MAIN PROJECTS
The i4i Mental Health Challenge Award: Immersive virtual reality to transform the lives of patients with psychosis
NHS NIHR Research Professorship: Overcoming Persecutory Delusions
Oxford Virtual Reality (VR) for Mental Health
The Feeling Safe Study
Immersive Virtual Reality Cognitive Treatment (VRCT) for persecutory delusions
Daniel Freeman
PhD DClinPsy CPsychol FBPsS FBA
Professor of Clinical Psychology
- Lead, Oxford Cognitive Approaches to Psychosis (O-CAP)
- National Institute for Health and Care Research (NIHR) Senior Investigator
- Consultant Clinical Psychologist, Oxford Health NHS Foundation Trust
- Psychological therapies theme co-lead, NIHR Oxford Health Biomedical Research Centre
- Founder of Oxford VR
- Fellow, University College Oxford
- Fellow, British Psychological Society
- Fellow, British Academy
Follow Daniel Freeman on Twitter
Research Group: Oxford Cognitive Approaches to Psychosis (O-CAP)
BBC Radio 4 Series: A History of Delusions
* Please note that from April 2023 I have moved to the Department of Experimental Psychology
Email address: daniel.freeman@psy.ox.ac.uk
The purpose of my work is to make significant advances in the understanding and treatment of mental health disorders, particularly the problem of paranoia. Drawing on a variety of approaches, including epidemiological studies, psychological experiments, clinical trials, and a ground-breaking virtual reality laboratory, I use the theoretical knowledge to develop carefully tested psychological treatments that will truly make a difference.
At the moment several randomised controlled treatment trials are in progress. This includes a test of a new targeted, personalised psychological treatment for persecutory delusions, called the Feeling Safe Programme. This is a translational treatment built upon advances by my research group in the theoretical understanding of paranoia. The target is a recovery rate of 50% for persecutory delusions that have not responded to previous treatment. There are also a number of studies running that will lead to a greater understanding of the causes of psychotic experiences. The research is supported by the National Institute of Health and Care Research (NIHR), UK Medical Research Council (MRC), and the Wellcome Trust.
I pioneered the use of virtual reality (VR) to assess, understand, and treat paranoia. Subsequently I have led work designing and testing new automated VR psychological therapies for mental health disorders. The aim is to produce VR therapies that produce greater clinical effects than face-to-face therapies. I founded and am a non-executive board member of Oxford VR, a spinout company from the University. Oxford VR built on my research into the use of virtual reality to understand and treat psychological disorders. I founded the company in 2016 with Jason Freeman, Mel Slater, Bernhard Spanlang, and Mavi Sánchez-Vives.
I’m also committed to making knowledge of the best psychological research and treatments for mental health problems available to the general public. Therefore I’ve written a number of popular science books on mental health issues. The latest to appear is The Stressed Sex: Uncovering the Truth about Men, Women, and Mental Health, which sets out to answer a simple, but crucial, question: are rates of psychological disorder different for men and women? This important issue has been largely ignored in all the debates raging about gender differences.
I studied natural sciences at the University of Cambridge, completed a PhD and a doctorate in clinical psychology (DClinPsy) at the Institute of Psychiatry, King's College London, then held a Wellcome Trust Fellowship and a Medical Research Council Senior Clinical Fellowship. In 2011 I moved to the University of Oxford and set up the Oxford Cognitive Approaches to Psychosis (O-CAP) research group. From 2015-2020 I was an NIHR Research Professor. I am the recipient of the 2020 British Psychological Society Presidents' Award for Distinguished Contributions to Psychological Knowledge.
Recent open access papers
COVID-19 vaccine hesitancy in the UK
Injection fears and COVID-19 vaccine hesitancy
Sleep disturbance and psychiatric disorders
Automated virtual reality cognitive therapy for patients with psychosis
Automated psychological therapy using virtual reality (VR) for patients with persecutory delusions
Coronavirus conspiracy beliefs, mistrust, and compliance with government guidelines in England
Automated psychological therapy using immersive VR for treatment of fear of heights
Virtual reality in the assessment, understanding, and treatment of mental health disorders
Treatable clinical intervention targets for patients with schizophrenia
The weeks before 100 persecutory delusions
The effects of improving sleep on mental health (OASIS)
Persecutory delusions: a cognitive perspective on understanding and treatment [pdf]
Suicidal ideation and behaviour in patients with persecutory delusions
The Dunn Worry Questionnaire and the Paranoia Worries Questionnaire: new assessments of worry
The revised Green et al., Paranoid Thoughts Scale (R-GPTS)
Virtual reality in the treatment of persecutory delusions
The concomitants of conspiracy concerns
Effects of cognitive behaviour therapy for worry on persecutory delusions (WIT)
Targeting recovery in persistent persecutory delusions
Advances in understanding and treating persecutory delusions
Height, social comparison, and paranoia: an immersive virtual reality experimental study
Key publications
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Automated virtual reality (VR) therapy (gameChange) treating agoraphobic avoidance and distress in patients with psychosis: a multicentre, parallel group, single-blind, randomised controlled trial in England with mediation and moderation analyses
FREEMAN D. and FREEMAN D., (2022), Lancet Psychiatry
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The psychological treatment of persistent persecutory delusions: an explanatory randomized controlled trial comparing a new theoretically-driven psychological treatment (Feeling Safe Programme) to befriending
FREEMAN D., (2021), Lancet Psychiatry
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Reducing COVID-19 vaccine hesitancy: a randomised controlled trial of the effects of different types of vaccination information (Oxford Coronavirus Explanations, Attitudes, and Narratives Survey (OCEANS) III).
FREEMAN D., (2021), Lancet Public Health
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COVID-19 VACCINE HESITANCY IN THE UK: THE OXFORD CORONAVIRUS EXPLANATIONS, ATTITUDES, AND NARRATIVES SURVEY (OCEANS) II
FREEMAN D., (2020), Psychological Medicine
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Injection fears and COVID-19 vaccine hesitancy
FREEMAN D., (2021), Psychological Medicine
Recent publications
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Theory driven psychological therapy for persecutory delusions: trajectories of patient outcomes.
Jenner L. et al, (2024), Psychol Med, 1 - 9
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Potential research priorities for understanding and treating severe paranoia (persecutory delusions): a priority setting partnership between patients, carers, mental health staff, and researchers.
Sher D. et al, (2024), BMJ Mental Health
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Supporting movement and physical activity in people with psychosis: A qualitative exploration of the carer perspective.
Diamond R. et al, (2024), Int J Soc Psychiatry
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Exploring stigma, shame, and safety behaviours in social anxiety and paranoia amongst people diagnosed with schizophrenia.
Aunjitsakul W. et al, (2024), Behav Cogn Psychother, 1 - 15
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A randomized controlled experiment testing the use of virtual reality to trigger cigarette craving in people who smoke.
Rovira A. et al, (2024), Sci Rep, 14
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Developing an Automated Virtual Reality Therapy for Improving Positive Self-Beliefs and Psychological Well-Being (Phoenix VR Self-Confidence Therapy): Tutorial.
Rosebrock L. et al, (2024), JMIR Serious Games, 12
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A randomised controlled test in virtual reality of the effects on paranoid thoughts of virtual humans' facial animation and expression.
Wei S. et al, (2024), Sci Rep, 14
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Study protocol for an adaptive, multi-arm, multi-stage (MAMS) randomised controlled trial of brief remotely delivered psychosocial interventions for people with serious mental health problems who have experienced a recent suicidal crisis: Remote Approaches to Psychosocial Intervention Delivery (RAPID).
Pyle M. et al, (2024), Trials, 25
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A framework for understanding movement and physical activity in patients diagnosed with psychosis
DIAMOND R., (2024), BMJ Mental Health
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Paranoia: A Journey Into Extreme Mistrust and Anxiety
Freeman D., (2024)
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Understanding and treating persecutory delusions
FREEMAN D., (2024), Schizophrenia Bulletin
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Developing Psychological Treatments for Psychosis
FREEMAN D., (2024), British Journal of Psychiatry
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Daydreaming and grandiose delusions: development of the Qualities of Daydreaming Scale.
Isham L., (2024), Behavioural and Cognitive Psychotherapy
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Visual Attention and Virtual Human Facial Animations in Virtual Reality (VR): An Eye-Tracking Study
Wei S. et al, (2024), Proceedings - 2024 IEEE Conference on Virtual Reality and 3D User Interfaces Abstracts and Workshops, VRW 2024, 891 - 892
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A Randomised Controlled Trial of Automated VR Therapy to Improve Positive Self-Beliefs and Psychological Wellbeing in Young People Diagnosed with Psychosis: Study Protocol for the Phoenix VR Self-Confidence Therapy Trial
FREEMAN D., (2023), BMJ Open
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Explaining paranoia: cognitive and social processes in the occurrence of extreme mistrust.
Freeman D. and Loe BS., (2023), BMJ Ment Health, 26
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Explaining Paranoia
FREEMAN D. and Loe BS., (2023), BMJ Mental Health
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Automated VR therapy for improving positive self-beliefs and psychological wellbeing in young patients with psychosis: a proof of concept evaluation of Phoenix VR self-confidence therapy
FREEMAN D., (2023), Behavioual and Cognitive Psychotherapy
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Testing the combination of Feeling Safe and peer counselling against formulation-based cognitive behaviour therapy to promote psychological wellbeing in people with persecutory delusions: study protocol for a randomized controlled trial (the Feeling Safe-NL Trial).
Tolmeijer E. et al, (2023), Trials, 24
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A psychological framework to understand interpersonal violence by forensic patients with psychosis.
LAMBE S. et al, (2023), British Journal of Psychiatry
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[Recent developments in the modeling and psychological management of persecutory ideation].
Raffard S. et al, (2023), Encephale
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Automated virtual reality cognitive therapy versus virtual reality mental relaxation therapy for the treatment of persistent persecutory delusions in patients with psychosis (THRIVE): a parallel-group, single-blind, randomised controlled trial in England with mediation analyses.
Freeman D. et al, (2023), Lancet Psychiatry
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Measuring dissociation across adolescence and adulthood: Developing the short-form Černis Felt Sense of Anomaly scale (ČEFSA-14)
Cernis E. et al, (2023), Behavioural and Cognitive Psychotherapy
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A targeted psychological treatment for sleep problems in young people at ultra-high risk of psychosis in England (SleepWell): a parallel group, single-blind, randomised controlled feasibility trial.
Waite F. et al, (2023), Lancet Psychiatry
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A randomised controlled test of emotional attributes of a virtual coach within a virtual reality (VR) mental health treatment.
Wei S. et al, (2023), Sci Rep, 13
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AN EARLY CLINICAL PHASE COMPARISON OF AN AUTOMATED VR COGNITIVE THERAPY WITH VR MENTAL RELAXATION THERAPY FOR THE TREATMENT OF PERSISTENT PERSECUTORY DELUSIONS IN PATIENTS DIAGNOSED WITH PSYCHOSIS (THRIVE): A PARALLEL GROUP, SINGLE-BLIND, RANDOMISED CONTROLLED TRIAL IN ENGLAND WITH MEDIATION ANALYSES.
FREEMAN D., (2023), Lancet Psychiatry
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Does treating insomnia with digital cognitive behavioural therapy (Sleepio) mediate improvements in anxiety for those with insomnia and comorbid anxiety? An analysis using individual participant data from two large randomised controlled trials.
Henry AL. et al, (2023), J Affect Disord, 339, 58 - 63
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Measuring dissociation across adolescence and adulthood: Developing the short-form Cernis Felt Sense of Anomaly scale (CEFSA-14)
Černis E. et al, (2023)
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The Difficulties of Grandiose Delusions: Harms, Challenges, and Implications for Treatment Engagement.
Isham L. et al, (2023), Schizophr Bull
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The Oxford Positive Self Scale: psychometric development of an assessment of cognitions associated with psychological well-being
ROSEBROCK L. et al, (2023), Psychological Medicine
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The Oxford Positive Self Scale: psychometric development of an assessment of cognitions associated with psychological well-being
FREEMAN D. et al, (2023), Psychological Medicine
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Breathlessness in a virtual world: An experimental paradigm testing how discrepancy between VR visual gradients and pedal resistance during stationary cycling affects breathlessness perception.
Finnegan SL. et al, (2023), PLoS One, 18
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Developing a virtual reality environment for educational and therapeutic application to investigate psychological reactivity to bullying
Badger JR. et al, (2023), Virtual Reality
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Disentangling the Consequences of Systemic Racism and Clinical Paranoia to Promote Effectiveness of a Cognitive-Behavioral Intervention for Persecutory Delusions in Minoritized Individuals: A Case-Example
Moussa-Tooks AB. et al, (2023), Clinical Case Studies
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UNDERSTANDING THE MEDIATING ROLE OF SLEEP IMPROVEMENT ON ANXIETY SYMPTOMS USING DIGITAL CBT FOR INSOMNIA
Henry A. et al, (2023), SLEEP, 46
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Nightmares and psychiatric symptoms: A systematic review of longitudinal, experimental, and clinical trial studies.
Sheaves B. et al, (2022), Clin Psychol Rev, 100
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Agoraphobic avoidance in patients with psychosis: Severity and response to automated VR therapy in a secondary analysis of a randomised controlled clinical trial.
Freeman D. et al, (2022), Schizophr Res, 250, 50 - 59
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Estimating the Economic Value of Automated Virtual Reality Cognitive Therapy for Treating Agoraphobic Avoidance in Patients With Psychosis: Findings From the gameChange Randomized Controlled Clinical Trial
Altunkaya J. et al, (2022), Journal of Medical Internet Research
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A Safe Place to Learn: A Peer Research Qualitative Investigation of Automated Virtual Reality Cognitive Therapy (gameChange).
WAITE F. et al, (2022), JMIR Serious Games
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Psychotic experiences and negative symptoms from adolescence to emerging adulthood: developmental trajectories and associations with polygenic scores and childhood characteristics.
Havers L. et al, (2022), Psychol Med, 1 - 13
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The physical activity profiles of patients with persecutory delusions
Diamond R. et al, (2022), Mental Health and Physical Activity, 23
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COVID-19 Vaccine Hesitancy in Australian Patients with Solid Organ Cancers
Bain N. et al, (2022), Vaccines, 10, 1373 - 1373
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A life more ordinary: A peer research method qualitative study of the Feeling Safe Programme for persecutory delusions.
Bond J. et al, (2022), Psychol Psychother
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Heritability of Psychotic Experiences in Adolescents and Interaction With Environmental Risk.
Taylor MJ. et al, (2022), JAMA Psychiatry
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Identifying potential mechanisms between childhood trauma and the psychological response to the COVID-19 pandemic in Germany: a longitudinal study.
Rek SV. et al, (2022), Sci Rep, 12
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Listening to and believing derogatory and threatening voices
SHEAVES B. et al, (2022), Schizophrenia Bulletin
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CBT-I protocols for insomnia co-morbid with other mental disorders
Hertenstein E. et al, (2022), Cognitive-Behavioural Therapy for Insomnia (CBT-I) Across the Life Span: Guidelines and Clinical Protocols for Health Professionals, 151 - 160
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Bridging the Digital Divide in Psychological Therapies: Observational Study of Engagement With the SlowMo Mobile App for Paranoia in Psychosis
Hardy A. et al, (2022), JMIR Human Factors, 9, e29725 - e29725
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The meaning in grandiose delusions: measure development and cohort studies in clinical psychosis and non-clinical general population groups in the UK.
Isham L. et al, (2022), Lancet Psychiatry
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The meaning in grandiose delusions: measure development and cohort studies in clinical psychosis and non-clinical general population groups in the UK.
Isham L. and FREEMAN D., (2022), Lancet Psychiatry
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The Disease Influenced Vaccine Acceptance Scale-Six (DIVAS-6): Validation of a Measure to Assess Disease-Related COVID-19 Vaccine Attitudes and Concerns
Grech L. et al, (2022), Behavioral Medicine, 1 - 10
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Serious Underlying Medical Conditions and COVID-19 Vaccine Hesitancy: A Large Cross-Sectional Analysis from Australia.
Day D. et al, (2022), Vaccines (Basel), 10
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The service user experience of SlowMo therapy: A co-produced thematic analysis of service users' subjective experience.
Greenwood KE. et al, (2022), Psychol Psychother
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Automated Virtual Reality Cognitive Therapy (gameChange) in Inpatient Psychiatric Wards: Qualitative Study of Staff and Patient Views Using an Implementation Framework (Preprint)
Brown P. et al, (2022)
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Automated Virtual Reality Cognitive Therapy (gameChange) in Inpatient Psychiatric Wards: Qualitative Study of Staff and Patient Views Using an Implementation Framework.
Brown P. et al, (2022), JMIR Form Res, 6
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Body image concerns in patients with persecutory delusions
WAITE F. et al, (2022), Psychological Medicine
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VIRTUAL REALITY (VR) THERAPY FOR PATIENTS WITH PSYCHOSIS: SATISFACTION AND SIDE EFFECTS
FREEMAN D. et al, (2022), Psychological Medicine
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Psychological mechanisms connected to dissociation: Generating hypotheses using network analyses: Psychological mechanisms of dissociation
Černis E. et al, (2022), Journal of Psychiatric Research, 148, 165 - 173
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Automated virtual reality (VR) therapy (gameChange) treating agoraphobic avoidance and distress in patients with psychosis: a multicentre, parallel group, single-blind, randomised controlled trial in England with mediation and moderation analyses
FREEMAN D. and FREEMAN D., (2022), Lancet Psychiatry
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"It seems impossible that it's been made so quickly": a qualitative investigation of concerns about the speed of COVID-19 vaccine development and how these may be overcome.
Brown P. et al, (2022), Human vaccines & immunotherapeutics, 1 - 8
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Understanding agoraphobic avoidance: the development of the Oxford Cognitions and Defences Questionnaire (O-CDQ).
Rosebrock L. et al, (2022), Behavioural and cognitive psychotherapy, 1 - 12
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The journey of adolescent paranoia: A qualitative study with patients attending child and adolescent mental health services.
Bird JC. et al, (2022), Psychol Psychother
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The psychological journey of weight gain in psychosis.
Waite F. et al, (2022), Psychol Psychother
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COVID-19 vaccination rates, intent, and hesitancy in patients with solid organ and blood cancers: A multicenter study.
Nguyen M. et al, (2022), Asia Pac J Clin Oncol
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SlowMo therapy, a new digital blended therapy for fear of harm from others: An account of therapy personalisation within a targeted intervention.
Ward T. et al, (2022), Psychol Psychother
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A validation study to trigger nicotine craving in virtual reality
Yu CJ. et al, (2022), Proceedings - 2022 IEEE Conference on Virtual Reality and 3D User Interfaces Abstracts and Workshops, VRW 2022, 868 - 869
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The Latent Structure of Negative Symptoms in the General Population in Adolescence and Emerging Adulthood.
Havers L. et al, (2022), Schizophr Bull Open, 3
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What moderates CBT for insomnia? Findings from a participant-level analysis of 8,549 individuals in 12 randomised controlled trials of digital CBT (Sleepio)
Miller C. et al, (2022), JOURNAL OF SLEEP RESEARCH, 31
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Why conspiracy theorists are not always paranoid: Conspiracy theories and paranoia form separate factors with distinct psychological predictors.
Alsuhibani A. et al, (2022), PLoS One, 17
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Self-observation of a virtual body-double engaged in social interaction reduces persecutory thoughts.
Gorisse G. et al, (2021), Sci Rep, 11
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Dissociation in patients with non-affective psychosis: prevalence, symptom associations, and maintenance factors
Cernis E. et al, (2021), Schizophrenia Research
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Associations Between the Subdomains of Negative Symptoms in the General Population and Genome-Wide Polygenic Scores for Major Depressive Disorder and Schizophrenia
Havers L. et al, (2021), BEHAVIOR GENETICS, 51, 709 - 709
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The impact of Patient and Public Involvement in the SlowMo study: Reflections on peer innovation.
Greenwood K. et al, (2021), Health Expect
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Willingness of children and adolescents to have a COVID-19 vaccination: results of a large whole schools survey in England
FAZEL M. et al, (2021), E Clinical Medicine
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The COVID-19 Pandemic Mental Health Questionnaire (CoPaQ): psychometric evaluation and compliance with countermeasures in psychiatric inpatients and non-clinical individuals.
Rek SV. et al, (2021), BMC Psychiatry, 21
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Appraisal of patient-level health economic models of severe mental illness: systematic review
Altunkaya J. et al, (2021), The British Journal of Psychiatry, 1 - 12
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Digitally supported CBT to reduce paranoia and improve reasoning for people with schizophrenia-spectrum psychosis: the SlowMo RCT
Garety P. et al, (2021), Efficacy and Mechanism Evaluation, 8, 1 - 90
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Differential psychological response to the COVID-19 pandemic in psychiatric inpatients compared to a non-clinical population from Germany.
Rek SV. et al, (2021), Eur Arch Psychiatry Clin Neurosci
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Does raising heart rate prior to a behavioural test enhance learning in cognitive therapy for anxiety? An experimental test for the treatment of fear of heights using virtual reality.
McInerney J. et al, (2021), Behav Res Ther, 144
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Injection fears and COVID-19 vaccine hesitancy
FREEMAN D., (2021), Psychological Medicine
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A compassionate imagery intervention for patients with persecutory delusions.
Forkert A. et al, (2021), Behav Cogn Psychother, 1 - 13
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Bridging the Digital Divide in Psychological Therapies: Observational Study of Engagement With the SlowMo Mobile App for Paranoia in Psychosis (Preprint)
Hardy A. et al, (2021)
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Reducing COVID-19 vaccine hesitancy: a randomised controlled trial of the effects of different types of vaccination information (Oxford Coronavirus Explanations, Attitudes, and Narratives Survey (OCEANS) III).
FREEMAN D., (2021), Lancet Public Health
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COVID-19 vaccines, hesitancy and mental health.
Smith K. et al, (2021), Evid Based Ment Health
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The psychological treatment of persistent persecutory delusions: an explanatory randomized controlled trial comparing a new theoretically-driven psychological treatment (Feeling Safe Programme) to befriending
FREEMAN D., (2021), Lancet Psychiatry
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Effects of SlowMo, a Blended Digital Therapy Targeting Reasoning, on Paranoia Among People With Psychosis: A Randomized Clinical Trial.
Garety P. et al, (2021), JAMA Psychiatry
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Coronavirus conspiracy beliefs in the German-speaking general population: Endorsement rates and links to reasoning biases and paranoia.
Kuhn SAK. et al, (2021), Psychol Med, 1 - 33
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Participatory design to create a VR therapy for psychosis
Knight I. et al, (2021), Design for Health, 1 - 22
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A new perspective and assessment measure for common dissociative experiences: ‘Felt Sense of Anomaly’
Cernis E. et al, (2021), PLoS One
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Catastrophic Cognitions about Coronavirus: The Oxford Psychological Investigation of Coronavirus Questionnaire [TOPIC-Q].
Rosebrock L. et al, (2021), Psychol Med, 1 - 34
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Immersive virtual reality and digital applied gaming interventions for the treatment of mental health problems in children and young people: The need for rigorous treatment development and clinical evaluation
CRESWELL C. et al, (2021), Journal of Child Psychology and Psychiatry
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Paranoia in patients attending child and adolescent mental health services.
Bird JC. et al, (2021), Aust N Z J Psychiatry
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Excessive sleepiness in patients with psychosis: An initial investigation.
Reeve S. et al, (2021), PLoS One, 16
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Online Social Endorsement and Covid-19 Vaccine Hesitancy in the United Kingdom
Chadwick A. et al, (2021), Social Media and Society, 7
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Paranoia and Grandiosity in the General Population: Differential Associations With Putative Causal Factors.
Sheffield JM. et al, (2021), Front Psychiatry, 12
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Psychological intervention, antipsychotic medication or a combined treatment for adolescents with a first episode of psychosis: the MAPS feasibility three-arm RCT.
Morrison AP. et al, (2021), Health Technol Assess, 25, 1 - 124
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Psychotic-Like Experiences in Adolescence Occurring in Combination or Isolation: Associations with Schizophrenia Risk Factors.
Cardno AG. et al, (2021), Psychiatr Res Clin Pract, 3, 67 - 75
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Anticipatory pleasure in current psychosis: Cognitive and emotional correlates.
Rosebrock LE. et al, (2020), Psychiatry Res, 297
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COVID-19 VACCINE HESITANCY IN THE UK: THE OXFORD CORONAVIRUS EXPLANATIONS, ATTITUDES, AND NARRATIVES SURVEY (OCEANS) II
FREEMAN D., (2020), Psychological Medicine
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Cognitive appraisals of dissociation in psychosis: A brief new measure
CERNIS E. et al, (2020), Behavioural and Cognitive Psychotherapy