Meeting OCD face-to-face: Preliminary findings from an avatar-based dialogue intervention.

Background: Obsessive-compulsive disorder (OCD) is a chronic, debilitating condition typically treated with cognitive-behavioural therapy (CBT) and exposure and response prevention (ERP). While effective, these approaches are often met with hesitation, as many patients struggle to engage in exposure-based treatment, and relapse remains a significant challenge. Virtual Reality-assisted Therapy (VRT), initially developed for auditory hallucinations, offers a novel, immersive approach that may enhance insight by helping patients externalize their OCD symptoms. This perspective shift may increase engagement and motivation for ERP. This study evaluates the feasibility, safety, acceptability and preliminary treatment effects of VRT adapted for OCD (VRT-OCD), in which patients interact with a virtual avatar embodying their disorder. Methods: Eight inpatients with OCD received three weekly VRT-OCD sessions alongside standard care. Participants created personalized avatars representing their OCD and engaged in therapist-guided dialogues aimed at confronting their OCD. Assessments focused on feasibility, safety, acceptability, and preliminary treatment effectiveness (e.g. OC symptoms, insight, self-esteem). Findings: VRT-OCD did not show negative side effects and was well accepted by both patients and therapists. Participants reported an increased motivation for therapy and ERP. Interpretation: VRT-OCD appears to be a feasible, safe and well-accepted adjunctive treatment for OCD. Larger-scale studies are needed to validate these findings and further explore their potential to increase motivation for ERP. Funding: This research was not supported by third-party funding.