Avatar Therapy Eases Psychosis-Related Paranoia, Anxiety
Virtual reality–based cognitive-behavioral therapy (VR-CBT) can reduce paranoia and anxiety in patients with psychotic disorders, results of a multicenter randomized controlled trial show. CBT is the most effective psychological treatment for people with psychosis, but its ability to reduce paranoia and improve social functioning has been limited. Geraets, with lead investigator Roos Pot-Kolder, MSc, VU University, the Netherlands, and colleagues investigated the effects of VR-CBT on paranoid thoughts and social participation in 116 outpatients who in the past month had received a diagnosis of psychotic disorder and paranoid ideation on the basis of criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Half of patients received 16 VR-CBT sessions delivered by CBT-trained therapists during an 8- to 12-week period in addition to usual treatment. The other half received only usual treatment (control patients).
@monomoy The therapist could alter the number of avatars, their appearance, and their response to the patient (neutral or hostile). The therapist spoke directly with the patient during the therapy, helping them to explore and challenge their feelings within the virtual social situations, to stop using "safety" behaviors, such as avoidance of eye contact, and to challenge their concerns that others wish to harm them. Compared with usual treatment, VR-CBT reduced momentary paranoia and anxiety at the 3-month posttreatment assessment (Cohen's d, -1.49 and -0.75, respectively) and at a 6-month follow-up visit (Cohen's d, -1.24 and -0.52, respectively). VR-CBT did not significantly increase the amount of time patients spent with other people at 3 months compared with control patients. However, after 6 months, for patients in the VR-CBT arm, time spent with others had increased marginally in comparison with control patients (+0.3% vs -2.4%).