Many patients with a psychotic disorder have persistent paranoid ideation and avoid social situations because of suspiciousness and anxiety. We studied the effects, working mechanisms and costs of virtual reality based cognitive behavioral therapy (VR-CBT) for paranoid thoughts and social participation. VR-CBT reduces paranoid ideation and anxiety in real life social situations. Safety behavior and social cognition problems are mediators of change in paranoid ideation. In this skill class we will focus on which types of safety behaviors can be found in patients with psychosis, and how virtual reality can be used to drop them.