Lisa Murray, Nurse Researcher with the Royal Marsden NHS Foundation Trust and member of the SafeSpace study team led by Professor Theresa Wiseman, tells us about this innovative virtual reality intervention study with the potential to benefit people living with and beyond cancer. SafeSpace is being featured at the 2019 NCRI and NHS England Living With and Beyond conference.

Many people living with and beyond cancer (LWBC) experience poor psychological wellbeing including increased levels of stress, anxiety, depression, guilt, anger, shame and other unwanted emotional states. Apart from being unpleasant, these states can contribute to poor engagement with therapy, poor lifestyle choices and a worsening of important relationships.

Co-designed health intervention

Experience based co-design (EBCD) is an approach for engaging all key stakeholders in the identification and the co-design of services and/or care pathways. It places an importance on working in partnership with service users to identify their priorities and solutions for service improvement as often these are very different to those of the service and staff working within it.

The SafeSpace study is a one-year study, funded by Macmillan Cancer Support, which seeks to use an adapted form of EBCD to co-design with people living with and beyond cancer a low cost, quality controlled and self-managed psychological health intervention.

Cultivating self-compassion

In addition to being able to enter and immerse themselves in high quality peaceful, calm environments, people with cancer will be able to access a series of guided exercises to help them cultivate and experience self-compassion, which is known to be associated with several therapeutic effects, helping them to rapidly relax and de-stress, while experiencing improved psychological wellbeing and self-compassion.

Study development

During the first phase of this study we ran an initial event to determine when and how this wellbeing intervention might be used along the cancer pathway. This was followed by four user-testing workshops at which participants were asked to test the VR experience and give feedback at each iteration of the design process.

The SafeSpace experience has now been developed and consists of three separate VR sessions which last approximately 10-12 minutes each. The user will be able to select from three VR environments: mountain, forest or beach. Once in the virtual environment, the user will listen to an audio recording which guides them through a series of exercises. Based on the feedback during the co-design, the user will hear a different, professionally recorded audio each time they use the experience, during which the concept and focus on compassion will be gradually developed. The aim of this is to introduce the concept of compassion to self gradually and help them orientate to this new way of thinking about themselves.

In phase 2, we will evaluate the feasibility and acceptability of using the SafeSpace intervention in the clinical setting and collect preliminary data to assess psychological and physiological effects of the experience. To achieve this, we plan to recruit 20 people who are undergoing cancer treatment into the study. Each participant will receive the three sessions of the SafeSpace study with each session being delivered separately.

Potential impact

The potential impact of this project could be significant – helping to reduce suffering and improve compliance during cancer treatment, as well as improving wellbeing, resilience and quality of life generally and at specific points along the cancer patient journey. General engagement with life, ability to cope with uncertainty and self-management skills may also be improved.

The team

The SafeSpace study is led by Professor Theresa Wiseman (Lead for Health Services Research), Lisa Murray and Geraldine O’Gara (Nurse Researchers) at the Royal Marsden NHS Foundation Trust. The study team also includes the following experts: Dr Andrew Macquarrie and Professor Anthony Steed (virtual environments and computer graphics), University College London; Professor Paul Gilbert (compassion focussed Therapy), University of Derby and Dr Tim Anstiss (psychological behaviour change therapies).

Further information

For more information about SafeSpace visit the Macmillan Cancer Support funded research site and find the study on the NCRI Portfolio Maps (‘Psychosocial Oncology and Survivorship’ area, Map A).