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Avatar therapy heralds a new age in mental health treatments


A recent Radio 4 Today programme highlighted a new treatment for patients with schizophrenia, pioneered by Professor Julian Leff at University College London [1]. The preliminary findings from his research group suggest that there may be therapeutic potential from future treatments employing computer and communications based technology. When I first heard on Avatar therapy, I immediately thought of the James Cameron’s film of 2009 that was a technological marvel of its day when it pioneered new 3D technology.

Leff’s avatar treatment is another major technological leap forward. This avatar is a graphical representation on a computer of the imaginary character that a patient with schizophrenia sees or hears. The patient chooses a face and voice that most resembles the auditory hallucination they believe is talking to them. The computer programme synchronises the avatars’ lips with its speech and the therapist is therefore able to speak to the patient in real time through the avatar. The therapist gradually encourages the patient to oppose the voice and teaches them to take control of this distressing symptom. Almost the entire treatment group in the study reported an improvement in the frequency and severity of voices they hear. This followed only 7 sessions held weekly, each lasting no more than 30 minutes. These early results will need to be replicated on a larger scale but these findings are extremely encouraging.

Kingdon in a recent British Journal of Psychiatry describes links between university departments of psychology and psychiatry leading to a golden age of discovery of new treatments [2].A number of computerised cognitive behaviour therapy programmes have developed in recent years such as “Living life to the full”, “Mood gym” and “Beating the blues” [3]. Emerging technologies now employ use of email, SMS, virtual reality, computer games, phone apps and social networking.

Rizzo et al. [4] have used Virtual Reality (VR) (simulated real environments through digital media) to successfully treat Post-Traumatic Stress Disorder. Adolescents reluctant to engage in therapy have responded favourably to computer game based treatments [5]. Future uses for mobile phone technology include sensing when sufferers’ mood states are changing by noticing a change in voice pattern or usage frequency. Phone apps may even be able to detect location, time and activity (e.g. buying alcohol) thus predicting high risk situations for users.

There are many reasons why people don’t always seek treatment for their mental disorders. These include social stigmas and unwillingness to try psychotropic medication. This new wave of technology driven interventions however present a fresh perspective on mental health treatments and may offer new hope to many sufferers.


1. Leff J, Williams G, Huckvale MA, Arbuthnot M, Leff AP. Computer-assisted therapy for medication-resistant auditory hallucinations: proof-of-concept study. Br J Psychiatry 2013; 202: 428-33

2. Kingdon D. A golden age of discovery. B J Psychiatry 2013; 202: 394-395

3. NHS South Central. Computerised Therapy. NHS South Central, 2013

4. Rizzo, A; Pair, J; Graap, K; Manson, B; McNerney, P.J; Wiederhold, B; Wiederhold, M; Spira, B (2006). “A Virtual Reality Exposure Therapy Application for Iraq War Military Personnel with Post Traumatic Stress Disorder: From Training to Toy to Treatment“. In Roy. M. (ed.). NATO Advanced Research Workshop on Novel Approaches to the Diagnosis and Treatment of Posttraumatic Stress Disorder. Washington D.C: IOS Press. pp. 235–250.

5. Coyle, G; Matthews, M; Sharry, J; Nisbet, A; Doherty (2005). “Personal Investigator: A therapeutic 3D game for adolecscent psychotherapy”. Journal of Interactive Technology & Smart Education 2 (2): 73–88.

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