RecruitingInterventional

Experiences of feeling exceptional: preliminary testing of a new therapy for treating harmful grandiose delusions

Around one in three people treated for psychosis experience beliefs that they have special powers, a secret mission, or an extraordinary identity. Mental health professionals often call these 'grandiose delusions'. While these beliefs can feel deeply important, they can also lead to dangerous risks, relationship strain, or distress. Current treatments do not always help with these specific feelings. Researchers at Oxford Health NHS Foundation Trust and the University of Oxford have designed a brand-new talking therapy to tackle this. This early-stage study will test the therapy with eligible NHS patients aged 16 and over. Everyone taking part will receive 16 weekly one-to-one sessions with a psychologist. The aim is to see whether this new approach is practical, comfortable for patients, and helpful in supporting a balanced, purposeful life with fewer negative consequences.

At a glance

Status

Recruiting

Sponsor

University of Oxford

Enrolment target

Start

06 Jul 2026

Estimated completion

14 Feb 2027

Treating persistent harmful grandiose delusions in patients attending NHS mental health services for the treatment of affective or non-affective psychosis.

What is this study about?

Experiences of feeling exceptional happen when someone firmly believes they have special abilities, immense wealth, or a unique life mission. While these experiences can provide a strong sense of purpose, they can also carry hidden costs. For example, someone might put themselves in physical danger believing they cannot be harmed, or get into conflicts trying to carry out an imaginary duty. Standard medications and talking therapies often do not work well enough to address these specific beliefs.

To fill this gap, researchers have developed the first psychological therapy specifically focused on harmful experiences of feeling exceptional. Instead of simply trying to argue away a person's beliefs, this therapy aims to understand what drives them. It helps people explore ways to keep a positive sense of meaning and identity in their everyday life, but without the dangerous or disruptive fallout.

This study is the very first clinical test of the new therapy. Researchers want to find out whether patients find the therapy acceptable and whether it helps improve their wellbeing. Because it is a preliminary study, every person who joins will get to try the new therapy alongside their standard NHS care.

Key takeaways

Tests a new 16-week talking therapy for persistent, harmful beliefs about having special powers or status.
Open to people aged 16+ receiving care for psychosis through Oxford Health NHS Foundation Trust.
Everyone who takes part will receive the one-to-one therapy with a psychologist.
You will stay on your regular medication and keep your usual NHS mental health care team.
Taking part is voluntary, and you can stop at any time without losing your standard care.

Who may be eligible?

This study is open to people aged 16 and over who are currently receiving care from Oxford Health NHS Foundation Trust for affective or non-affective psychosis. To take part, you must have held strong beliefs about having special powers, status, or identity for at least three months, and you must be able to give your own informed consent.

The study is not suitable for people who are currently being treated in a psychiatric intensive care unit (PICU) or a forensic mental health setting. You also cannot join if you are already taking part in another intensive, one-to-one talking therapy, or if you have major changes planned for your medication.

In addition, people with severe learning difficulties, severe substance use problems that need urgent treatment first, or active crisis needs (such as immediate suicidal plans) will not be able to join. Taking part also requires a good understanding of spoken English so you can comfortably speak with the therapist.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

I am aged 16 or older.
I am currently receiving care from Oxford Health NHS Foundation Trust for psychosis.
I have had strong feelings or beliefs about being exceptional or having special powers for at least 3 months.
I am not currently receiving another intensive individual talking therapy.
My mental health medication is generally stable with no big changes planned.
I am comfortable speaking and understanding English in therapy sessions.

Answer every question to see your result.

What does participation involve?

If you take part, your total time in the study will last about six to seven months. Before therapy starts, you will have a waiting period of four to six weeks. During this time, you will fill out brief weekly questionnaires so researchers can see how your feelings change naturally over time.

You will then receive 16 weekly, one-to-one therapy sessions with a trained psychologist. Throughout these 16 weeks, you will continue completing brief weekly check-ins. There are also four longer assessments: one at the very start, one just before therapy begins, one midway through, and one at the end of therapy.

After your sessions finish, there is a short follow-up check and an optional interview to share your feedback about the therapy. Your regular psychiatric medication will stay the same, and your usual NHS care team will remain fully involved throughout the study.

Potential risks and benefits

Because this is the first time the therapy is being tested, researchers cannot guarantee it will help you. However, it is hoped that the sessions will help you find healthy purpose in life and reduce any stress or danger linked to your beliefs. Talking about personal experiences can sometimes feel tiring or bring up difficult emotions. You can ask to pause, shorten your assessments, or take a break at any point. Your usual NHS care team remains available for support, and you are free to leave the study at any time without it affecting your everyday medical care.

Locations (1)

Some site locations are approximate. We're improving this — please verify with the trial team before travelling.

Oxford Health NHS Foundation Trust
City only
Oxford, England

Common questions

Will I definitely receive the new talking therapy?

Yes. In this study, every eligible participant receives the 16-week talking therapy after a short waiting period.

Do I need to change or stop my current medication?

No. You will continue taking your prescribed medication as usual. In fact, you should not join if you have major medication changes planned.

Will the therapist try to argue with my beliefs?

No. The therapy is designed to be collaborative and supportive. The focus is on helping you stay safe, reduce distress, and find meaningful goals that matter to you.

Where do the sessions take place?

The study is based within Oxford Health NHS Foundation Trust, and sessions will be arranged through your local study team.

Can I leave the study if I change my mind?

Yes. Taking part is completely voluntary. You can withdraw at any time, and doing so will never affect your regular NHS treatment or support.

How to find out more

Louise Isham

louise.isham@psy.ox.ac.uk +44 01865 283804 Official trial record

Always speak to your GP or specialist before deciding to take part in a study.