Exploring how extended reality could support mental health recovery

Many mental health interventions focus on helping people identify early warning signs that may indicate a decline in wellbeing or an increased risk of relapse.

However, once therapy concludes, service users are often left without an engaging way to revisit or maintain this learning. While existing digital versions of relapse prevention exercises improved accessibility by enabling remote sessions, they also introduced new challenges around engagement, attention, and emotional connection.

The project set out to explore whether extended reality could bridge this gap by creating a more immersive and memorable experience while maintaining the therapeutic value of the original intervention.

The question was not whether XR was technically possible, but whether it could genuinely improve outcomes for service users and healthcare professionals.

The project was based on an established relapse prevention exercise originally developed by James Plaistow and later digitised by Dr Fergus Kane. The exercise helps service users identify, organise, and understand the feelings, behaviours, and symptoms that may indicate deteriorating mental health.

Animorph's XR concept sought to build upon this foundation by introducing several new capabilities, including:

• More immersive and engaging interactions
• Visual representations of feelings and symptoms
• Symptom mapping across timelines
• Easier updating and sharing of warning signs
• Improved retention of therapeutic learning

Importantly, the project was designed to complement existing therapeutic practices rather than replace them.

Our first objective was understanding whether an XR solution was both desirable and practical.

We conducted user interviews with two primary audiences: service users and mental health professionals. These conversations helped us understand existing challenges, identify potential risks, and validate assumptions about how XR might fit into therapeutic settings.

Several key insights emerged.

Participants felt that the exercise could sometimes be emotionally triggering, making it important that any immersive solution allowed users to remain grounded and connected to their physical surroundings. This led to a preference for mixed reality rather than fully immersive virtual reality experiences.

We also discovered that while some scepticism around XR technology existed, both service users and providers were open to exploring its potential benefits. Participants consistently highlighted the importance of collaboration, accessibility, physical interaction, and producing a shareable output from the session.

These findings helped shape the design direction for subsequent prototypes.

Following the research phase, we worked closely with Animorph to prioritise improvements and prepare the prototype for usability testing.

We conducted multiple rounds of testing, beginning with early-stage sessions and progressing towards evaluations with mental health professionals and service users. The testing focused on three core areas:

• Selecting and organising symptoms
• Creating visual representations of symptoms
• Mapping symptoms onto timelines

The sessions generated valuable feedback around usability, emotional impact, and overall effectiveness. While some participants found aspects of the experience challenging or emotionally triggering, feedback suggested the concept showed promise and warranted further exploration. Notably, participants remained willing to engage with the experience again despite some of the limitations associated with an early-stage prototype.

The project was ultimately designed as a feasibility study rather than a product launch.

Alongside user research and usability testing, we evaluated the broader opportunity for XR-based mental health interventions, identifying key opportunities, risks, and considerations for future development.

Throughout the process, we remained focused on a central question: could XR provide meaningful therapeutic value beyond novelty?

The findings helped establish a clearer understanding of where immersive technologies might support mental health services and where further evidence, research, and development would be required.

The Staying Well XR project successfully demonstrated how user-centred research can be used to evaluate emerging technologies within highly sensitive healthcare contexts.

The research validated several assumptions around engagement, accessibility, and the potential value of mixed reality experiences, while also highlighting important considerations around safety, emotional wellbeing, and implementation within clinical settings.

Most importantly, the project provided a structured evidence base that could inform future investment, development, and research into XR-supported mental health interventions.

Rather than asking what technology could do, the project focused on what people genuinely needed, ensuring future development remains grounded in therapeutic value rather than technical possibility alone.