avatarUsing avatars can help to treat people with a diagnosis of schizophrenia who hear voices, a University College of London study has suggested.

Through customised computer software, the people in the study, chosen because they had not responded to medication, created avatars to match the voices they had been hearing. The system then synchronises the avatar’s lips with its speech, enabling a therapist to speak to the patient through the avatar in real time. The therapist encourages the patient to oppose the voice and gradually teaches them to take control of their hallucinations.

After up to six therapy sessions most people said there had been an improvement in the frequency and severity of the voices they heard. Three participants – who had experienced auditory hallucinations for 16, 13 and 3.5 years – said the voices had stopped entirely.

'Stand up to their voices'
The study was led by psychiatrist emeritus professor Julian Leff, who spoke to participants in the study through their on-screen avatars in therapy sessions. Gradually he coached patients to stand up to their voices.

"I encourage the patient saying, 'you mustn't put up with this, you must tell the avatar that what he or she is saying is nonsense, you don't believe these things, he or she must go away, leave you alone, you don't need this kind of torment'," said Professor Leff.

"The avatar gradually changes to saying, 'all right I'll leave you alone, I can see I've made your life a misery, how can I help you?' And then begins to encourage them to do things that would actually improve their life."

By the end of their treatment, patients reported that they heard the voices less often and that they were less distressed by them. Levels of depression and suicidal thoughts also decreased; a particularly relevant outcome-measure in a patient group where one in 10 will attempt suicide.

While the avatar does not address the participants' delusions directly, the study found that they do improve as an overall effect of the therapy.

New treatment options for schizophrenia
The trial, conducted by Professor Leff and his team from University College London, compared 14 patients who underwent avatar therapy with 12 patients receiving standard antipsychotic medication and occasional visits to professionals.

New treatment options have been welcomed by mental health charities for the one in four people with a diagnosis of schizophrenia who does not respond to medication.

Rethink Mental Illness’ CEO, Paul Jenkins, said: "As our Schizophrenia Commission reported last year, people with the illness are currently being let down by the limited treatments available.

"While antipsychotic medication is crucial for many people, it comes with some very severe side effects. Our members would be extremely interested in the development of any alternative treatments."

Simplicity and brevity of treatment
A larger trial featuring 142 patients is planned to start next month in collaboration with the King's College London Institute of Psychiatry.

Professor Thomas Craig, who will lead the study, said: "The beauty of the therapy is its simplicity and brevity. Most other therapies for these conditions are costly and take many months to deliver.

"If we show that this treatment is effective, we expect it would be widely available in the UK within just a couple of years as the basic technology is well developed and many mental health professionals already have the basic therapy skills that are needed to deliver it."