What would happen if the voices schizophrenia patients often hear, were to encounter them in person. They would get better apparently.
An experimental therapy which involves a face-to-face discussion between a person with schizophrenia and an avatar representing their auditory hallucination may help reduce symptoms, when provided alongside usual treatment, according to a study published in the journal Lancet Psychiatry. The randomised controlled trial comparing the avatar therapy to supportive counselling found that the avatar therapy was more effective at reducing hallucinations at 12-week follow-up, and had a large effect size.
Around 60-70% of people who have schizophrenia experience auditory hallucinations that are typically insulting and threatening. For most people, drug treatments reduce these symptoms, but approximately one in four people continue to experience voices. According to lead author Professor Tom Craig from King’s College London, and the South London and Maudsley NHS Foundation Trust, UK: “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.”
This type of therapy was tried for the first time in a largescale controlled trial in people with schizophrenia who had had persistent and distressing auditory hallucinations for more than a year. The treatment participants were originally receiving continued during the trial.
Professor Craig added: “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. So far, these improvements appear to last for up to six months for these patients. 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.”
After 12 weeks, the avatar group’s symptoms were rated as less severe than those who received counselling
During the trial patients who had had schizophrenia for approximately 20 years and heard 3-4 voices on an average were given six sessions of therapy using a computer simulation of the voice that they heard. There was one 50-minute session each week . Of these, 75 people had the avatar therapy and the other 75 people had a form of supportive counselling designed for this study. Therapy involved a three-way conversation between the patient, therapist, and avatar, with the therapist speaking as themselves and also voicing the avatar.
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. The avatar came to recognise the patient’s strengths and good qualities, and the patient’s greater control and power in the relationship. The sessions were recorded, and an audio recording was given to the patient to take home to listen to when they heard the voices.
After 12 weeks, the avatar group’s symptoms were rated as less severe than those who received counselling.
