A method for conducting digital cognitive behavioural therapy

Abstract

A method for conducting digital cognitive behavioural therapy is disclosed. The method involves displaying a virtual interactive setting on the interface of both a therapist's and patient's computing device. The interactive virtual setting represents a real-world scenario designed to trigger an existing phobia or anxiety disorder in the patient. The therapist's interface includes controls that allow them to make changes to the virtual setting to continuously expose the patient to triggering scenarios in a form of exposure therapy contained in a controlled environment.

Description

[0001] A Method for Conducting Digital Cognitive Behavioural Therapy

[0002] Background to the Invention

[0003] The present invention relates to a method for conducting digital cognitive behavioural therapy (CBT) and relates particularly, but not exclusively, to an enhanced form of phobia treatment using CBT delivered by a therapist to a patient using interactive computerised software .

[0004] CBT is a talking therapy used to treat various anxiety disorders , depression and a range of other mental health conditions including phobias . Treating phobias with CBT involves a form of exposure therapy, wherein the therapist accompanies the patient into the environment which triggers the phobia and gradually increases the challenge to the patient . For example, if the patient has a phobia of heights , the therapist may accompany the patient into a tall building and expose them to incrementally increasing heights as they climb to higher floors .

[0005] However, as this form of therapy takes place in uncontrolled environments in the real world, the therapist is unable to control many aspects of the session which may be harmful to the patient . In the above example, the therapist has no control over how many people are in the building, how loud it is or who they may interact with during the session . The patient could have an adverse reaction to an unexpected occurrence and become overstimulated or overwhelmed, negatively affecting their progress . Furthermore, this involves significantly more time for the therapist finding suitable potentially triggering environments .

[0006] Consequently, some therapists attempt to conduct this form of CBT in a controlled environment, such as the therapist' s office or the patient' s home, using video clips or animations to recreate the triggering environment . However, this methodis less effective as it does not create a sufficiently immersive experience for the patient to build up resilience to the triggering environment . As a result, the patient may need a large number of sessions to achieve the desired result, which can be expensive and time consuming .

[0007] Preferred embodiments of the present invention seek to overcome or alleviate the above-described disadvantages of the prior art .

[0008] Summary of the Invention

[0009] According to an aspect of the present invention there is provided a method of conducting a digital cognitive behavioural therapy session, comprising the steps :

[0010] hosting on a first server setting data relating to an interactive virtual setting;

[0011] sending said setting data to first and second computing devices for displaying on respective first and second interfaces thereof , said first computing device being used by a therapist and said second computing device being used by a patient, wherein said interactive virtual setting represents a real-world scenario designed to trigger a change in the emotional state of said patient;

[0012] hosting on a second server first and second control data relating to respective first and second controls;

[0013] sending said first control data to said first computing device for displaying said first controls on said first interface, said first controls being used by said therapist to control said interactive virtual setting; and

[0014] sending said second control data to said second computing device for displaying said second controls on said second interface, said second controls being different to said first controls .CBT sessions according to the present invention are conducted in a controlled environment with both the therapist and patient using connected computing devices . A virtual, interactive, three-dimensional setting is displayed on each of the computing device interfaces . The virtual setting represents an environment designed to trigger an existing phobia or anxiety disorder of the patient . For example, if the patient has a phobia of heights, the virtual setting may represent the viewpoint of a person peering over balconies as they climb to higher floors of a tall building . Importantly, the controls on the therapist' s interface give the therapist full control over the virtual environment . In this example, the therapist would be able to control how high the person climbs , how quickly they climb (returning to lower floors if necessary) , and how close to the edge of the balcony they get . The therapist would also be able to ensure that the virtual setting is designed such that the environment inside of the building does not negatively impact the patient . In doing so, the patient is exposed to a triggering environment in a form of exposure therapy designed to increase their resilience to an equivalent environment in the real world, with the aim of overcoming or lessening their phobia or anxiety disorder .

[0015] As the sessions take place in a controlled environment such as the therapist' s office or the patient' s home, the patient is safe from occurrences in the real world that may be overwhelming or detrimental to their progress . Furthermore, as the virtual setting is interactive, it offers a more immersive experience to the patient that is more representative of the equivalent real-world scenario compared to a video recording or animation . Using the displayed controls, the therapist is able to precisely control aspects of the session, meaning the patient' s safety and comfort is prioritised while still exposing them to an appropriate challenge from the triggering environment .Having the data for the interactive virtual setting and both sets of controls hosted on external servers increases the accessibility of the therapy as it allows the sessions to be carried out in a web browser . As a result, any device with a browser and internet connection can be used to deliver or receive the therapy, meaning that there is no requirement for specialised software and the patient is able to use their own device, for example from their own home .

[0016] The method may further comprise :

[0017] hosting second control data relating to said second controls on a said second server; and

[0018] sending said second control data to said second computing device for displaying said second controls on said second interface, said second controls being different to said first controls .

[0019] By having the controls on the patient' s interface that do not allow them to carry out the changes allowed by the therapist in the virtual environment, the advantage is provided that the appropriate level of control can be provided to the patient enabling them to feel empowered but while enabling the therapist to facilitate the therapeutic session .

[0020] In a preferred embodiment, said first and second computing devices are connected to said first and second servers via an internet connection .

[0021] Having the computing devices connected via an internet connection would allow the therapy sessions to be conducted remotely, for example with the patient in their own home and the therapist in their office . This makes the invention more accessible in cases where the patient is unable to travel or feels more comfortable receiving therapy at home .

[0022] Having both the therapist' s and patient' s computing devices connected to each other allows their displays to be synchronised . Having synchronised displays when the patient isimmersed in the virtual setting during a therapy session is necessary in order for the therapist to be aware of what the patient is experiencing in real-time, helping them to maintain full control of the environment and, if necessary, to make quick changes to the challenge that the patient is exposed to .

[0023] In a further preferred embodiment, said first and second computing devices further comprise microphones , speakers and cameras to allow communication between said therapist and said patient during the therapy session.

[0024] In cases where the therapy is conducted remotely, or when the patient is in a different room to the therapist, for example the treatment room of the therapist' s office, it is necessary for the therapist and patient to be able to communicate with each other . A microphone and speaker (or headset ) would allow the two users to speak to and hear each other, and the addition of a camera would allow them to see each other during the remote session . While this may help the patient to feel more comfortable, it is also useful for the therapist to observe the patient' s reactions and emotional state during the session.

[0025] In a preferred embodiment, said first controls further comprise buttons pressable by said therapist to pause or end the therapy session.

[0026] It is important for the therapist to have the ability to quickly stop the immersive experience or otherwise end the session in cases where the patient becomes overwhelmed, or where it is clear that further exposure to the virtual setting will not help the patient or may even be harmful to them.

[0027] In another preferred embodiment, said second controls further comprise a scale for said patient to indicate changes in their emotional state throughout the therapy session, said changes being displayed on said first and second interfaces .In an additional preferred embodiment, said emotional state is a level of anxiety.

[0028] During a session, the therapist must be able to monitor how changes in the virtual setting, particularly increases in the level of challenge, affect the patient' s emotional state . As phobias are an anxiety disorder and the aim of such therapy is to reduce the level of anxiety felt by the patient in response to the triggering environment, having the patient able to quantify their own level of anxiety on a scale viewable by the therapist is a convenient tool allowing the therapist to monitor progress between sessions, but also make changes to the virtual setting within a session if the patient' s anxiety becomes too high or too low.

[0029] In a further preferred embodiment, said second controls further comprise a button pressable by said patient to indicate that assistance is required from said therapist .

[0030] There may be instances during a session where the patient requires assistance or attention from the therapist, but they may be unable to verbalise the request, and they may not be under a degree of distress that warrants ending the session. It is therefore important for the patient to have a means of quickly requesting assistance or attention from the therapist by pressing a button .

[0031] In a preferred embodiment, said second controls further comprise a button pressable by said patient to indicate that they require said therapist to pause or end the therapy session.

[0032] It is also important for the patient to have the ability to signal to the therapist that they require the session to be paused or brought to an immediate end, for example if they have become overwhelmed or are under an unacceptable level of distress .According to another aspect of the present invention, there is provided a method for conducting a digital cognitive behavioural therapy session, comprising the steps : displaying an interactive virtual setting on a first interface, said first interface being part of a first computing device, said first interface additionally displaying a first set of controls for a therapist to control said interactive virtual setting, said interactive virtual setting representing a real-world scenario designed to trigger a change in the emotional state of a patient; and

[0033] displaying to said patient said interactive virtual setting on a second interface, said second interface being part of a second computing device connected to said first computing device .

[0034] In a preferred embodiment, said second interface additionally displaying a second set of controls for said patient wherein said second controls are different to said first controls .

[0035] In a preferred embodiment, setting data relating to said interactive virtual setting is hosted on a first server and received by said first and second computing devices during the therapy session.

[0036] In another preferred embodiment, first and second control data relating to respective first and second controls is hosted on a second server and received by first and second computing devices during the therapy session.

[0037] In an additional preferred embodiment, said second controls further comprise a scale for said patient to indicate changes in their emotional state throughout the therapy session, wherein said changes are displayed on said first and second interfaces .

[0038] In a further preferred embodiment, said emotional state is a level of anxiety.In a preferred embodiment, said second controls further comprise a button pressable by said patient to indicate that assistance is required from said therapist .

[0039] In another preferred embodiment, said second controls further comprise a button pressable by said patient to indicate that they require said therapist to pause or end the therapy session .

[0040] According to a further aspect of the present invention, there is provided a computer program for conducting a digital cognitive behavioural therapy session, comprising :

[0041] first computer code for hosting on a first server setting data relating to an interactive virtual setting;

[0042] second computer code for sending said setting data to first and second computing devices for displaying on respective first and second interfaces thereof, said first computing device being used by a therapist and said second computing device being used by a patient, wherein said interactive virtual setting represents a real-world scenario designed to trigger a change in the emotional state of said patient;

[0043] third computer code for hosting on a second server first control data relating to first controls;

[0044] fourth computer code for sending said first control data to said first computing device for displaying said first controls on said first interface, said first controls being used by said therapist to control said interactive virtual setting .

[0045] The program may further comprise fifth computer code for sending said second control data to said second computing device for displaying said second controls on said second interface, said second controls being different to said first controls .

[0046] In a preferred embodiment the first and second computing devices are connected to said first and second servers via an internet connection .In another preferred embodiment the first and second computing devices further comprise microphones , speakers and cameras to allow communication between said therapist and said patient during the therapy session.

[0047] In a further preferred embodiment the first controls further comprise buttons pressable by said therapist to pause or end the therapy session.

[0048] The second controls may further comprise a scale for said patient to indicate changes in their emotional state throughout the therapy session, wherein said changes are displayed on said first and second interfaces .

[0049] In a preferred embodiment the emotional state is a level of anxiety.

[0050] In another preferred embodiment the second controls further comprise a button pressable by said patient to indicate that assistance is required from said therapist .

[0051] In a further preferred embodiment the second controls further comprise a button pressable by said patient to indicate that they require said therapist to pause or end the therapy session .

[0052] The program may further comprise sixth computer code for hosting on a third server on a third server call data handling a video call between said first and second computer devices being displayed on said first and second interfaces respectively .

[0053] Brief Description of the Drawings Preferred embodiments of the present invention will now be described, by way of example only, and not in any limitative sense with reference to the accompanying drawings in which: Figure 1 is a schematic representation of an apparatus used in the implementation of the present invention;Figure 2 is a capture of a therapist' s interface during a session of an embodiment of the present invention;

[0054] Figure 3 is a capture of the patient' s interface during a session of the invention of figure 2 ;

[0055] Figure 4 is a flow chart setting out the basic steps of an embodiment of the present invention; and

[0056] Figure 5 is a flow chart showing the interaction between various digital platforms on which an embodiment of the present invention relies .

[0057] Detailed Description of the Invention Referring initially to figure 1, there is provided a system 10 for conducting digital cognitive behavioural therapy (CBT ) . The system comprises a first server 12 for hosting setting data relating to an interactive virtual setting 14 and a second server 16 for hosting first and second control data for respective first controls 18 and second controls 20. The system 10 additionally comprises a first computing device 22 with a first interface 24 and first controls 18 for a therapist . The system 10 further comprises a second computing device 26 with a second interface 28 and second set of controls 20 for a patient, with the second set of controls being different from the first set of controls 18. The therapist is trained to use the system 10 and the patient is to receive CBT from the therapist facilitated by the system.

[0058] Referring additionally to figures 2 and 3, the first and second interfaces 24 and 28 are shown in more detail . Both interfaces are displaying an interactive virtual setting 14 that represents a real-world scenario designed to trigger a change in the emotional state, particularly the level of anxiety, in the patient . In particular, the interactive virtual setting 14 is designed to immerse the patient in an environment which triggers an existing phobia . Figures 2 and 3 are screen capturesfrom an interactive virtual setting 14 designed to treat patients with a phobia of heights or other height-related anxieties . Therefore, the interactive virtual setting displayed in figures 2 and 3 is the interior of a tall building . The first set of controls 18 allows the therapist to control the interactive virtual setting 14 during the session, for example by changing the camera angle, moving closer to or further away from the edge of a balcony, or going to higher or lower floors of the building . As the two computing devices 22 and 26 are connected via the first and second servers 12 and 16, the displays of the therapist and patient are synchronised . This synchronisation is instigated by the PureWeb server . In particular, a sessionlD is generated when the therapist starts the scene and this is transferred over to the patient via the Firestore . As a result, the streams are delivered and synchronised by Pureweb . That is, the therapist uses their controls to create requests to generate the scene from their device which then receives the streamed scene from the server as does the patient' s device . As a result, the streams are synchronised without dependence on the connection from the therapist to the patient .

[0059] The first set of controls 18 also includes a Pause Session button ( 32 ) and an End Session button (34 ) , for the therapist to pause or end the session, which would cause the first and second interfaces 24 and 28 to cease displaying the interactive virtual setting 14 . The second set of controls 20 includes an interactive scale 36 for the patient to indicate their level of anxiety, a Request Assistance button 38 for the patient to indicate that they require assistance from the therapist, and a Request Pause / End button 40 for the patient to indicate to the therapist that they require the session to be paused or ended. Importantly, the second interface 28 does not display the first set of controls 18 , and the second set of controls 20 does notallow the patient to make changes to the interactive virtual setting 14.

[0060] Operation of the system 10 will now be described with additional reference to figure 4 . A therapist trained to use the system 10 to deliver CBT uses a first computing device 22 with a first interface 24 and a first set of controls 18. A patient who is to receive CBT from the therapist, facilitated by the system 10, uses a second computing device 26 with a second interface 28 and a second set of controls 20 that is different from the first set of controls 18 . A selection of interactive virtual settings 14 are hosted on a first server 12 (step SI ) . The therapist selects an appropriate interactive virtual setting 14 ( step S2 ) to be displayed on both the first and second interfaces 24 and 28 (step S3 ) . The selected interactive virtual setting 14 represents a real-world scenario designed to induce a change in the emotional state, particularly the level of anxiety, in the patient by immersing them in a virtual environment that triggers an existing phobia or anxiety disorder . Both the first and second set of controls 18 and 20 are hosted on a second server 16 and overlaid onto respective first and second interfaces 24 and 28 (step S4 ) . The therapist uses the first set of controls 18 to expose the patient to various triggering scenarios in the interactive virtual setting 14 (step S5 ) . The patient uses the second set of controls 20 to indicate their level of anxiety using an interactive scale 36 (step S6) . If the indicated level of anxiety is too low or too high (step S7 ) , the therapist makes changes to the interactive virtual setting 14 using the first set of controls 18 ( step S8 ) , with the aim being to consistently expose the patient to a level of challenge that induces a moderate amount of anxiety throughout the session. If the patient' s anxiety becomes overwhelmingly high (step S9 ) , they can indicate to the therapist that they require the session to be paused or ended using the Request Pause / End button 40 on the second set ofcontrols 20 (step S10 ) . The therapist would then press the Pause Session ( 32 ) or End Session ( 34 ) button on the first set of controls 18 as appropriate (step Sil ) . If the patient requires additional assistance from the therapist ( step S12 ) , they can press the Request Assistance button 38 on the second set of controls 20 ( step S13 ) . If the patient is overwhelmed or if the session is over (step S14 ) , the therapist presses the End Session button ( S15 ) . Alternatively, if the patient is indicating that they are feeling overwhelmed, the therapist can switch the scene to a more relaxing and less anxiety triggering scene . Otherwise, the therapist continues to expose the patient to further triggering scenarios in the interactive virtual setting 14 (step S5 ) until the end of the session or until the patient becomes overwhelmed and / or requests the session to be paused or ended.

[0061] With reference to figure 5 , a more detailed illustration of the relationship between various cooperating features of the invention are described. The illustration is divided into eight sections labelled: Boundless Dashboard; Boundless Session; Firebase; STUN / TURN Servers ; Pureweb Servers ; and Unity.

[0062] The "Boundless Dashboard" illustrates the sign up, log in and booking creation processes . These are connected to a user database, which is termed "Firestore" and is located on a server, which is identified as "Firebase" in figure 5. This firebase server could be either the first or second server referred to above . However, the Firestore Database includes the Scene Info which itself includes the button layout data and therefore, the Firebase server is more preferably the second server .

[0063] The "Boundless Session" illustrates the process of the therapy session previously described. This includes three aspects . These are the streaming of the scene (the interactive virtual setting) , the handling of visual and oral communication between the therapist and patient (WebRTC) , and the overlayingof the controls and buttons for the therapist and patient . The Boundless Session shows connections direct to three servers . There is the connection to the Firebase server, providing the overlaid buttons . There is also the connection to the STUN / TURN Servers which handle the call aspects using Web RTC to provide real time communication between patient and therapist . Unity is effectively a games engine that generates the scene that is streamed to the therapist and patient .

[0064] Turning to figures 6 and 7 , these images illustrate examples of the therapist' s view of their interface 24 . This includes the virtual setting 14 and the first controls 18 ( separated into clusters 18a, 18b and 18c) . Also shown are the views 42 and 44 of the therapist and patient respectively, which enables the therapist to see and gauge reactions of the patient and the patient to see the therapist they are working with. In figure 6, the first controls 18 are divided into a series of three buttons which are clustered together for convenience . For example, the buttons 18a are used by the therapist to select the scene that is viewed as well as providing other controls . This includes a "Start / Stop Stream" for progressing and pausing the scene . There is also a "Fullscreen Toggle" for enabling the therapist to alter the patient' s screen between a mode where the scene substantially fills the whole of their screen. An alternative scene can be selected with the " [Relaxation] Zen Garden at night" button and the "Relaxation" button . The "Coffee Shop" button is used to select the scene that is to be used by the therapist during the session. Finally, a self-explanatory "Restart Current Scene" is also provided.

[0065] The next cluster of buttons 18b enable the viewing position within the scene to be altered by the therapist between, in this example, viewing the scene as though sitting a "Table 1" or "Table 2" or standing in the "Corner" . These differing view point allow the therapist to introduce the patient into thescene with varying degrees of intensity, for example, starting by standing in the corner, moving to a first table then moving on to a second table .

[0066] The third cluster of buttons 18c enable the therapist to alter features of the scene that are also likely to alter the anxiety levels experienced by the patient . For example, in a section labelled "People" there are buttons to create a view including a crowd of people by toggling the "Crowd On / Off" and determining whether they are seated using the "Seated On / Off" button. In the section labelled "Queue Length" the therapist can "Increase" or "Decrease" the length of the queue of people represented in the scene . A final button allows the therapist to "Toggle On / Off" background "Music" in the scene . In figure 7 , a similar view is shown relating to a scene set in a hospital with a different arrangement of the buttons 18a and 18b / c (in which the clusters of buttons 18b and 18c are collected together) .

[0067] It will be appreciated by persons skilled in the art that the above embodiments have been described by way of example only and not in any limitative sense, and that various alterations and modifications are possible without departure from the scope of the protection which is defined by the appended claims . In particular, where various embodiments and aspects of the invention have been described above, features and steps of the apparatus and method are interchangeable between the embodiments and aspects of the invention.

[0068] For example, the first and second computing devices 22 and 26 are typically tablet devices with integrated touchscreen interfaces for displaying both the virtual interactive setting 14 and a first or second set of controls 18 or 20. However, suitable alternatives may be used including laptops , PCs with monitors, mobile devices, or virtual reality (VR) devices .As another example, the second controls , as used by the patient, are not essential to the operation of the invention . Although it may be desirable for the patient to be able to make non-verbal communications to the therapist, this feature can be removed reducing the operation of the second computer device to displaying the scene and providing the video and audio communication between the patient and therapist . It should also be noted that the first and second computing devices 22 and 26 may further comprise microphones, speakers (or headsets ) and cameras . In cases where the CBT is carried out remotely, for example with the patient at home and the therapist in their office, these additional components would be necessary to allow communication between the therapist and patient during the session .

Claims

Claims1 . A method of conducting a digital cognitive behavioural therapy session, comprising the steps :hosting on a first server setting data relating to an interactive virtual setting;sending said setting data to first and second computing devices for displaying on respective first and second interfaces thereof , said first computing device being used by a therapist and said second computing device being used by a patient, wherein said interactive virtual setting represents a real-world scenario designed to trigger a change in the emotional state of said patient;hosting on a second server first control data relating to first controls; andsending said first control data to said first computing device for displaying said first controls on said first interface, said first controls being used by said therapist to control said interactive virtual setting .2 . A method according to claim 1 , further comprising : hosting second control data relating to said second controls on a said second server; andsending said second control data to said second computing device for displaying said second controls on said second interface, said second controls being different to said first controls .

3. A method according to claim 1 or 2 , wherein said first and second computing devices are connected to the or each said first server via internet connections .4 . A method according to any preceding claim, wherein said first and second computing devices further comprise microphones, speakers and cameras to allow communication between said therapist and said patient during the therapy session.5 . A method according to any preceding claim, wherein said first controls further comprise buttons pressable by said therapist to pause or end the therapy session .

6. A method according to of preceding claim2 2 to 5 , wherein said second controls further comprise a scale for said patient to indicate changes in their emotional state throughout the therapy session, wherein said changes are displayed on said first and second interfaces .7 . A method according to claim 5 , wherein said emotional state is a level of anxiety.8 . A method according to any of claims 2 to 7 , wherein said second controls further comprise a button pressable by said patient to indicate that assistance is required from said therapist .

9. A method according to any of claims 2 to 8 , wherein said second controls further comprise a button pressable by said patient to indicate that they require said therapist to pause or end the therapy session.

10. A method according to any preceding claim, further comprising hosting on a third server on a third server call data handling a video call between said first and second computer devices being displayed on said first and second interfaces respectively .

11. A method of conducting a digital cognitive behavioural therapy session, comprising the steps :displaying an interactive virtual setting on a first interface, said first interface being part of a first computing device, said first interface additionally displaying a first set of controls for a therapist to control said interactive virtual setting, said interactive virtual setting representing a real-world scenario designed to trigger a change in the emotional state of a patient; anddisplaying to said patient said interactive virtual setting on a second interface, said second interface being part of a second computing device connected to said first computing device .

12. A method according to claim 11, wherein said second interface additionally displaying a second set of controls for said patient wherein said second controls are different to said first controls .

13. A method according to claim 11 or 12 , wherein setting data relating to said interactive virtual setting is hosted on a first server and received by said first and second computing devices during the therapy session.

14. A method according to claim 12 or 13 , wherein first and second control data relating to respective first and second controls is hosted on a second server and received by first and second computing devices during the therapy session.

15. A method according to claims 12 to 14 , wherein said second controls further comprise a scale for said patient to indicate changes in their emotional state throughout the therapy session, wherein said changes are displayed on said first and second interfaces .

16. A method according to claim 15 , wherein said emotional state is a level of anxiety.

17. A method according to claims 12 to 16, wherein said second controls further comprise a button pressable by said patient to indicate that assistance is required from said therapist .

18. A method according to claims 12 to 17 , wherein said second controls further comprise a button pressable by said patient to indicate that they require said therapist to pause or end the therapy session.19A computer program for conducting a digital cognitive behavioural therapy session, comprising :first computer code for hosting on a first server setting data relating to an interactive virtual setting;second computer code for sending said setting data to first and second computing devices for displaying on respective first and second interfaces thereof, said first computing device being used by a therapist and said second computing device being used by a patient, wherein said interactive virtual setting represents a real-world scenario designed to trigger a change in the emotional state of said patient;third computer code for hosting on a second server first control data relating to first controls;fourth computer code for sending said first control data to said first computing device for displaying said first controls on said first interface, said first controls being used by said therapist to control said interactive virtual setting .

20. A computer program according to claim 19, wherein said third computer code enables hosting second control data relating to said second controls on a said second server and said program further comprises fifth computer code for sending said second control data to said second computing device for displaying said second controls on said second interface, said second controls being different to said first controls .

21. A program according to claim 19 or 20 , wherein said first and second computing devices are connected to said first and second servers via an internet connection .

22. A program according to any of claims 19 to 21, wherein said first and second computing devices further comprise microphones, speakers and cameras to allow communication between said therapist and said patient during the therapy session.

23. A program according to any of claims 19 to 22 , wherein said first controls further comprise buttons pressable by said therapist to pause or end the therapy session .

24. A program according to any of claims 20 to 23, wherein said second controls further comprise a scale for said patient to indicate changes in their emotional state throughout the therapy session, wherein said changes are displayed on said first and second interfaces .

25. A program according to claim 24 , wherein said emotional state is a level of anxiety.

26. A program according to any of claims 20 to 25 , wherein said second controls further comprise a button pressable by said patient to indicate that assistance is required from said therapist .

27. A program according to any of claims 20 to 26, wherein said second controls further comprise a button pressable by said patient to indicate that they require said therapist to pause or end the therapy session.

28. A program according to any of claims 19 to 27 , further comprising sixth computer code for hosting on a third server on a third server call data handling a video call between said first and second computer devices being displayed on said first and second interfaces respectively.

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