Avatar therapy for persecutory auditory hallucinations: What is it and how does it work?

Area of Science:

• Psychiatry
• Clinical Psychology
• Digital Therapeutics

Background:

• Auditory hallucinations, often persecutory, are a core symptom of psychosis.
• Existing treatments for auditory hallucinations have variable efficacy.
• Novel therapeutic approaches are needed to address distressing voices.

Purpose of the Study:

• To evaluate the efficacy of a novel computer-based intervention, Avatar therapy, for auditory hallucinations.
• To assess the impact of Avatar therapy on the frequency, intensity, and characteristics of persecutory voices.

Main Methods:

• A randomized controlled trial with a partial crossover design was used.
• Patients created and interacted with a digital avatar representing their persecutory entity.
• Therapists guided patients in gaining control over the avatar, transforming it from abusive to supportive over six 30-minute sessions.

Main Results:

• Significant reductions in the frequency and intensity of auditory hallucinations were observed.
• The perceived omnipotence and malevolence of the voices decreased significantly.
• Several participants experienced complete cessation of voices, with an average effect size of 0.8.

Conclusions:

• Avatar therapy demonstrates significant efficacy in reducing distressing auditory hallucinations.
• The therapy's success suggests potential psychological mechanisms related to control and therapeutic alliance.
• This digital intervention offers a promising new avenue for managing persecutory voices in psychosis.