The avatar came to recognise the patient's strengths and good qualities, and the patient's greater control and power in the relationship. In each session, after discussing the targets for that day's work, patients spent 10-15 minutes speaking face-to-face with the avatar, practising standing up to it, correcting any misconceptions it had about them, and taking control of the conversation, so that power shifted from the avatar to the patient. Therapy involved a three-way conversation between the patient, therapist, and avatar, with the therapist speaking as themselves and also voicing the avatar. Before starting treatment, patients worked with the therapist to create a computerised simulation (avatar) of the voice they most wanted to influence - including what the voice said, how it sounded, and how it could look. The avatar therapy took place over six sessions, with one 50-minute session each week. They also continued with their usual antipsychotic medication throughout the trial. Of these, 75 people had the avatar therapy and the other 75 people had a form of supportive counselling designed for this study. ![]() This study, which took place at Maudsley Hospital SHARP clinic and the Institute of Psychiatry, Psychology & Neuroscience at King's College London, involved 150 patients who had had schizophrenia for approximately 20 years and heard 3-4 voices on average. ![]() However, these results come from one treatment centre and more research is needed to optimise the way the treatment is delivered and demonstrate that it is effective in other NHS settings." So far, these improvements appear to last for up to six months for these patients. He adds: "Our study provides early evidence that avatar therapy rapidly improves auditory hallucinations for people with schizophrenia, reducing their frequency and how distressing they are, compared to a type of counselling. "A large proportion of people with schizophrenia continue to experience distressing voices despite lengthy treatment, so it is important that we look at newer, effective and shorter forms of therapy," says lead author Professor Tom Craig from King's College London, and the South London and Maudsley NHS Foundation Trust, UK. Cognitive behavioural therapy for psychosis (CBTp) can also be helpful but is a lengthy therapy with at times limited effects on voices. For most people, drug treatments reduce these symptoms, but approximately one in four people continue to experience voices. All participants continued to receive their usual treatment throughout the trial.Īround 60-70% of people who have schizophrenia experience auditory hallucinations that are typically insulting and threatening. The study is the first large-scale randomized controlled trial of this type of therapy, and was used in people with schizophrenia who had had persistent and distressing auditory hallucinations for more than a year, despite treatment. It found that avatar therapy was more effective at reducing hallucinations at 12-week follow-up, and had a large effect size.įurther research to investigate the treatment's effectiveness in other healthcare settings will be needed, and so the treatment is not yet widely available. The randomised controlled trial compared the avatar therapy to a form of supportive counselling (adapted specifically for the study).
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