Seven virtual-reality avatar therapy sessions were linked to meaningful improvement in 13 of 30 people with schizophrenia in a Semmelweis University study. That’s 43.3% of participants, all of whom continued to hear voices despite medication. The findings are promising but preliminary: researchers compared the therapy with a preceding period of usual treatment, rather than a separate control group treated at the same time.
According to the university’s Wednesday statement, reported by MTI, the approach lets patients meet a virtual representation of a voice they hear, often one that threatens or insults them. In their study, published in Acta Psychologica, the researchers stress that VR avatar therapy cannot replace medication. It can only be used alongside it.
The study ran between January 2024 and June 2025 and involved 30 patients who had regularly heard voices for at least three months while taking medication. Participants continued their usual medication treatment for 12 weeks, then attended seven avatar therapy sessions over another 12 weeks. Researchers compared changes after VR therapy with the patients’ condition during the preceding treatment period.
By the end of treatment, two participants no longer experienced auditory hallucinations, while another four had at least a 50% reduction in symptom severity. Researchers measured reductions in both how often patients heard voices and the distress those voices caused. Persistent anxiety also eased. Given the study’s comparison design, however, the results do not establish how much of the improvement was attributable to avatar therapy alone.
The virtual encounters required detailed preparation, not just putting on a headset. Each patient worked with a clinician to create an avatar representing either the voice they heard most often or the one that caused them the most distress. Together, they defined its appearance, voice and tone of delivery, along with the sentences the patient heard it say.
During the headset sessions, the therapist spoke through the avatar. The system altered the therapist’s voice to resemble the hallucinated voice as closely as possible. If the encounter became too distressing, the therapist switched back to their own voice to reassure and support the patient.
Luca Egervári, a psychiatrist at Semmelweis University’s Department of Psychiatry and Psychotherapy and the study’s first author, said these encounters can feel very real. Patients are therefore prepared for every situation in advance: nothing happens unexpectedly, and they can stop the session at any time.
“The goal is not necessarily for the voice to disappear completely, but for it to cause less anxiety and suffering,” Egervári explained.
Age was associated with treatment response. Older participants tended to show greater improvement or a more stable condition. The researchers suggest one possible explanation: older patients may have more experience with the illness and different treatments, which could make them more motivated to participate in therapy.
The team’s earlier pilot study and further analyses also suggest that a longer history of illness, more severe symptoms at the outset and more active coping with the voices may be associated with a better response to therapy. These are tentative associations, not established predictors. The researchers emphasize that the small number of patients means further studies are needed to confirm the findings.
Avatar therapy itself is not new, but the researchers say it had not previously been studied in Central and Eastern Europe. This version combines virtual reality with psychotherapeutic methods intended to help patients change how they relate to the voices they hear. The Hungarian study is part of a larger international research project involving research sites in Hungary, Poland, Denmark and Spain.
The approach may offer an additional option primarily for people who continue to hear voices despite medication and experience substantial anxiety and tension as a result. According to Edit Haluska-Vass, an assistant professor at Semmelweis University’s Department of Psychiatry and Psychotherapy, the next step is to identify which patients benefit most. Further findings should also help establish the conditions under which VR avatar therapy could become part of routine patient care.
