{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T05:41:41Z","timestamp":1785908501711,"version":"3.56.0"},"reference-count":55,"publisher":"Wiley","license":[{"start":{"date-parts":[[2025,12,7]],"date-time":"2025-12-07T00:00:00Z","timestamp":1765065600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bpspsychub.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psychol Psychother"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>For voice\u2010hearers from minoritised communities, voices may reflect interpersonal and societal discrimination, including experiences of feeling silenced or \u2018voiceless\u2019. AVATAR therapy is a relational approach involving facilitated dialogues between a voice\u2010hearer and a digital embodiment of their main distressing voice (the avatar). The aim is for the voice hearer to gain understanding, acceptance and empowerment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This paper illustrates an extended form of AVATAR therapy (AV\u2010EXT), which seeks to understand a person\u2018s voices within their developmental and relational context.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We present three therapy narratives in which voices mirrored experiences of discrimination and marginalisation based on aspects of the person\u2018s identity. Personalised avatars were used during dialogues to re\u2010enact the lived experience of voice\u2010hearing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Avatar dialogues offered opportunities to rescript disempowering experiences, target associated meanings and connect individuals with the power of their own identity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Implications for the continued refinement of AVATAR therapy and other relational approaches are considered. This paper aims to support wider reflection on the impact of discrimination on distressing voices.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/papt.70027","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T04:15:36Z","timestamp":1765167336000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Relational work with distressing voices mirroring experiences of discrimination and marginalisation: Three illustrative cases of an extended form of\n                    <scp>AVATAR<\/scp>\n                    therapy (\n                    <scp>AV<\/scp>\n                    \u2010\n                    <scp>EXT<\/scp>\n                    )"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7608-5755","authenticated-orcid":false,"given":"Thomas","family":"Ward","sequence":"first","affiliation":[{"name":"Department of Psychology, Institute of Psychiatry, Psychology &amp; Neuroscience King's College London  London UK"},{"name":"South London &amp; Maudsley NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1178-5080","authenticated-orcid":false,"given":"Hannah","family":"Ball","sequence":"additional","affiliation":[{"name":"Division of Psychology and Mental Health, School of Health Sciences University of Manchester and the Manchester Academic Health Sciences Centre  Manchester UK"},{"name":"Greater Manchester Mental Health NHS Foundation Trust and the Manchester Academic Health Sciences Centre  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Montague","sequence":"additional","affiliation":[{"name":"South London &amp; Maudsley NHS Foundation Trust  London UK"},{"name":"Research Department of Clinical, Educational and Health Psychology University College London  London UK"},{"name":"North East London NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9680-3697","authenticated-orcid":false,"given":"Nikos","family":"Xanidis","sequence":"additional","affiliation":[{"name":"School of Health and Wellbeing University of Glasgow  Glasgow UK"},{"name":"NHS Greater Glasgow &amp; 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