| Summary: | Virtual reality technologies have been utilized in the treatment of psychiatric disorders by offering means to practice
challenging situations in a safe environment. In this narrative description, we illustrate the development of a virtual realitybased intervention rationale to treat paranoid ideations of individuals with psychotic disorders with immersive 360-degree
video material. Using 360-videos with a head-mounted display was judged as an interesting and flexible low-tech solution
compared to other solutions. 360-degree videos were filmed with a head-mounted camera, simulating everyday social
situations which people with paranoid delusions often find threatening. These situations were chosen by a team consisting
of clinicians and an expert by experience and included commuting, grocery shopping as well as walking in a crowded street
or a dark alley. Five weekly sessions with a clinician were included in the treatment protocol, following a treatment manual
and individualized case formulation. The patients were exposed to the simulations using a virtual reality headset. The goals
of the pilot were to evaluate the feasibility of 360-degree videos as an immersive technology and the rationale for using this
technology in an exposure-based psychotherapeutic treatment, as well as to create a detailed description of the development
and materials for treatment for others to follow and use. The intervention was found feasible by the clinicians and was positively
received by the first pilot patients. The only observed disadvantage was nausea and dizziness caused by specific video clips.
360-degree videos were deemed suitable as a material for exposure. As far as we know, 360-degree video technology has not
been previously evaluated in the context of psychotic disorders. The utility of this technology and the content created in
the treatment of paranoid ideation appears promising. Based on this pilot, creating a virtual reality intervention based on
exposure for psychotic disorders is possible without excessive resources and without any specific technical know-how with
360-degree videos. Developing novel forms of treatment using low technology solutions, which are easy to pilot in a day-to-day
clinical environment, may bridge the gap between controlled studies and standard practice. The process of development and
implementation is carefully laid out so this paper can be used as a guide for the development of similar protocols
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