A novel therapy which helps people with schizophrenia to interact face-to-face with a digital avatar of the entity that they believe is persecuting them has been proven effective, results of a clinical trial has revealed.

Auditory verbal hallucinations, which are typically of a derogatory and threatening nature, are reported by approximately 60-70 per cent of people with schizophrenia. Despite treatment with antipsychotic medications, nearly 25 per cent of people continue to experience such persecutory hallucinations and delusions. Avatar therapy is a new approach in which people who hear voices have a dialogue with a digital representation (avatar) of their presumed persecutor, voiced by the therapist so that the avatar responds by becoming less hostile and concedes power over the course of therapy. 

The trial, led by Tom KJ Craig from the King's College London, showed that the Avatar therapy effects on the frequency and severity of auditory verbal hallucinations. The therapy is also stronger than more general cognitive behavioural therapy and has shown clinically worthwhile benefits for voice hearers. The study, published in The Lancet Psychiatry journal, included 150 people aged 18 to 65 years and were randomly assigned to receive either Avatar therapy or supportive counselling. Participants first created a computerised representation of the entity that they believed was the source of their main voice. 

In the therapy, delivered over six weekly 50-min sessions, the participants spent 10-15 min of each session face-to-face with the avatar, wherein the therapist facilitated a direct dialogue between the participant and the avatar. The control condition, supportive counselling, was delivered by graduate assistant psychologists. And the intervention comprised a manual-based, face-to-face supportive counselling approach . 

The results showed a reduction in auditory verbal hallucinations at 12 weeks, which was significantly greater for Avatar therapy than for supportive counselling. Avatar therapy was feasible to deliver, acceptable to participants, and did not result in any adverse events that could be attributed to the therapy, the researchers said.