Immersive Preparation and Resourcing
A therapist-led pathway focused on orientation, grounding, emotional regulation, resource development and familiarity with immersive environments.
Explore preparation and resourcingPathfinder clinical innovation
Therapy before technology
Advancing safe, ethical and accessible immersive trauma care for veterans, adults with complex trauma and amputees experiencing phantom limb pain.
Pilot launching in 2026
Pathfinder Adaptive Immersive Trauma Therapy Pilot (AITT)
A developing clinical pilot and service-evaluation programme
Pathfinder Therapy CIC is developing a specialist clinical pilot exploring how immersive virtual reality can be integrated carefully into trauma psychotherapy and rehabilitation-informed care.
The pilot combines therapist-led practice, EMDR, accessibility planning and immersive technology using Meta Quest 3S headsets and PsyTechVR.
Our purpose is not to replace established psychotherapy, pain management or amputee rehabilitation. It is to understand where immersive environments may contribute meaningfully to preparation, regulation, resourcing, bilateral stimulation, trauma treatment, virtual limb embodiment and the management of distress associated with phantom limb pain.
Therapy before technology. Rehabilitation through collaboration. Accessibility is a core element of responsible clinical innovation.
Our vision
Our vision
To become Europe’s leading clinical centre for adaptive immersive trauma therapy, advancing the safe, ethical and evidence-informed use of immersive technologies for military veterans and adults with complex trauma.
Pathfinder aims to bridge trauma psychotherapy, military culture, disability, pain, rehabilitation, accessibility and immersive technology.
Our work is clinically led. Technology is introduced only where it serves a clear therapeutic or rehabilitative purpose and remains within the competence, professional responsibilities and clinical judgement of the practitioner.
For amputees, immersive interventions will be developed collaboratively and must complement the person’s wider medical, prosthetic and rehabilitation plan.
What is Adaptive Immersive Trauma Therapy?
Adaptive Immersive Trauma Therapy is Pathfinder’s developing framework for integrating immersive technology into established trauma and rehabilitation-informed practice.
AITT is not a standalone psychotherapy and is not a substitute for EMDR, counselling, psychotherapy, pain medicine, prosthetic care or physical rehabilitation.
“Adaptive” means adjusting the technology, environment, sensory input, duration, movement demands and therapeutic task to the individual. The person should not be expected to adapt to a rigid technological system.
AITT may include:
- Calm and predictable immersive environments
- Present-time orientation
- Grounding
- Emotional regulation
- Preparation for trauma processing
- Resource development
- Visual or auditory bilateral stimulation
- Therapist-guided EMDR
- Virtual limb embodiment
- Visualised limb movement
- Body representation exercises
- Pain-related relaxation
- Closure
- Outcome monitoring
- Accessibility adjustments
- Multidisciplinary liaison
Three clinical pathways
The pilot presents three connected but clinically distinct pathways. Immersive technology supports clinical practice and multidisciplinary care; the headset or software does not independently provide treatment.
VR-Assisted EMDR
Carefully assessed use of immersive technology to support selected elements of EMDR delivered by appropriately trained practitioners.
Understand VR-assisted EMDRImmersive Support for Phantom Limb Pain
A rehabilitation-informed feasibility pathway exploring virtual limb embodiment, movement visualisation and therapeutic support for amputees experiencing phantom limb pain or phantom limb sensations.
Explore the phantom limb pathwayPreparation, grounding and resourcing
For many clients, the first purpose of immersive technology will not be trauma processing.
Initial work may focus on:
- Learning how the headset works
- Establishing control
- Remaining aware of the physical therapy room
- Practising a stop signal
- Orientating to the therapist’s voice
- Identifying bodily sensations
- Grounding
- Developing adaptive resources
- Testing visual or auditory stimulation
- Assessing emotional and physical tolerance
The first experience should normally be brief, predictable and non-traumatic.
VR-assisted EMDR
EMDR is an established psychotherapy approach with a structured clinical protocol.
Within the Pathfinder pilot, virtual reality may be used to support carefully selected elements of therapist-led EMDR. The technology does not replace history taking, assessment, preparation, formulation, consent, clinical judgement, supervision or closure.
Potential uses may include preparation, safe-enough-place work, adaptive resource installation, bilateral stimulation, present-time orientation, selected therapist-led processing, closure, and future-template work where appropriate.
Use will depend on client suitability, the therapeutic relationship, treatment stage, dissociation risk, physical tolerability, practitioner competence, supervision, delivery setting, and the capabilities and limitations of the platform.
The availability of VR does not mean it will be clinically appropriate for every EMDR client or every phase of treatment.
Informed by the wider immersive trauma field
The Pathfinder pilot acknowledges the established development of immersive trauma interventions, including research associated with 3MDR.
3MDR combines immersive trauma-related material, movement, therapist guidance and dual-attention tasks within a defined intervention.
The Pathfinder pilot does not constitute 3MDR and must not be described as 3MDR treatment.
Pathfinder’s initial work will focus on headset-based, therapist-led feasibility, accessibility and clinical implementation. Future collaboration with established 3MDR researchers or services may be explored.
Immersive technology and phantom limb pain
Phantom limb pain is pain experienced as arising from a limb or part of a limb that is no longer physically present.
People may also experience movement sensations, pressure, tingling, burning, cramping, twisting, itching, temperature sensations, or a sense that the missing limb is fixed in an uncomfortable position. The severity, pattern and meaning of phantom sensations vary considerably between individuals.
Virtual and augmented reality approaches are being explored as possible ways to support some people experiencing phantom limb pain. These approaches may use visual feedback, movement representation or virtual embodiment to create an experience of seeing and moving a virtual limb.
The evidence remains developing. Pathfinder will not describe immersive technology as a cure or guaranteed treatment.
Potential pilot elements
- Viewing a virtual representation of a missing limb
- Imagining or directing movement of the phantom limb
- Mirrored or mapped movement from the intact limb
- Guided opening, closing, flexion or extension
- Releasing a perceived clenched or fixed position
- Gentle task-based virtual movement
- Relaxation before and after movement
- Attention redirection
- Pain-distress monitoring
- Present-time grounding
- Trauma therapy where injury-related trauma is identified separately
Phantom limb pain is not assumed to be caused solely by psychological trauma. Any psychological or EMDR intervention will be based on a separate clinical formulation.
Pathfinder’s immersive phantom limb pain pathway is intended to complement—not replace—medical, prosthetic, rehabilitation or pain-management care.
Working with Specialist Mobility Rehabilitation Centres
Pathfinder intends to develop the phantom limb pain pathway collaboratively with Specialist Mobility Rehabilitation Centres, prosthetic services and multidisciplinary amputee rehabilitation teams.
These services provide essential specialist expertise in areas such as amputee rehabilitation, prosthetic assessment and fitting, residual-limb care, gait and mobility, functional independence, pain management, physiotherapy, occupational therapy, psychological adjustment, rehabilitation medicine, complex disability and long-term follow-up.
Pathfinder’s role is focused on psychotherapy, trauma-informed care, immersive clinical implementation and participant experience. It does not replace the specialist rehabilitation team.
Where appropriate and with the participant’s consent, Pathfinder should seek to liaise with the person’s existing rehabilitation or healthcare professionals.
Pathfinder will only communicate with a participant’s rehabilitation or healthcare professionals with appropriate consent, except where disclosure is required by law or immediate safety obligations.
Potential sources of referral
Potential sources may include Specialist Mobility Rehabilitation Centres, NHS or independent prosthetic services, rehabilitation consultants, pain services, physiotherapists, occupational therapists, veteran welfare teams, GPs, psychotherapists, EMDR practitioners, veteran organisations and self-referral. Formal referral arrangements and partner logos are not presented unless written agreement exists. Pathfinder intends to explore opportunities for collaboration with veteran organisations, subject to agreement and appropriate governance.
Why use immersive technology?
Reduced external distraction
A headset may help some clients focus on a selected therapeutic or rehabilitative task by reducing external distraction.
Greater presence
An immersive environment may create a stronger sense of presence than imagery or a conventional screen.
Adjustable bilateral stimulation
Visual and auditory stimuli may be adjusted by the therapist according to clinical need.
Virtual embodiment
For some amputees, virtual limb representation may provide a way to explore movement or body representation that is not possible through ordinary visualisation alone.
Choice and control
The participant can stop. The therapist can pause or end the experience.
Accessibility development
The pilot will evaluate whether immersive methods can be adapted for people with limb loss, reduced mobility, pain, fatigue or other rehabilitation needs.
Designed with accessibility in mind
Pathfinder has a particular interest in the adaptation of immersive trauma and rehabilitation support for wounded, injured and sick veterans.
Accessibility is not an additional feature. It is a core part of responsible clinical innovation.
The pilot will consider upper- and lower-limb amputation, bilateral limb loss, prosthetic comfort, residual-limb sensitivity, wheelchair use, seated participation, reduced mobility, chronic pain, balance difficulties, vestibular symptoms, traumatic brain injury, blast injury, visual or hearing impairment, reduced hand movement, controller access, fatigue, older age, cognitive load, headset weight, neck discomfort and remote-use safety.
Not all barriers have already been solved. Suitability and practical adaptations must be assessed individually.
In-clinic immersive therapy
In-clinic delivery allows the practitioner to remain physically present while the participant uses the headset.
The therapist can maintain verbal contact, observe visible signs of discomfort or activation, adjust the experience, pause bilateral stimulation, end the intervention, assist with reorientation and review the experience afterwards.
Initial use should normally be seated, brief, predictable, free from trip hazards, supported by a clear stop procedure, and followed by grounding and review.
For amputee participants, assess seating, balance, prosthetic position, residual-limb comfort, transfer requirements, controller access, risk of falls, fatigue, and pain before and after the experience.
Remote immersive therapy
Remote delivery may be considered only after separate assessment of clinical stability, physical safety, dissociation, pain-related distress, cognitive ability, headset competence, privacy, internet reliability, ability to remove the headset, emergency contact arrangements, safe seating, fall risk, home environment, practitioner location and jurisdiction, insurance and professional requirements, and data protection.
Remote availability will never be based solely on technological capability. Clinical and physical suitability will determine whether remote participation is offered.
For phantom limb pain work, do not start remotely unless the participant has completed appropriate orientation and any required rehabilitation or medical liaison.
Who may be suitable?
Potential participants should normally be aged 18 or over, have capacity to consent, be able to communicate discomfort and request a stop, be interested in immersive technology, have a clinically appropriate goal, be sufficiently stable for the proposed intervention, be able to remain orientated, have no known contraindication to headset use, agree to follow safety instructions, and understand that benefit is not guaranteed.
For the phantom limb pathway, assessment may also consider type and level of amputation, date and cause of amputation, phantom limb symptoms, residual-limb pain, prosthetic use, current rehabilitation care, pain-management involvement, neurological or vascular history, and the existing treatment plan. Detailed clinical information is collected only during secure assessment—not through the public interest form.
When immersive technology may not be appropriate
VR may need to be postponed, adapted or avoided where there is acute psychological crisis, current psychosis, markedly impaired reality testing, severe or unstable dissociation, frequent uncontrolled flashbacks, acute intoxication, unmanaged seizure risk, severe motion sickness, significant vestibular difficulties, recent eye surgery, screen-triggered migraine, unstable medical condition, significant uncontrolled pain, acute residual-limb or skin problems, recent surgery without relevant clearance, high fall risk, inability to communicate a stop, insufficient privacy for remote use, inability to remove the headset safely, or strong pressure to participate to please another person.
Suitability will be determined individually. A listed condition may require adaptation, professional advice or an alternative intervention rather than creating an automatic exclusion in every case.
Safety and possible side effects
Possible effects include nausea, dizziness, eyestrain, headache, disorientation, balance disturbance, neck discomfort, fatigue, anxiety, emotional activation, flashbacks, dissociation, depersonalisation, derealisation, temporary increase in pain awareness, unexpected phantom sensations, frustration if the virtual limb does not correspond to the participant’s experience, and distress connected with body image or limb loss.
Participants may stop at any time. The therapist may also end the experience when continuing is not clinically or physically appropriate.
Any increase in pain or distress must be reviewed rather than assumed to be a necessary part of treatment.
Participant journey
- Initial enquiry The person submits a brief expression of interest without providing a detailed trauma or medical history.
- Initial conversation A practitioner explains the pilot, limitations, possible risks and alternative options.
- Clinical and physical suitability assessment The practitioner considers trauma history, stability, pain, mobility, rehabilitation needs, headset safety and any need for multidisciplinary advice.
- Professional liaison With consent, the practitioner may liaise with the participant’s rehabilitation, pain or healthcare team.
- Information and consent The participant receives clear information about the technology, experimental nature of the pathway, data use and right to stop.
- Orientation The participant learns how to use and remove the headset and agrees a stop signal.
- Brief introductory experience The first experience is short, neutral and carefully monitored.
- Clinically selected intervention Further use is based on formulation, tolerability and agreed goals.
- Immediate review The practitioner reviews physical comfort, pain, emotional response, presence, control and adverse effects.
- Follow-up The participant is contacted or reviewed to identify delayed effects and decide whether to continue, modify or stop.
Clinical principles
Therapy before technology
Technology is used only where it supports a clear clinical or rehabilitation purpose.
Relationship before immersion
The therapeutic relationship remains central.
Rehabilitation through collaboration
Phantom limb and amputee work should complement multidisciplinary care.
Evidence before enthusiasm
Benefits, limitations, non-response and adverse effects will be evaluated honestly.
Accessibility is innovation
Technology should adapt to different bodies, injuries and abilities.
Choice and control
Participation is voluntary and can be stopped immediately.
How the pilot will be evaluated
The initial pilot will evaluate feasibility, accessibility, acceptability and safety. These measures do not prove effectiveness.
General outcomes
- Physical comfort, cybersickness, emotional response, present-time orientation, sense of control
- Connection with the therapist, perceived usefulness, technical reliability
- Willingness to use VR again, delayed adverse effects, practitioner experience, remote-delivery feasibility
Trauma pathway outcomes
- Grounding, resource access, tolerance of bilateral stimulation, emotional activation, dissociation
- Ability to maintain dual attention, quality of closure
Phantom limb pathway outcomes
- Pain intensity before and after, pain interference, phantom limb sensation
- Perceived movement and position of the phantom limb, distress associated with sensations
- Ability to engage with a virtual limb, congruence of the virtual representation
- Residual-limb comfort, functional confidence, acceptability, delayed symptom change
Anonymised and aggregated learning may be used to improve the programme and communicate general findings. Identifiable information will not be published without explicit separate consent.
Technology used in the pilot
Meta Quest 3S
The Meta Quest 3S is the intended standalone headset for immersive delivery. Pathfinder does not claim that the headset is a medical device unless that status is separately confirmed.
PsyTechVR
PsyTechVR is the intended clinical platform for therapist-controlled virtual environments and bilateral stimulation. Pathfinder does not claim that PsyTechVR currently provides a dedicated phantom limb pain module unless confirmed directly.
Meta Quest and Meta are trademarks of Meta Platforms, Inc. PsyTechVR is a third-party platform. References to these products describe technology intended for evaluation and do not imply endorsement, sponsorship or formal partnership unless confirmed separately in writing.
Research and clinical innovation
Pathfinder Therapy CIC is committed to responsible innovation in trauma and rehabilitation-informed care. The programme will evaluate technology rather than assuming that novelty creates clinical value.
Intended areas of learning include veteran acceptability, complex trauma, dissociation, phantom limb pain, virtual embodiment, accessibility, therapist-led implementation, remote delivery, clinical governance, multidisciplinary collaboration, adverse-event monitoring, technology limitations and practitioner competencies.
Status tracker
Clinical governance
The pilot is a service-development and feasibility evaluation programme. It is not presented as a formal clinical trial unless ethics approval and research sponsorship are subsequently obtained.
Practitioners remain responsible for assessment, consent, pacing, safety, supervision or consultation, and review. Immersive technology supports—not replaces—clinical judgement and the therapeutic relationship.
Pathfinder does not diagnose the physical cause of pain and does not advise clients to stop or alter prescribed medication.
A collaborative pathway for amputee rehabilitation services
Pathfinder Therapy CIC welcomes discussion with Specialist Mobility Rehabilitation Centres, prosthetic services, rehabilitation clinicians and pain teams interested in evaluating the role of immersive technology in amputee care.
The pilot is designed to complement existing specialist services and to develop practical knowledge about participant selection, psychological readiness, trauma and adjustment, phantom limb pain, virtual embodiment, accessibility, outcome monitoring, remote implementation, adverse-event management, therapist competencies and multidisciplinary governance.
Partnership options
Clinical demonstrations
Staff briefings
Feasibility pilots
Referral-pathway development
Co-design workshops
Accessibility evaluation
Outcome-framework development
Research partnerships
Professional training
Technology evaluation
Professional and rehabilitation partnerships
Important: Pathfinder’s website and enquiry forms are not emergency services and are not monitored continuously. Reuse existing crisis routes on the Crisis & Safeguarding page.
Register your interest
The pilot is being introduced gradually. Submitting this form does not confirm acceptance, establish a therapeutic relationship or guarantee that immersive technology will be suitable.
Please do not provide detailed descriptions of traumatic events, medical records or images through this form. The form is for initial contact only and is not monitored as an emergency service. If there is immediate danger to life, call 999 or go to your nearest A&E. See Crisis & Safeguarding.
Frequently asked questions
What is Adaptive Immersive Trauma Therapy?
It is Pathfinder’s developing framework for integrating immersive technology into established trauma and rehabilitation-informed practice.
Is AITT a separate psychotherapy?
No. It is a framework for using immersive technology within appropriate clinical care.
Is immersive therapy the same as EMDR?
No. EMDR is an established psychotherapy. Virtual reality may support selected elements but does not replace the EMDR protocol or practitioner.
Is this 3MDR?
No. The pilot acknowledges the wider immersive trauma field, including 3MDR research, but does not constitute 3MDR treatment.
Can VR cure phantom limb pain?
No such claim is made. Research is developing, and not everyone responds in the same way. The pilot will evaluate feasibility, safety, acceptability and possible clinical value.
Is phantom limb pain psychological?
Phantom limb pain is a complex pain experience. Pathfinder will not assume that it is solely psychological. Psychological therapy may be relevant to distress, trauma or adjustment but does not replace medical and rehabilitation assessment.
What is virtual limb embodiment?
It is the experience of seeing or interacting with a computer-generated limb as though it forms part of one’s body or movement experience.
Will Pathfinder replace my prosthetic or rehabilitation service?
No. Pathfinder’s work is intended to complement specialist rehabilitation and pain care.
Will you contact my rehabilitation team?
Only with appropriate consent, except where disclosure is required by law or immediate safety obligations.
Can I participate remotely?
Potentially. Remote delivery requires separate clinical, physical, technological and jurisdictional assessment.
Can I stop at any time?
Yes.
Will I process trauma during my first session?
Normally not. Initial use should focus on orientation, control, comfort and suitability.
Does VR cause motion sickness?
Some people experience nausea, dizziness, headache, eyestrain or disorientation.
Can people with amputations or wheelchairs participate?
Potentially. Accessibility is a central focus, but suitability and practical adaptations must be assessed individually.
Is the pilot free?
Fees, funded places and eligibility arrangements will be explained before participation is agreed.
Does registering guarantee a place?
No.
Programme disclaimer
The Pathfinder Adaptive Immersive Trauma Therapy Pilot is a developing service-evaluation programme. Immersive technology may not be suitable for every person or condition. VR-assisted EMDR will only be delivered by appropriately trained practitioners following individual assessment. The phantom limb pain pathway is intended to complement—not replace—medical, pain-management, prosthetic or specialist rehabilitation care. No outcome can be guaranteed.
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