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The Oxford Cognitive Approaches to Psychosis (O-CAP) research group, set up in 2011 by Prof Daniel Freeman, is one of the largest clinical psychology research teams in the world. We work to understand why mental health problems happen and how they can be best treated. Notable achievements include the development of the most effective psychological therapy for persecutory delusions, the Feeling Safe programme, and the pioneering of automated psychological treatment delivered in virtual reality (VR). 



Our team comprises clinical psychologists, computer scientists, clinical trial co-ordinators, 3D artists, programmers, research assistants, DPhil students, trainee clinical psychologists, and administrative support.

Drawing on a variety of approaches, including epidemiological studies, qualitative interviews, psychological experiments, and clinical trials, we use our theoretical knowledge to develop carefully tested treatments that will truly make a difference. We ensure patients with lived experience fully influence our work.

We have conducted new research showing the importance of sleep problems, worry, low self-confidence, reasoning biases, and defence behaviours to the occurrence of paranoia. When we treat these problems, paranoia lessens. The Feeling Safe Programme is a 20-session therapy that combines all this work.

We have pioneered the use of virtual reality (VR) in the assessment, understanding, and treatment of mental health conditions. gameChange, a ground-breaking VR treatment for people with persecutory delusions, is now being used in mental health services in the UK and USA. Development of gameChange was supported by the inaugural National Institute for Health and Care Research (NIHR) Invention for Innovation Mental Health Challenge Award.

Our current work includes producing a more accessible version of the landmark Feeling Safe programme (Feeling Safer); conducting a clinical trial of our new automated VR therapy for young patients with psychosis (Phoenix); developing and testing a new automated VR therapy for needle fears; running a large multi-centre clinical trial testing the effects of treating sleep difficulties in patients with psychosis (Sleeping Better); testing brief psychological interventions for patients in crisis (RAPID); and carrying out new psychological studies of paranoia, grandiose delusions, and hallucinations.

Alongside these clinical interventions, we are committed to making our research - and especially therapeutic techniques - available to the widest possible audience, with several books for the general reader published and more in preparation.

We are also committed to helping develop a new generation of researchers and clinicians. In the past ten years, over twenty-five of our research assistants have gone on to clinical psychology training. We have a number of clinicians carrying out DPhil fellowships.

Our work is supported by the National Institute for Health and Care Research (NIHR), the Wellcome Trust, Medical Research Council (MRC), International Foundation (IF), and the Beryl Alexander charity.



Paranoid Thoughts website

Follow Daniel Freeman on Twitter


BBC Radio 4 Series: A History of Delusions 

Feeling Safe Illustration Module




Assessment Tools

Assessment tools and measures developed by the O-CAP team and available for download.


Upcoming workshops facilitated by members of the O-CAP team.