| Čoahkkáigeassu: | This paper describes how participatory design was employed in the design of an automated Virtual Reality (VR) psychological therapy (gameChange), putting people with lived experience of psychosis at the heart of the process. Solutions to complex challenges invariably need to include the expertise and ideas of specialists from a broad variety of disciplines and experiences. The design of gameChange relied on the insights of clinical psychologists, programmers, animators, designers, product managers, producers, writers, researchers, 3 D artists, mental health advocates, and people with lived experience of psychosis. This involved a considerable diversity of working cultures, professional disciplines, and vocabulary. A transdisciplinary, participatory design process was established during the project. It allowed for rapid iteration, meaningful input from people with lived experience of psychosis, and delivered a VR psychological therapy with robust cognitive therapeutic principles. The structures put in place to support the different disciplines working together on the design, particularly people with lived experience of psychosis, are detailed in this paper, with examples of how decisions were made and their outcomes. The clinical effectiveness of the gameChange VR therapy is now being tested in a randomized controlled trial with several hundred patients with psychosis. <a href=https://gamechangevr.com/intro_video/ target="_blank">https://gamechangevr.com/intro_video/</a>
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