Schizophrenia patients can interact with voice hallucinations in new computerised treatment technique

Facing up to avatars with characteristics of the patients’ internal ‘voices’ helped reduce their occurrence

Tackling voice hallucinations face-to-face may be the key to treating schizophrenia, according to the results of a new medical trial carried out in London.

AVATAR therapy is a new technique that involves creating a computerised representation of the voices inside the head of a schizophrenia patient, and encouraging them to interact with it.

Voices are heard by the majority of people with schizophrenia, and they are typically insulting and threatening.

While drug treatments can reduce these symptoms, they are not always effective.

“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,” said lead study author Professor Tom Craig from King’s College London.

In the trial, patients were able to choose characteristics of their avatar, such as gender, appearance and the sound of their voice.

They then interacted with the avatar, voiced by their therapist, while also speaking to their therapist talking in their normal voice.

The avatars began by saying the typical upsetting things to patients, such as “you’re rubbish” and “you’re a waste of space”. The patients were encouraged to stand up to the avatar, shifting the power away from their voices.

The trial, published in The Lancet Psychiatry journal, was conducted with 150 patients – half of whom were provided with AVATAR therapy – in the South London and Maudsley NHS Trust.

The group who experienced the new therapy were more likely to experience reduced voice hallucinations after a three month follow-up than the other group, who received more conventional therapy.

This suggests the treatment was a success and could help where other methods cannot.

The treatment will still require further research before it is widely available, but responses from other scientists have been positive.

“This is an impressively large and robust randomised control trial in a difficult to treat population,” said Professor Stephen Lawrie, a psychiatrist at the University of Edinburgh who was not involved in the trial.

Professor Sir Robin Murray, a psychiatric researcher at King’s College London, who was also not involved in the trial, agreed that this is “a most interesting study”.

“In addition, it will also make psychiatrists and neuroscientists reflect on the mechanisms underlying persistent voices,” added Professor Murray.

As it stands ‘voices’ are thought to be a manifestation of an abnormality in brain function.

“If a wholly psychological intervention such as AVATAR therapy can cause produce such an improvement, then it should make us rethink the way we conceptualise auditory hallucinations,” said Professor Murray.