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Computer avatar 'may ease schizophrenia voices'

WebMD UK Health News
Medically Reviewed by Dr Sheena Meredith
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24th November 2017 – Scientists say they have seen promising results for an experimental type of therapy for schizophrenia which involves a face-to-face discussion on a computer screen between a patient and an avatar.

Between 60% and 70% of people with schizophrenia say they hear voices and these are often of a derogatory and threatening nature.

Drug treatment works for many people with auditory hallucinations but approximately a quarter of people with psychotic conditions continue to experience them.

London trial

A study in The Lancet Psychiatry journal found that people who confronted an avatar were more able to control the hallucinations than those who received counselling.

The study in the South London and Maudsley NHS Trust involved 150 adults who had been hearing distressing voices in their heads for at least a year. All the participants had been taking antipsychotic medication previously with only partial or no improvements to their symptoms.

Half of the people in the trial underwent avatar therapy and the remainder had a form of counselling All those involved continued with their antipsychotic medication.

Before starting treatment, those in the avatar group worked alongside a therapist to create the computerised figure, including the sound of its voice and its appearance.

Confronting auditory hallucinations

The therapy took place over 6 weekly sessions, each lasting 50 minutes. The therapy involved a 3-way conversation between the patient, therapist, and avatar.

Each session lasted 50 minutes, with 10 to 15 minutes spent talking face-to-face with the avatar. The participants sat in one room facing their avatar on a computer monitor. The therapist sat in a second room with a control panel that allowed them to speak in his or her own voice, or as the avatar.

Each computer session involved the patient practising standing up to the avatar, correcting any misconceptions it had about them, and taking control of the conversation. This helped shift power from the avatar to the patient, reports the research team, led by King's College London and University College London.

The avatar evolved during the sessions during which it came to recognise a patient's strengths and good qualities, as well as their greater control and power in the relationship.

The researchers say after 12 weeks, those in the avatar group were experiencing less severe symptoms than those who received counselling.

They say that people who had received avatar therapy also found their hallucinations less distressing and less powerful than those in the counselling group.

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

However, after 24 weeks, participants in both groups showed the same level of improvement.

'Interesting' study

Sir Robin Murray, professor of psychiatric research at King's College London's Institute of Psychiatry, Psychology and Neuroscience, says the new treatment might one day provide an alternative treatment to medication and counselling. "If the findings of the study are generally replicated it will add an important new approach to care," he says in a statement.

"But in addition, it will also make psychiatrists and neuroscientists reflect on the mechanisms underlying persistent voices. At present, most models consider voices as the manifestation of some underlying abnormality of the functioning of the brain. If a wholly psychological intervention such as avatar therapy can produce such an improvement, then it should make us rethink the way we conceptualise auditory hallucinations."

Reviewed on November 24, 2017

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