Feeling Safer: Developing a Digital Therapy Medical Device for Oxford University

We built an online programme to digitise the University of Oxford Department of Experimental Psychology’s Feeling Safe programme, an in-person therapy for treating individuals who suffer from persecutory delusions.

The Oxford Cognitive Approaches to Psychosis (OCAP) group at the Oxford Dept. of Experimental Psychology run the Feeling Safer programme to help people suffering from delusions of persecution. An example of this is fears that the neighbours might be out to get them. These delusions can be very distressing.

Our Bespoke Software development team helped OCAP by developing a mobile app to provide online digital therapy modules for patients. These modules take the form of complex multimedia presentations, interspersed with assessments and exercises to be completed. These modules are configurable, data driven, and can be changed without altering the application code.

An In-depth Look at Functionality

The app is made of different modules, based on existing in-person Feeling Safe sessions, for patients to complete over a six-month period. Application content was developed from existing booklets used in the programme, and digitised into text, video, and audio media, ready for us to import into the application. New modules were created to extend the applicability of the treatment, and the content was greatly enriched with over thirty animations featuring the accounts of people with lived experience of these issues and spoken introductions by the clinical psychologist who led the creation of Feeling Safer.

Personalised Therapy: Completing the welcome questionnaire generates personalised therapy plans for the user.

Feeling Safer is comprised of three key components: a core application, a mental health professionals’ portal and an administration portal. In the application, patients can complete modules and review their progress, whilst mental health professionals can monitor user engagement and more through their dedicated interface.

Further functionality includes:

•  An in-app messaging feature for patients to communicate with mental health professionals.

Creating a Patient-Centred Design

User experience and a patient-centred design were key to the Feeling Safer application. Users must be able to immediately trust and feel confident using the app. Guided by AA Accessibility Standards, and to ensure we created the best mobile-first user experience, we subcontracted Fruto to guide the design of the app. This involved Discovery sessions to define the page content and copy, as well as one-to-one user workshops to test low-fidelity prototypes and gain insights into the application’s usability.

Fruto was brought in to lead the UX design and branding of the platform, ensuring it was engaging and accessible and adapting the treatment as effectively as possible for this new medium.

Customisable Theme: Customising the appearance of the app makes users feel more comfortable.

Building a solution for Mobile and Web

The application leverages PWA technologies and is currently available across iOS, Android, smartphones, tablets, and desktops. It is also implemented on Azure, ensuring it is scalable to meet increasing demand. It is a Medical Device certified and built to NHS standards (ORCHA).

Medical Device Development

As Feeling Safer is a regulated medical device, System C helped OCAP ensure they were able to get the necessary certification to use the system in clinical practice. We provided documentary support as well as ensuring that our development practice followed the Quality Management System developed by our partners, BCS Clinical Consulting. A particular concern was user-friendliness and usability, particularly for our users, who might need to use the system whilst in some distress, and for whom unexpected system behaviour or unintuitive UI might be a cause of anxiety. In collaboration with Fruto and user representatives, we ensured excellent usability.

Personalised Dashboard: Users can easily see how they are progressing and resume their therapy.

Visible Results

The result is a patient-centred, scalable, and engaging digital therapy platform. We are currently conducting a large trial to demonstrate how the app enables individuals with persecutory delusions to access potentially life-changing therapy. The app provides an intuitive and supportive experience, encouraging patients to engage with therapy regularly while allowing clinicians to track progress and provide tailored support.

By balancing scientific credibility with human-centred design, with support from Fruto we helped create an experience that fosters trust, confidence, and hope, critical elements for success in mental health interventions. The platform’s seamless UX ensures that patients can easily navigate therapy modules, track their progress, and communicate with mental health professionals, improving treatment adherence.

Modules: Interactive modules that help users to stay engaged in their therapy.

Next steps

Our work on the Feeling Safer app, developed for the University of Oxford, exemplifies our ability to digitise complex therapeutic programmes. This project highlights our commitment to patient-centred design and delivering software tailored for clinical use. Having built the medical device, we’re now supporting the team with regular updates to keep the product the best that it can be. Learn more about the feeling safe programme and how It has been designed by researchers and clinicians alike.

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