Avatar-mediated Therapy Versus Cognitive Behavioural Therapy for Persisting Experiences of Hearing Voices

Inclusion Criteria:

• Schizophrenia-related disorder or a mood disorder with psychotic symptoms diagnosisconfirmed using the Structured Clinical Interview for DSM (SCID)

• Experiencing current auditory verbal hallucinations as measured by the Positive andNegative Syndrome Scale (PANSS) item P3 ≥ 4

• Auditory verbal hallucinations present for at least one year

• AVHs include significant negative content (PSYRATS item 6 ≥ 2) and/or AVHs aredistressing (PSYRATS item item 9 ≥ 2)

• Current treatment with antipsychotic medication, or has been treated withantipsychotic medication in the past, with at least two different antipsychoticcompounds, and these have been discontinued due to insufficient treatment responseand/or poor tolerability.

• Access to the internet and a computer or other device on which videoconferencingsoftware can be used

• Sufficient fluency in English for meaningful participation

• Age 18 or over

• Ability to give informed consent

Exclusion Criteria:

• Auditory verbal hallucinations attributable to a primary substance use disorder ororganic disorder

• Estimated full scale IQ < 70 (using the Test of Premorbid Functioning, TOPF)

• Within the last month or planned at the time of intake: a change of antipsychoticmedication,

• Current or within the past 3 months receipt of individual psychological therapy forhearing voices, or receipt of electro-convulsive therapy or other brain stimulationtreatment;

• AVHs in a language not spoken by the therapists.