RESEARCH PROTOTYPE
PRISM
Psychosis Recovery through Inquiry, Scaffolding, and Metacognition. A card deck for navigating altered states with structure and dignity.
THE GAP
Clinical tools exist. Peer tools don't.
Metacognitive Training has 43 studies behind it. AVATAR Therapy has two completed RCTs. CBTp is the NICE-recommended gold standard. All require a clinician.
For the person in psychosis recovery between appointments — or the Hearing Voices Group facilitator working without clinical supervision — there is no structured physical tool that combines open inquiry with cognitive bias awareness.
PRISM was designed for this gap: a card deck that can be used by peers, facilitators, or individuals to navigate altered states with structure, safety, and respect for the experience.
Important disclaimer
PRISM is a research prototype, not a clinical tool. It has not been tested in controlled trials. It is not a replacement for professional mental health treatment.
This project emerges from lived experience with psychosis and a deep respect for both the clinical evidence base and the Hearing Voices Movement's person-centered approach.
40 cards, 7 layers
Organized as a progression from safety to mastery, mapped to the Kabbalistic Tree of Life. Each layer has a specific purpose and visual identity.
0. Foundation (4 cards)
Establish the safe container. Earth tones, nested squares. Never skip this layer.
1. Grounding (6 cards)
Anchor in present-moment sensory reality. Lunar blues, wave geometry.
2. Mapping (6 cards)
Describe and map the experience without judgment. Purple/gold, hexagram/spiral.
3. Verification (8 cards)
Reality-testing without dismissal. The critical thinking core. Solar gold/rose.
4. Integration (6 cards)
Extract meaning, process content. Deep violet/crimson, vesica piscis.
5. Differentiation (6 cards)
Separate states as non-inherent but complementary. Stellar gray/lavender.
6. Mastery (4 cards)
Sovereignty, return, capacity for future navigation. Crown gold/white, radiating light.
EVIDENCE BASE
Standing on shoulders
PRISM is not evidence-based (no trials of its own). It is evidence-informed — drawing on the strongest existing research in psychosis recovery:
| Approach | Researcher | Evidence Level |
|---|---|---|
| Metacognitive Training (MCT) | Steffen Moritz, Hamburg | 43-study meta-review (2025). Effect sizes: g=0.50 positive symptoms, g=0.69 delusions |
| AVATAR Therapy | Julian Leff / KCL | Two completed RCTs including AVATAR2 multi-centre (2024, N=345). NICE-recommended |
| SloMo | King's College London | RCT-backed. NICE-recommended 2024. First UKCA-marked digital therapeutic for paranoia |
| Maastricht Approach | Romme & Escher | Established movement. Observational evidence, case series. Not RCT-backed |
| CBTp | Chadwick, Turkington, Morrison | Gold standard. Multiple systematic reviews. NICE CG178 |
| Predictive Processing | Corlett & Fletcher | Strong theoretical framework. Psychosis as precision weighting failure |
| Meditation adverse effects | Willoughby Britton, Brown | 83% of participants reported at least one adverse effect. Emerging field |
All sources verified against primary publications, February 2026.
Three modes
Sequential (Guided)
Layers in order, Foundation through Mastery. Never skip Foundation or Grounding. Best for structured facilitated sessions.
Intuitive (Self-Directed)
Shuffle, draw. If a card feels irrelevant, sit with why before discarding. Best for ongoing reflection practice.
Crisis (Acute Support)
Foundation (cards 1–4) and Grounding (cards 5–10) only. No deeper layers until stable. Safety first, always.
CURRENT STATUS
Research prototype. Seeking partners for pilot testing.
Card designs exist as PDFs. No physical prototype has been printed or tested. No user testing or clinical feedback has been conducted. The next step is printing 10 prototype decks and testing with a Hearing Voices Network group.
If you work in peer support, hearing voices facilitation, or psychosis recovery research — I'd welcome a conversation.
Research Partnership Inquiry