Avatar Therapy for Persistent Auditory Verbal Hallucinations in an Ultra-Resistant Schizophrenia Patient: A Case Report
Effective treatment strategies for schizophrenia remain very challenging and many treatment-resistant patients will suffer from persistent auditory verbal hallucinations (AVH). While clozapine is the gold-standard medication for this complex population, many will not respond to this molecule. For th...
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doaj-de454c3f7bea4fd78a8982f6829aa42c2020-11-24T23:00:05ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402018-04-01910.3389/fpsyt.2018.00131342722Avatar Therapy for Persistent Auditory Verbal Hallucinations in an Ultra-Resistant Schizophrenia Patient: A Case ReportLaura Dellazizzo0Laura Dellazizzo1Laura Dellazizzo2Stéphane Potvin3Stéphane Potvin4Kingsada Phraxayavong5Pierre Lalonde6Pierre Lalonde7Alexandre Dumais8Alexandre Dumais9Alexandre Dumais10Alexandre Dumais11Centre de recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, CanadaDepartment of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, QC, CanadaInstitut Philippe-Pinel de Montréal, Montreal, QC, CanadaCentre de recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, CanadaDepartment of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, QC, CanadaServices et Recherches Psychiatriques AD, Montreal, QC, CanadaCentre de recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, CanadaDepartment of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, QC, CanadaCentre de recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, CanadaDepartment of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, QC, CanadaInstitut Philippe-Pinel de Montréal, Montreal, QC, CanadaServices et Recherches Psychiatriques AD, Montreal, QC, CanadaEffective treatment strategies for schizophrenia remain very challenging and many treatment-resistant patients will suffer from persistent auditory verbal hallucinations (AVH). While clozapine is the gold-standard medication for this complex population, many will not respond to this molecule. For these ultra-resistant patients, limited options are available. Cognitive-behavioral therapy (CBT) is the most widely used psychological intervention, though it offers modest effects. With the interpersonal dimension of AVH being recognized, Avatar Therapy (AT), a novel experiential treatment enabling patients to create an avatar of their persecutor and allowing them to gain control over their symptoms, was developed and tested. Results have shown significant improvements in AVH symptomatology. This paper details a case report showcasing the beneficial results of AT for even the most severe and symptomatic cases of schizophrenia. Mr. Smith has been afflicted with the persistency of all his voices for almost 20 years. To our knowledge, this patient tried almost all possible treatments with little efficacy. This case highlights the difficulty of finding an adequate treatment for ultra-resistant patients. Mr. Smith first followed CBT before initiating AT. With AT, he significantly improved in a way that was not observed with any other intervention and these improvements remained afterward. The severity of his positive symptoms as well as his depressive symptoms diminished, and his most distressing persecutory voice disappeared. He was able to regain a life. The effects of AT went well beyond the patient, the morale of the entire family improved. This ultra-resistant case suggests that AT may be a promising intervention for refractory AVH in schizophrenia.http://journal.frontiersin.org/article/10.3389/fpsyt.2018.00131/fulltreatment-resistant schizophreniaauditory verbal hallucinationspsychological treatmentcognitive-behavioral therapyavatar therapyvirtual reality |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Laura Dellazizzo Laura Dellazizzo Laura Dellazizzo Stéphane Potvin Stéphane Potvin Kingsada Phraxayavong Pierre Lalonde Pierre Lalonde Alexandre Dumais Alexandre Dumais Alexandre Dumais Alexandre Dumais |
spellingShingle |
Laura Dellazizzo Laura Dellazizzo Laura Dellazizzo Stéphane Potvin Stéphane Potvin Kingsada Phraxayavong Pierre Lalonde Pierre Lalonde Alexandre Dumais Alexandre Dumais Alexandre Dumais Alexandre Dumais Avatar Therapy for Persistent Auditory Verbal Hallucinations in an Ultra-Resistant Schizophrenia Patient: A Case Report Frontiers in Psychiatry treatment-resistant schizophrenia auditory verbal hallucinations psychological treatment cognitive-behavioral therapy avatar therapy virtual reality |
author_facet |
Laura Dellazizzo Laura Dellazizzo Laura Dellazizzo Stéphane Potvin Stéphane Potvin Kingsada Phraxayavong Pierre Lalonde Pierre Lalonde Alexandre Dumais Alexandre Dumais Alexandre Dumais Alexandre Dumais |
author_sort |
Laura Dellazizzo |
title |
Avatar Therapy for Persistent Auditory Verbal Hallucinations in an Ultra-Resistant Schizophrenia Patient: A Case Report |
title_short |
Avatar Therapy for Persistent Auditory Verbal Hallucinations in an Ultra-Resistant Schizophrenia Patient: A Case Report |
title_full |
Avatar Therapy for Persistent Auditory Verbal Hallucinations in an Ultra-Resistant Schizophrenia Patient: A Case Report |
title_fullStr |
Avatar Therapy for Persistent Auditory Verbal Hallucinations in an Ultra-Resistant Schizophrenia Patient: A Case Report |
title_full_unstemmed |
Avatar Therapy for Persistent Auditory Verbal Hallucinations in an Ultra-Resistant Schizophrenia Patient: A Case Report |
title_sort |
avatar therapy for persistent auditory verbal hallucinations in an ultra-resistant schizophrenia patient: a case report |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Psychiatry |
issn |
1664-0640 |
publishDate |
2018-04-01 |
description |
Effective treatment strategies for schizophrenia remain very challenging and many treatment-resistant patients will suffer from persistent auditory verbal hallucinations (AVH). While clozapine is the gold-standard medication for this complex population, many will not respond to this molecule. For these ultra-resistant patients, limited options are available. Cognitive-behavioral therapy (CBT) is the most widely used psychological intervention, though it offers modest effects. With the interpersonal dimension of AVH being recognized, Avatar Therapy (AT), a novel experiential treatment enabling patients to create an avatar of their persecutor and allowing them to gain control over their symptoms, was developed and tested. Results have shown significant improvements in AVH symptomatology. This paper details a case report showcasing the beneficial results of AT for even the most severe and symptomatic cases of schizophrenia. Mr. Smith has been afflicted with the persistency of all his voices for almost 20 years. To our knowledge, this patient tried almost all possible treatments with little efficacy. This case highlights the difficulty of finding an adequate treatment for ultra-resistant patients. Mr. Smith first followed CBT before initiating AT. With AT, he significantly improved in a way that was not observed with any other intervention and these improvements remained afterward. The severity of his positive symptoms as well as his depressive symptoms diminished, and his most distressing persecutory voice disappeared. He was able to regain a life. The effects of AT went well beyond the patient, the morale of the entire family improved. This ultra-resistant case suggests that AT may be a promising intervention for refractory AVH in schizophrenia. |
topic |
treatment-resistant schizophrenia auditory verbal hallucinations psychological treatment cognitive-behavioral therapy avatar therapy virtual reality |
url |
http://journal.frontiersin.org/article/10.3389/fpsyt.2018.00131/full |
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