Distressing auditory visual hallucinations (“voices”) are a common feature of psychotic disorders such as schizophrenia and often persist despite pharmacological or psychological treatment. Many patients feel frustrated that their experience is difficult to share with others and poorly understood by their psychiatrist or therapist. AVATAR therapy uses digital technology to create a visual representation (avatar) of the voice that closely matches what the patient says they experience. This avatar is used in a videoconferencing format to enable a trialogue between patient, avatar and therapist. The therapist, advising the patient and controlling the avatar, enables the patient to challenge the voice that responds by becoming less threatening and concedes power over the course of 6-8 treatment sessions. The approach has been shown to be highly effective in controlled clinical trials in reducing the frequency of voices and associated distress. In this presentation, I will demonstrate the creation and use of the avatar in therapy, briefly review evidence for efficacy and describe a new project that attempts to develop our understanding of the effective therapeutic mechanisms.

See: Craig et al., AVATAR therapy for auditory verbal hallucinations in people with psychosis: a single-blind, randomised controlled trial, “Lancet Psychiatry” n. 5, 2018, pp. 31-40.