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Research Shows Using ProReal Helps Reduce Psychological Distress

12 September 2016

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In January 2015 ProReal Ltd was awarded a Phase 2 contract by NHS England’s Small Business Research Initiative Healthcare to evaluate the use of ProReal software with young people.  Professor Mick Cooper (Counselling Psychology, University of Roehampton, London) lead this research; Mick is an internationally recognised authority in the field of counselling and psychotherapy and a chartered psychologist and has led a range of research studies into school-based counselling.

Mick’s team have now released the findings of their evaluation – click here to read the university’s press release.

Project challenges

The project was complex; it required recruitment and consents across multiple schools, there were dependencies with the development of new technology and constraints on both the project duration and budget.

“I was determined to get a good sample size for this research, and to do the best job we could for the young people was paramount.” explains Eileen Peters who project managed both SBRI Healthcare projects. “With the support of SBRI and the schools, we continued into a second school term and were therefore able to include 54 young people in this study as opposed to 30. We’re extremely proud of this achievement and grateful to everyone who worked so hard to make this happen.”

The school environment is complex from an IT perspective too. David Littlewood, Technical Lead at ProReal explains “The development of a new version of the software which does not rely on an internet connection was really important, as was phasing the development work so that we could complete the research on time.”  This new version (V3.1) of ProReal is now commercially available.

Introducing our Avatar Consultants

Co-creation with end users is at the heart of our product development strategy in all our work across healthcare and corporate.  As well as the feedback from the young people involved in the study we worked with an experienced ex-teacher to design and hold workshops with young people at Bramhall High School in Stockport. This was informed by early user workshops with Action for Children and Oxford Health.  All these young people are part of a growing community of Avatar Consultants – a group of YP from across the country who provide input into the design and functionality of the software who enjoy knowing that their input is being listened to and considered.

Economic Impact

Based on our work in corporate coaching and in charity counselling settings, where remote and online working is more common, ProReal has shown to provide cost reductions of between 30-40%.  Our early-stage clinical work and Phase 2 findings identify potential for significant cost saving, based on acceleration of treatment outcomes and increased engagement from young people, particularly young males. We are continuing to explore these potential savings with clinicians and health economists.

Collaboration and partnerships

Throughout the project there was a strong sense of determination and collaboration between everyone involved and although it would take a long time to list everyone who participated we would like to say particular thanks to:

  • The students who took part in our study, pilot & user-workshops
  • Professor Chris Hollis, Dr Caroline Falconer and Dr Jen Martin – NIHR MindTech HTC
  • Dr Anne Blackwood, Joop Tanis, Chris Armstrong – Health Enterprise East and SBRI Healthcare
  • Professor Mick Cooper and Dr Evi Chryssaffidou – University of Roehampton
  • Dr Biljana van Rijn, Peter Pearce, Sarah Osman and the Align school counsellors from Metanoia Institute
  • Sarah Golden and Fiona Pienaar and the school counsellors from Place2Be
  • The head teachers and pastoral care teams from the 8 schools who helped make this happen
  • Bramhall High School and their students who participated in our user-workshops
  • Maureen Nuttall and the young carers at Action for Children
  • Professor Paul Stallard, the clinicians and the young service-users at Oxford Health

We’ve created a film which summarises the evaluation design and findings and includes a review of a session between counsellor and client:

Watch a recording of the live, online demonstration here.

Our future research focus

A research collaboration team has been established to steer pilot research in which ProReal will be used as an adjunct to existing treatments for depression/anxiety/emotional difficulties in Bethlam SLAM and Oxford Health in late 2016. The team includes Professor Chris Hollis and Dr Caroline Falconer (NIHR MindTech HTC), Dr Paul Moran (University of Bristol) and Professor Paul Stallard (Oxford Health).  We are also preparing for several other pilots in St Mary’s SARC (Manchester) and are working with NIHR MindTech HTC on an Emotional Resilience pilot with university students in late 2016.

If you’d like to know more about our SBRI Phase 2 ‘Avatar Therapy for Young People’ project or have any other questions, please contact us at

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