Digital avatars transform psychosis therapy for people who hear voices

A groundbreaking therapy using digital avatars offers new hope to people living with psychosis who find little relief in medication. AVATAR therapy uses personalised, computer-generated representations of the voices people hear to facilitate therapeutic dialogue in real time. Results are striking: participants report fewer and less distressing voice-hearing experiences. 

Rooted in lived experience, the therapy has been co-designed with people who hear voices—from avatar design to how success is defined—ensuring it feels authentic, empowering, and respectful. It enables participants to confront distressing voices in a safe, controlled environment, supported by a trained therapist.  

Nick, a participant, described the impact: “I was hearing up to 30 or 40 abusive voices a day and it brought it down to about four or five. I felt like I was taking back control of my life again.” 

Building on almost two decades of research, AVATAR therapy is now led by King’s College London and supported by Wellcome*. Research into AVATAR therapy began in 2008, when Professor Julian Leff—then retired from UCL—received a small grant to pilot the idea of giving voice-hearers a visual and audible representation of the voices causing them distress. Over the next five years, he and a team at UCL developed the software and conducted a 2013 pilot study, which showed dramatic reductions in distress—some participants even stopped hearing voices after just a few sessions.  

This early success laid the groundwork for researchers at King’s College London to lead the first full-scale randomised controlled trial (AVATAR1), paving the way for the AVATAR2 study and the therapy’s continued development. 

AVATAR therapy is more than a treatment—it’s a movement towards dignity-centred care in psychosis. Following the latest research results, the next steps are to refine the therapy’s digital infrastructure and expand therapist training, ahead of wider rollout across healthcare systems. At a time when too many people with psychosis face limited options, this work is a powerful reminder that sustained investment in research can transform lives. 

*IAMHRF Member