AVATAR therapy offers a new approach to working with distressing voices. It involves innovative use of digital technology to allow ‘face-to-face’ dialogue between the voice-hearer and a computerised representation of their voice (the avatar), with a therapeutic focus on increasing power and control over the voice.

The digital technology allows us to bring the person’s experience of hearing the voice into therapy in a new and potentially powerful way.

Building on pioneering work by Professor Julian Leff, researchers at King's College London have developed the AVATAR therapy approach. In 2018, the researchers led the first fully-powered randomised controlled clinical trial of AVATAR therapy (AVATAR 1) with funding from Wellcome and the National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre. The trial found that AVATAR Therapy reduced the distress experienced by people who hear voices when compared to supportive counselling.

With further funding from Wellcome, the researchers introduced AVATAR therapy in eight clinical settings across the UK in centres linked to King’s, UCL and the Universities of Glasgow and Manchester. In 2024, they published the results of the largest randomised controlled trial of the therapy (AVATAR2), demonstrating that both Brief and Extended versions of AVATAR therapy were effective across more geographically diverse settings.

345 participants were randomly assigned to one of three treatment groups – AVATAR Brief, AVATAR Extended and their usual treatment. 16 weeks after therapy was completed, participants who received both versions of the therapy showed statistically significant improvements in the severity of the voice itself and related distress, compared to those who received their usual treatment.

Participants who received AVATAR Extended also saw a sustained reduction in the frequency of distressing and a wide range of other benefits in wellbeing, recovery and empowerment.

For the latest AVATAR2 trial updates please see our dedicated website – www.avatartherapytrial.com.