Relational work with distressing voices mirroring experiences of discrimination and marginalisation: Three illustrative cases of an extended form of <scp>AVATAR</scp> therapy ( <scp>AV</scp> ‐ <scp>EXT</scp> )

BACKGROUND: For voice-hearers from minoritised communities, voices may reflect interpersonal and societal discrimination, including experiences of feeling silenced or 'voiceless'. AVATAR therapy is a relational approach involving facilitated dialogues between a voice-hearer and a digital embodiment of their main distressing voice (the avatar). The aim is for the voice hearer to gain understanding, acceptance and empowerment. AIMS: This paper illustrates an extended form of AVATAR therapy (AV-EXT), which seeks to understand a person's voices within their developmental and relational context. METHODS: We present three therapy narratives in which voices mirrored experiences of discrimination and marginalisation based on aspects of the person's identity. Personalised avatars were used during dialogues to re-enact the lived experience of voice-hearing. RESULTS: Avatar dialogues offered opportunities to rescript disempowering experiences, target associated meanings and connect individuals with the power of their own identity. CONCLUSIONS: 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.