Virtual Reality Avatar Therapy for People Hearing Voices

Study Overview
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Brief Summary
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Hearing voices is probably the worst form of acoustic hallucinations; which can be experienced as severely disturbing and is influenced by diverse factors including the ability of the individual to influence and control the hallucinatory experience itself. In recent years virtual reality has become a treatment option. In the so-called AVATAR Therapy, patients with schizophrenia and acoustic hallucinations design a visual and auditory recreation (avatar) of the entity to which they attribute their hallucinations. Working with a therapist over the course of several sessions, participants change the avatar from controlling to benevolent. Avatar Therapy involves similar processes to learning and cognitive restructuring, comparable to other psychotherapeutic interventions. The investigators plan to conduct an interventional study using a cross-over design, to compare the feasibility and efficacy of virtual reality avatar therapy for patients with acoustic hallucinations (independent of psychiatric diagnosis) with a cognitive behavioural group therapy aimed to improve social competence.

Official Title
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Virtual Reality Avatar Therapy for People Hearing Voices

Conditions
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Psychosis, Schizophrenia, Schizo Affective Disorder, Hearing Voices When No One is Talking (Symptom)

Intervention / Treatment
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* Behavioral: Virtual Reality Avatar Therapy (VRAT)
* Behavioral: Assertiveness Training Program (ATP)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Consistent acoustic hallucinations, with the presence of voices for at least two months. Participants are competent to give informed consent, as determined by the referring physician or psychiatrist. German language proficiency as a native speaker or level B1 Common European Framework of Reference for Languages (CEFRL) Exclusion Criteria: Current neurological disorder. Current substance use or withdrawal. Concomitant group psychotherapeutic intervention.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Crossover Assignment
Interventional Model Description: The investigators plan to conduct a single-blind, randomised, controlled trial in a cross-over design to assess the feasibility and efficacy of VRAT in patients with acoustic hallucinations, independent of the main diagnosis.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Virtual Reality Avatar Therapy (VRAT)<br>In the VRAT, patients with schizophrenia and acoustic hallucinations design a visual and auditory recreation (avatar) of the entity to which they attribute their hallucinations. Working with a therapist over the course of several sessions, participants change the avatar from controlling to benevolent. | Behavioral: Virtual Reality Avatar Therapy (VRAT)<br>* The Virtual Reality Avatar Therapy (VRAT) is a Cognitive Behavioral Intervention, delivered through Virtual Reality.<br>Behavioral: Assertiveness Training Program (ATP)<br>* The Assertiveness Training Program (ATP) is a Cognitive Behavioral Intervention, delivered as group therapy.<br>|
| Active Comparator: Assertiveness Training Program (ATP)<br>The ATP is a transdiagnostic cognitive behavioural treatment programme, which aims to increase self-confidence and social competence in patients with a psychiatric disorder. | Behavioral: Virtual Reality Avatar Therapy (VRAT)<br>* The Virtual Reality Avatar Therapy (VRAT) is a Cognitive Behavioral Intervention, delivered through Virtual Reality.<br>Behavioral: Assertiveness Training Program (ATP)<br>* The Assertiveness Training Program (ATP) is a Cognitive Behavioral Intervention, delivered as group therapy.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Psychopathological Assessment | Symptom Questionnaire | Change: Baseline, 3, 6 weeks, 6 and 12 months] | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Psychotic Symptoms | Symptom Questionnaire | Change: Baseline, 3, 6 weeks, 6 and 12 months] | 
| Insecurity- Self-confidence | Symptom Questionnaire | Change: Baseline, 3, 6 weeks, 6 and 12 months] | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Hearing Voices, Virtual Reality Avatar Therapy, Cognitive Behavioural Therapy