2025. doi:10.2196/74519.
BibTeX
@article{christensen2025,
  author = {Christensen, M. J. and Rydborg, M. P. and Jørgensen, R. and Nielsen, C. D. and Mainz, J. and Bell, I. H. and Thomas, N. and Smith, L. C. and Mariegaard, L. S. and Ward, T. and Nordentoft, M. and Glenthøj, L. B. and Vernal, D. L.},
  title = {Immersive Virtual Reality–Assisted Therapy for Distressing Voices in Psychosis: Qualitative Study of Participants' and Therapists' Experiences in the Challenge Trial},
  journal = {JMIR Mental Health},
  year = {2025},
  doi = {10.2196/74519},
  url = {https://withvr.app/evidence/studies/christensen-2025}
}
RIS
TY  - JOUR
AU  - Christensen, M. J.
AU  - Rydborg, M. P.
AU  - Jørgensen, R.
AU  - Nielsen, C. D.
AU  - Mainz, J.
AU  - Bell, I. H.
AU  - Thomas, N.
AU  - Smith, L. C.
AU  - Mariegaard, L. S.
AU  - Ward, T.
AU  - Nordentoft, M.
AU  - Glenthøj, L. B.
AU  - Vernal, D. L.
TI  - Immersive Virtual Reality–Assisted Therapy for Distressing Voices in Psychosis: Qualitative Study of Participants' and Therapists' Experiences in the Challenge Trial
JO  - JMIR Mental Health
PY  - 2025
DO  - 10.2196/74519
UR  - https://withvr.app/evidence/studies/christensen-2025
ER  -

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Funding & independence

Affiliations: 14 multi-country (Denmark, Australia, UK). Funding sources reported in published article. Peer-reviewed in JMIR Mental Health (JMIR Publications, open access). No withVR BV involvement.

Last reviewed: 2026-05-17 Next review due: 2027-05-17 Reviewed by: Gareth Walkom