Experimental therapy can treat voice-hearing in psychosis

Home when they encounter the voices again. The supportive counselling ran for the same length and number of sessions. In each session the patients were encouraged to discuss issues of concern. The sessions were aimed to reduce their distress and help them find way to improve their quality of life. At the end of each of these sessions, patients tool a recorded positive message to listen to during the week. The patients symptoms were assessed at the end of all sessions by the researchers who were blind to which kind of therapy session each patients received. They found that the patients who received Avatar therapy had less severe symptoms than the control group. People in the Avatar group found their symptoms less distressful and less powerful than those in the supportive counselling group. Seven people who had the avatar therapy and two in the counselling group also reported that their hallucinations completely disappeared after 12 weeks. The results of the avatar therapy group were sustained at 24 weeks. However, during this time the hallucination became less distressful and less frequent in the counselling group showing that supportive counselling can be a potential therapy method. As a result, at 24 weeks, there was no difference in outcomes between the two groups. While further research is needed in this area, the study shows that avatar therapy is more effective in reducing hallucinations at 12 weeks with a large effect size. But supportive counselling can be a useful therapy in treating voice hallucinations over a longer-term. Source: The Lancet Psychiatry”>Schizophrenia is a mental disorder which affects the functioning of the human mind. Often characterised by delusion and hallucinations, people with schizophrenia fail to understand what is real.

About 60-70 per cent of people who have schizophrenia also experience auditory hallucinations – they hear people’s voices which are often insulting or threatening.

For most, drug treatment reduces the symptoms but one in for people continue to hear voices.

Another treatment option is cognitive behavioural therapy for psychosis (CBTp) which can be helpful but it is a lengthy therapy and may have limited effects on voices.

They found that the patients who received Avatar therapy had less severe symptoms than the control group.

To find an effective therapy for auditory hallucinations that can help people with schizophrenia, researchers investigated the effect of AVATAR therapy on auditory hallucinations compared to supportive counselling control conditions.

Avatar therapy is a new approach in which people who hear voices have a face-to-face dialogue with a digital representation or 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.

In a first large-scale single-blind randomised controlled trial, this therapy was used on participants who had persistent auditory hallucinations for more than a year, despite treatment. The participants continued to receive their usual treatment during this study.

The study took place at a single location and involved 150 people who had schizophrenia for about 20 years and had heard 3-4 voices on average.75 people had Avatar therapy while the other 75 received supportive counselling designed for this study.

Participants also continued their usual antipsychotic medication during the course of this study.

The participants received avatar therapy for six sessions, with each 50 minute session once a week.

Before the therapy started, participants worked with the therapists to create a computerised simulation or avatar of the voice they most wanted to influence. This included what the voice said, how it sounded and what it could look like. The therapy involved a 3-way conversation – between therapist and patients and the avatar which was also voiced by the therapist.

In each session, the participants discussed the target for the day and then spent 10-15 minutes talking to the avatar in a face-to-face conversation. During this conversation the patient practised standing up to the voice and taking control of the conversation – correcting any misconceptions the voice had.

In this way the power shifted to the patient who then regained power in the conversation. The voice comes to recognise the strengths and good qualities of the patient and the greater control that the patient has in the relationship.

The sessions were recorded and given to the patient to listen at home when they encounter the voices again.

The supportive counselling ran for the same length and number of sessions. In each session the patients were encouraged to discuss issues of concern. The sessions were aimed to reduce their distress and help them find way to improve their quality of life. At the end of each of these sessions, patients took a recorded positive message home to listen to during the week.

The patients symptoms were assessed at the end of 12 weeks by the researchers who were blind to which kind of therapy session each patients received.

They found that the patients who received avatar therapy had less severe symptoms than the control group.

People in the avatar group found their symptoms less distressful and less powerful than those in the supportive counselling group.

Seven people who had the avatar therapy and two in the counselling group also reported that their hallucinations completely disappeared after 12 weeks.

The results of the avatar therapy group were sustained at 24 weeks.

However, during this time the hallucination became less distressful and less frequent in the counselling group showing that supportive counselling can be a potential therapy method.

As a result, at 24 weeks, there was no difference in outcomes between the two groups.

While further research is needed in this area, the study shows that avatar therapy is more effective in reducing hallucinations at 12 weeks with a large effect size. But supportive counselling can also be a useful therapy in treating voice hallucinations over a longer-term.

Source: The Lancet Psychiatry