du Sert OP, Potvin S, Lipp O, et al. (2018). Virtual reality therapy for refractory auditory verbal hallucinations in schizophrenia: A pilot randomized controlled trial. Schizophrenia Research. 197: 176-181. doi: 10.1016/j.schres.2018.02.031
Researchers conducted a pilot randomized controlled trial to evaluate the efficacy of avatar therapy adapted to virtual reality (VR) technology for treating auditory verbal hallucinations (i.e. hearing voices; AVHs) in patients with treatment-resistant schizophrenia. Avatar therapy uses computer technology that allows patients to create an avatar of a prominent AVH and engage in a conversation with that AVH. A therapist uses voice altering technology to act as the avatar. The avatar is initially abusive, but grows more supportive over time. The VR adaptation encouraged greater patient immersion by presenting the avatar on a VR headset. Researchers recruited 19 patients with treatment-resistant schizophrenia and randomized them to immediately receive VR-based avatar therapy for 7 weeks or to a wait-list control group that received VR-based avatar therapy after 7 weeks of treatment as usual (TAU). Participants completed assessments of AVH experiences, distress related to AVHs, perceptions of AVH omnipotence and malevolence, psychiatric symptoms, depression, and life satisfaction pre- and post-intervention period, pre- and post-TAU period (wait-list control only), and 3 months after the last VR-based avatar therapy session. Participants experienced significant improvements in AVH experiences, distress related to AVHs, perceptions of AVH omnipotence and malevolence, general psychiatric symptoms, depression, and quality of life between pre- and post-intervention. Intervention effects were maintained to 3 months follow-up. Wait-list control participants did not experience any significant changes between pre- and post-TAU period. Researchers concluded that VR-based avatar therapy holds promise for treating AVH in patients with treatment-resistant schizophrenia.