Relational Therapies for People Who Hear Voices: Operationalisation and Current Status of an Emergent Group of Psychological Therapies.
Level 5 - mechanism / opinion, no new human data
Conceptual review and expert consensus framework with no original data or quantitative synthesis
PubMed 41391108 · doi:10.1093/schbul/sbaf142
What was done
Researchers involved in developing Relating Therapy (RT), Talking with Voices (TwV), and AVATAR Therapy (AT) conducted collaborative discussions alongside a systematic literature search. They aimed to establish an agreed operational definition for relational therapies targeting auditory verbal hallucinations, identify common and distinctive therapeutic techniques, summarize proposed mechanisms of change, and outline future research priorities.
What was found
The authors operationalised relational therapies as interventions that target interaction patterns and relational dynamics between the voice hearer and the voice, using experiential dialogue as a primary therapeutic method. Distinctive features involve the dialogue modality (chair work role-play in RT, direct dialogue in TwV, and computerized avatar simulation in AT) and differing emphasis on broader relational models versus encapsulated meaning. Regarding trial evidence, the abstract notes that AT has demonstrated efficacy in several randomized controlled trials, RT is supported by two trials, and a multicentre trial is underway for TwV. No quantitative effect sizes or numerical outcome data are reported in the abstract.
Why it matters
It establishes a unifying operational definition and comparative framework for an emerging cluster of psychological therapies for distressing voices, clarifying shared mechanisms across differing dialogue formats.
Limits
This is a conceptual review and expert consensus rather than a formal quantitative meta-analysis or original trial. The abstract provides no numerical data, pooled effect sizes, or formal risk-of-bias evaluations for the cited trials.
Cited by
- supports Avatar therapy uses computer animation to create an image of a persecutory voice for dialogic therapy to reduce hallucination-related distress in schizophrenia.