Avatar Therapy
Virtual double helped patients with schizophrenia to get rid of hallucinations
Kristina Ulasovich, N+1
Experimental therapy, during which patients with schizophrenia talk to a virtual avatar personifying their auditory hallucinations, can reduce symptoms if it is used alongside conventional treatment. At an early stage of clinical trials, the new method showed a positive result, according to the Lancet journal (Craig et al., AVATAR therapy for auditory verbal hallucinations in people with psychosis: a single-blind, randomized controlled trial). After conducting additional research, avatar therapy can be used as an alternative or supplement to supportive psychotherapy for psychosis.
Approximately 60-70 percent of patients with schizophrenia experience auditory hallucinations, which are usually threatening or offensive in nature. The majority of patients are helped by specially selected drugs, but for 25 percent the treatment is ineffective and patients continue to hear voices. Cognitive behavioral therapy and supportive psychotherapy are used as an additional method for psychosis, but they take a lot of time and do not always give results.
A group of psychologists led by Tom KJ Craig from King's College London conducted a randomized controlled trial. It involved 150 patients aged 18 to 65 years, who had schizophrenia or affective disorder on average for 20 years. Over the past 12 months, they have heard 3-4 voices, despite ongoing treatment. The subjects were divided into two groups of 75 people – one received avatar therapy, and the other went to supportive psychotherapy developed specifically for the experiment. At the same time, all participants continued to take their usual antipsychotic medications throughout the study.
Avatar therapy took place during 6 sessions, each of them lasted 50 minutes. First, the subjects, together with the therapist, created a computer character (avatar), which personified the most disturbing voice in the head. The character, whose appearance corresponded to the patient's ideas, copied the manner of speech and the sound characteristics of the voice in his head. Therapy was a three–way conversation between the patient, the avatar and the psychiatrist - the latter spoke on his own behalf and voiced the avatar.
During the session, the patients spent 10-15 minutes talking to the avatar. They tried to rebuff him, correct his misconceptions, and also take control of the conversation. The avatar, in turn, recognized the strength and good qualities of the subject, as well as greater control and power of the patient in the relationship. The session was recorded on audio, and after that the patients took the recording home to turn it on every time they heard voices.
Avatars created by patients (King's College London)
Supportive psychotherapy, which was aimed at reducing anxiety and improving the quality of life of patients, took the same amount of time as avatar therapy. During the session, the subjects discussed any problems that caused them anxiety. After that, they also received an audio recording, which they had to listen to when voices appeared.
The patients' condition was assessed three times: at the beginning of the experiment, at 12 and 24 weeks. In the middle of the experiment, avatar therapy showed greater effectiveness in reducing the frequency of auditory hallucinations or the occurrence of voices in the patient's head than supportive psychotherapy. In addition, the hallucinations of people who received avatar therapy became less anxious and less intense compared to the other group. Seven people reported that their hallucinations completely disappeared after 12 weeks. In the second group, two patients managed to achieve this result.
The quick result was preserved in the avatar group 24 weeks later. However, by this time, the hallucinations of patients from the group who received consultations also became less frequent and less alarming, which indicates the benefits of this method of treatment. As a result, after 24 weeks there were no significant differences in the results between the groups.
The work has a number of limitations, including the fact that supportive psychotherapy was conducted by trainee students, and this could affect its effectiveness. In addition, it is unclear whether avatar therapy can be easily applied by specialists, since the study was conducted in a center with experience in the treatment of psychosis, and very experienced therapists acted on behalf of the avatar. The authors emphasize the need for further research in other treatment centers to determine the effectiveness of avatar therapy. If the results show effectiveness, the new method can help many patients with psychosis.
Schizophrenia is considered one of the most mysterious and complex diseases, and scientists have been trying to find the causes of its occurrence for many years. At the beginning of last year, scientists were able to discover for the first time the molecular mechanism of schizophrenia: the risk of developing a severe disease was higher in people with certain variants of a gene that is involved in the immune system and the "maturation" of synaptic connections in the brain.
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