Avatar Therapy

Julian Leff, Mark Huckvale, Geoff Williams

Avatar Therapy is a new approach to the treatment of auditory hallucinations (hearing voices). Computer avatars are first designed by patients to give a form to the voices they hear and then the avatars are controlled by therapists to encourage patients to oppose the voices so that the voices gradually come under the patient's control.

Introduction

Auditory hallucinations are an enduring problem in the treatment of serious mental illness such as schizophrenia. About 25% of people with this diagnosis continue to experience persecutory hallucinations and delusions despite treatment with antipsychotic medication (Kane, 1996). Their capacity to work and make relationships is grossly impaired, often for the rest of their life. We have developed and evaluated a novel therapy based on computer technology which enables each patient to create an avatar of the entity (human or non-human) that they believe is talking to them. The therapist promotes a dialogue between the patient and the avatar in which the avatar progressively comes under the patient’s control.

Pilot Study 2009-2011 funded by the National Institute for Health Research

The pilot study demonstrated the basic principles of avatar therapy, but only involved a very small number of patients. The outcomes of that study were promising in that there was a significant reduction in the severity of symptoms expressed by those taking part, and that three out of sixteen patients treated claimed that they were no longer affected by hearing voices.

The results of the pilot study may be found in these publications:

• Leff, J., Williams, G., Huckvale, M., Arbuthnot, M., & Leff, A. P. (2013). Silencing voices: a proof-of-concept study of computer-assisted therapy for medication-resistant auditory hallucinations. British Journal of Psychiatry (in press).
• Leff, J., Williams, G., Huckvale, M., Arbuthnot, M., & Leff, A. P. (2013). Avatar Therapy for persecutory auditory hallucinations: What is it and how does it work?. Psychosis: Psychological, Social and Integrative Approaches (in press).

Clinical Trial 2012-2015 funded by the Wellcome Trust

The project will refine the avatar therapy system, streamline the technology to make it more portable and user-friendly and evaluate the system by a randomised controlled trial conducted by an independent team of researchers.

The trial will be conducted by Thomas Jamieson-Craig at the South London and Maudsley NHS Foundation Trust. People interested in finding out more about the new avatar trial should email AVATAR@kcl.ac.uk.

Aims:

1. To develop a computer-based technology that will help the clinician to treat more effectively the auditory hallucinations of schizophrenia and manic-depressive psychosis.
2. To evaluate this technology in a randomised controlled trial.

Downloads from the Pilot Study

Audio file for BJP paper:

• Audio extract from a typical therapy session

Video clip from a typical therapy session:

• AVI file

• WMV file

Media links

Press releases:

• Wellcome Trust (29-May-2013)
• University College London (29-May-2013)
• Kings College London (29-May-2013)

Broadcast media:

• BBC World Service Health Check (audio)
• BBC World News Channel - Health Check (video)

News articles:

• BBC web site (29-May-2013)
• New Scientist (29-May-2013)
• The Guardian (29-May-2013)
• Bloomberg (29-May-2013)
• Evening Standard (29-May-2013)
• Reuters (29-May-2013)
• GizMag (30-May-2013)
• South London and Maudsley NHS Foundation Trust (30-May-2013)
• BBC web site (31-May 2013)
• Daily Mail Online (31-May-2013)
• Slashdot (31-May-2013)
• Hearing The Voice (31-May-2013)
• Psych Central (1-Jun-2013)
• Time Newsfeed (5-Jun-2013)
• Our Practice - Dudley Doctor (n.d.)