Therapy based on avatar-therapist synergy for patients with chronic auditory hallucinations: A pilot study

Stefaniak, Izabela; Sorokosz, Kamil; Janicki, Artur; Wciórka, Jacek

doi:10.1016/j.schres.2019.05.036

Cited by 14 publications

(9 citation statements)

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“…Lastly, the final variant was an intervention combining both CBT and AT approaches as one sole therapy, which was investigated with a case study (Stefaniak et al, 2017 ) followed by a pilot trial (Stefaniak, Sorokosz, Janicki, & Wciórka, 2019 ). One of the differences with AT was that during sessions, the therapist is seated next to the patient in the same room.…”

Section: Resultsmentioning

confidence: 99%

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A systematic review of relational-based therapies for the treatment of auditory hallucinations in patients with psychotic disorders

et al. 2022

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Background Auditory hallucinations in patients with psychotic disorders may be very distressing. Unfortunately, a large proportion of individuals are resistant to pharmacological interventions and the gold-standard cognitive-behavioral therapy for psychosis offers at best modest effects. To improve therapeutic outcomes, several therapies have been created to establish a relationship between voice-hearers and their voices. With increasing literature, we conducted a systematic review of dialogical therapies and examined the evidence behind their efficacy. Methods A systematic search was performed in PubMed, PsycINFO, Web of Science, and Google Scholar. Articles were included if they discussed the effects of dialogical interventions for patients with psychotic disorders. Results A total of 17 studies were included within this systematic review. Cumulative evidence from various therapies has shown that entering in a dialog with voices is beneficial to patients, even those who are resistant to current pharmacological treatments. Heightened benefits have been mainly observed with Relating Therapy and Avatar Therapy/Virtual Reality assisted Therapy, with evidence generally of moderate quality. Both these interventions have shown large to very large effects on voices and voice-related distress as well as moderate to large magnitude improvements on affective symptoms. Though, cognitive-behavioral therapy for command hallucinations and making sense of voices noted no improvements on voices. Conclusions Literature on relational-based interventions with a strong emphasis on the relational aspects of voice hearing has shown positive effects. Results suggest that these dialogical therapies might surpass the efficacy of current gold-standard approaches.

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Section: Resultsmentioning

confidence: 99%

“…This was particularly the case for the negative content and voice distress subscales. Large improvements were also observed on the total VPD at post-treatment ( d = 1.338, p < 0.0001), which was not maintained at follow-up (Stefaniak et al, 2019 ).…”

Section: Resultsmentioning

confidence: 99%

A systematic review of relational-based therapies for the treatment of auditory hallucinations in patients with psychotic disorders

et al. 2022

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“…Recently the study of Stefaniak et al (2019;cf. Stefniak 2015) introduces the following variation to the initial Leff study setup emphasizing shared presence of patient Avatar and therapist: "Contrary to the Leff et al study, the patient sat in the same office with the therapist and the on-screen avatar.…”

Section: Methodology and Enlargement Of Cybertherapies With Avatars F...mentioning

confidence: 99%

Hacking into Cybertherapy: Considering a Gesture-enhanced Therapy with Avatars (^g+TA)

Gerner¹

2020

Kairos. Journal of Philosophy &Amp; Science

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This paper will philosophically extend Julian Leff’s Avatar therapy paradigm (AT) for voice-like hallucinations that was initially proposed for treatment-resistant Schizophrenia patients into the realm of gesture-enhanced embodied cognition and Virtual Reality (VR), entitled g+TA (gesture-enhanced Avatar Therapy). I propose an philosophy of technology approach of embodied rhetorics of triadic kinetic “actions” in the sense of Charles Sanders Peirce that transforms the voice hallucination incorporated by an avatar- and that can confront acousmatic voice-like hallucinations with a method of gesture synchronization and dyssynchronization and gestural refusal of interaction that the player with the Avatar can resist in full embodiment. This paper therefore introduces a gesture-enhanced, extended version of Cybertherapy with Avatars that tackle multimodal bodily experience of voice-like hallucinations beyond mere visual or auditory stimulation. This is put forward theoretically in a 4E-cognition approach that expands Avatar Therapy with gestures into VR.

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“…Of the studies which included hearing voices as one of several focuses of the approach (n = 25), 14 examined CBTp [15,21,28,31,33,35,36,40,41,43,56,61,68,73]. One each applied [29].…”

Section: Approaches With a Focus On Voice Hearingmentioning

confidence: 99%

“…TABLE Outcome measurements used in the quantitative studies (n = ).a the two meta-analyses[15,21] included a total of 20 individual studies and 987 participants (studies included in more than one review were only counted once). The remaining 15 individual studies[11, 17, 28,29, 31,33,35, 40,41,43,56,61, 68, 73, 74] included 945 study participants. The CBTp approaches generally included relationship building and normalization, psychoeducation, a case formulation and the defining of individual goals at the beginning of the process.…”

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confidence: 99%

Talk-based approaches to support people who are distressed by their experience of hearing voices: A scoping review

Burr

Schnackenberg²,

Weidner³

2022

Front. Psychiatry

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BackgroundThe positive effects of both antipsychotic medication and cognitive behavioral therapy in psychosis (CBTp) for people who are distressed by their experience of hearing voices remain limited. As a result, there has been a recent surge in talk-based individual approaches. Many of these continue not to be very well known nor implemented in practice. Some of the approaches may focus more on understanding and dealing constructively with voices, an element that has been identified as potentially helpful by voice hearers. Existing barriers to a wider implementation include both the widespread pathologization of hearing voices and a lack of mental health professionals who have been trained and trusted to carry out these new interventions.MethodsThis scoping review aimed to identify and describe a current synthesis of talk-based individual approaches for people who hear voices, including studies independently of method of study or approach, diagnosis of voice hearers nor of the professional background of interventionists.ResultsNine different talk-based approaches were identified. These included: (1) Cognitive Behavioral Therapy for Psychosis (CBTp); (2) AVATAR therapy; (3) Making Sense of Voices (MsV) aka Experience Focused Counselling (EFC); (4) Relating Therapy; (5) Acceptance and Commitment Therapy; (6) Smartphone-based Coping-focused Intervention; (7) Prolonged and Virtual Reality Exposure Therapy; (8) Eye Movement Desensitization and Reprocessing, and (9) Individual Mindfulness-based Program for Voice Hearing. The different approaches differed greatly in relation to the number of sessions, length of time offered and the scientific evidence on efficacy. Psychologists represented the main professional group of interventionists. CBTp and the MsV/EFC approach also included health professionals, like nurses, as implementers. Most of the approaches showed positive outcomes in relation to voice related distress levels. None identified overall or voice specific deteriorations.ConclusionThere appears to be a strong case for the implementation of a broader heterogeneity of approaches in practice. This would also be in line with recommendations for recovery focused services and requirements of voice hearers. A greater emphasis on whole systems implementation and thus the involvement of frontline staff, like nurses, in the delivery of these approaches would likely reduce the research-practice implementation gap.

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Therapy based on avatar-therapist synergy for patients with chronic auditory hallucinations: A pilot study

Cited by 14 publications

References 9 publications

A systematic review of relational-based therapies for the treatment of auditory hallucinations in patients with psychotic disorders

A systematic review of relational-based therapies for the treatment of auditory hallucinations in patients with psychotic disorders

Hacking into Cybertherapy: Considering a Gesture-enhanced Therapy with Avatars (^g+TA)

Talk-based approaches to support people who are distressed by their experience of hearing voices: A scoping review

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Therapy based on avatar-therapist synergy for patients with chronic auditory hallucinations: A pilot study

Cited by 14 publications

References 9 publications

A systematic review of relational-based therapies for the treatment of auditory hallucinations in patients with psychotic disorders

A systematic review of relational-based therapies for the treatment of auditory hallucinations in patients with psychotic disorders

Hacking into Cybertherapy: Considering a Gesture-enhanced Therapy with Avatars (g+TA)

Talk-based approaches to support people who are distressed by their experience of hearing voices: A scoping review

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Hacking into Cybertherapy: Considering a Gesture-enhanced Therapy with Avatars (^g+TA)