Immersive virtual reality in the treatment of auditory hallucinations: A PRISMA scoping review

•Virtual reality therapy is a promising method for treating auditory hallucinations.•Currently, larger randomized controlled trials are needed to conclude on effect.•In-depth qualitative studies could inform on therapy processes and implementation.•Measuring presence and embodiment is vital to inform design of environments. A large group of psychiatric patients suffer from auditory hallucinations (AH) despite relevant treatment regimens. In mental health populations, AH tend to be verbal (AVH) and the content critical or abusive. Trials employing immersive virtual reality (VR) to treat mental health disorders are emerging. The aim of this scoping review is to provide an overview of clinical trials utilizing VR in the treatment of AH and to document knowledge gaps in the literature. PubMed, Cochrane Library, and Embase were searched for studies reporting on the use of VR to target AH. 16 papers were included in this PRISMA scoping review (ScR). In most studies VR therapy (VRT) was employed to ameliorate treatment resistant AVH in schizophrenia spectrum disorders. Only two studies included patients with a diagnosis of affective disorders. The VRT was carried out with the use of an avatar to represent the patient's most dominant voice. The research field employing VR to treat AH is promising but still in its infancy. Results from larger randomized clinical trials are needed to establish substantial evidence of therapy effectiveness. Additionally, the knowledge base would benefit from more profound qualitative data exploring views of patients and therapists.