TendVR: Referral Management System

Immersive MBCT delivered via VR

• Eight structured 40minute sessions

• Incorporates MBCT mechanisms: presentmoment awareness, selfcompassion, reduced rumination, metacognitive insight

• Designed with MBCT experts and clinical psychologists

Attentionstructuring for ADHD

• VR environments provide external attentional anchors

• Reduces cognitive load of imaginationbased therapies

• Participants report VR makes mindfulness possible where previous attempts failed

Betweensession selfmanagement app

• Breathing exercises

• Mindfulness prompts

• Tools for sleep, intrusive thought management, emotional regulation

Deployment flexibility

• Suitable for NHS clinics, GP practices, Talking Therapies, VCSE hubs, community facilities, or home use

• One VR headset can treat ~200 patients per year


Minimal clinician time

• Weekly phone or digital checkins only

• Suitable for workforceconstrained services

• Class I medical device (DCB0129governed)

• Cyber Essentials and ISO 27001 datamanagement compliance

• DPIAs completed for all deployments

• No patient-identifiable data stored on headsets

One headset treats 200 patients per year. Licensing/pricing structures will vary depending on procuring agencies requests.

Real world NHS delivery

• Large effect sizes: d = −1.15 to −1.45 (PHQ-9 depression and GAD-7 anxiety)

• Reliable recovery: 53%

• Reliable improvement: 82.6%

• Completion rate: 85%

Real-world deployments

• NHS Talking Therapies (TEWV)

• Christie NHS psycho-oncology

• Multiple Mind centers

• SBRI Agricultural Workforce mental-health project

MBCT evidence base

• MBCT is NICE-recommended

• ADHD-specific MBCT RCT (Janssen et al., 2019):

• Clinician-rated symptom improvement: d = 0.41

• Emotion dysregulation improvement: d = 1.27

• Works within existing NHS Talking Therapies digital pathways

• PHQ-9, GAD-7, WSAS captured by providers. Ongoing integration conversations with IAPTUS (Mayden)

• No patient data stored on devices

Tend VR was co-designed with:

• Lived experience users with anxiety and depression

• Self-reported ADHD participants

• Neurodivergent lived-experience experts (e.g., AuDHD co-development specialist)

• Clinical psychologists specialising in ADHD


Designed for ADHD challenges

• Task initiation support (reminders, weekly sessions)

• Attention regulation via immersive, distraction-controlled environments

• Supports those who struggle with imagination-based meditation

• Demonstrated acceptability for autistic adults and users with mild learning difficulties


Inclusion

• Sensory-considerate seated VR

• Delivered through trusted community partners for marginalised groups (Bevan Exemplar)

• Private headset use reduces stigma for women or gender-diverse adults