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Working life: Professor Daniel Freeman

by Guest Author on 30 Jan 2019

Daniel Freeman, Professor of Clinical Psychology at the University of Oxford, is pioneering virtual reality (VR) as a treatment for people with severe mental health problems. He tells us about his working life, the inspiration behind his ideas and the large potential for VR beyond gaming.

Professor Daniel Freeman holding a virtual reality headset

 

Career in brief:

  • BA Natural Sciences at the University of Cambridge
  • PhD in psychology and a DClinPsy in clinical psychology at King’s College London
  • Wellcome Trust Fellow at King’s College London
  • MRC Senior Clinical Fellow at the University of Oxford
  • NIHR Research Professor at the University of Oxford

I’m a psychologist now, but that wasn’t the original plan. I went to university thinking I’d be a physicist, but while I was there I had the opportunity to try a few different sciences. Psychology really stood out for me. I think I fell in love with the subject at that point.

Time spent with patients inspires me to improve treatments and help a greater number of people recover. I really value patient contact and feel privileged to have people share their concerns, fears and life stories with me. One of the joys of working in this area is helping people regain their confidence and fulfil their potential.

Causation is complex – two people experiencing similar symptoms may have somewhat different underlying causes of their mental health difficulties. This means that treatment needs to be tailored to the person because what may work for one patient may be ineffective for another. So, there’s a lot to learn.

Many of my research ideas are born in the clinic. By talking to patients about their difficulties I begin to decipher the psychology behind their condition, working with them to piece together the different causal factors. The first step is to gain a thorough understanding of what causes the problem, then use this to develop better treatments. This process generates so many ideas, so I’m not short of further ideas that I want to test.

For the past two decades, I’ve particularly focused my research on persecutory delusions. These delusions centre on the unfounded belief that others are deliberately trying to harm the person who is experiencing them. Having such thoughts can cause a very high degree of anxiety, depression, and withdrawal from everyday life.

Technology has enormous potential to change mental health treatment provision in the future. Schemes like ‘Improving Access to Psychological Therapy’ in the NHS have greatly increased access to face-to-face psychological treatment for common mental health conditions. However, there are still far too many people who don’t receive the psychological help they need. Good use of technologies, rigorously tested, could be part of the solution.

Immersive VR could become a way for people to access the very best psychological therapy. Through VR we can place people into computer simulations of the situations that trouble them in the real world. Because they know it’s not real, it’s easier to try new ways of thinking, feeling and behaving that they would usually consider impossible. In work funded by my MRC Fellowship, we tested this approach with 30 patients with persecutory delusions who entered VR recreations of two social situations: a train and a lift. A therapist was guiding them, helping them learn that they are safe when around other people.

Our pilot study revealed huge potential benefits in using VR with therapy. Doing VR work with the therapist led to patients’ experiencing immediate improvements in their paranoia and they were less distressed in everyday social situations. The next step for us was to build therapy into the VR environment itself – to create a ‘virtual therapist’ – with an aim to improve access to treatment and reduce the load on overstretched NHS therapists.

Professor Daniel Freeman and his team holding a virtual reality headset

Professor Daniel Freeman with his research team at the University of Oxford.

We’ve just started the THRIVE study, an MRC-funded clinical trial to test automated VR cognitive therapy. As soon as a patient puts on the VR headset, they meet the virtual therapist in their office who explains how the treatment works and the psychological principles. The patient then chooses where they’d like to go first within a shopping centre: a café, a clothes shop, up in a lift or to explore the atrium. Each scenario has different difficulty levels. For instance, when entering the lift for the first time, there are just a couple of people but by the hardest level, the lift is very full. The virtual therapist accompanies the person initially, but the hardest stages encourage the patient to explore independently.

The opportunity to work with such a variety of specialists is one of the joys of a career in science. Throughout my career, I’ve worked with other psychologists, psychiatrists, epidemiologists, statisticians, methodologists, computer scientists and software programmers. Having mentors has also helped me develop throughout my career. I’ve enjoyed working with senior colleagues – observing and learning from them. Now I gain a huge amount of satisfaction in seeing the younger scientists coming through and helping them flourish.

Hear more words of wisdom from Daniel, in our ‘career inspirations’ podcast interview.

It’s important to see the bigger picture of where your work fits in. But having said that, I think there are certain stages of your career where you should focus on the detail. Aiming to know everything you possibly can about your area of research is always going to be time well spent.

We’re in the early stages of this journey right now but I believe VR could one day be available in every mental health clinic. It has potential to be used for both assessing psychiatric problems and delivering psychological therapy. We’ve got to build up the evidence to show that the treatment works, but the potential is enormous.

As told to Debs Barber

THRIVE (THerapeutic Realistic Immersive Virtual Environments) is funded by the MRC Developmental Pathway Funding Scheme.

 

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