Voices are commonly experienced as communication with a personified ‘other’ with ascribed attitudes, intentionality and personality (their own ‘character’). Phenomenological work exploring voice characterisation informs a new wave of relational therapies. To date, no study has investigated the role of characterisation in behavioural engagement with voices or within psychological therapy for distressing voices.

Baseline characterisation (the degree to which the voice is an identifiable and characterful entity) of the dominant voice was rated (high, medium or low) using a newly developed coding framework, for n = 60 people prior to starting AVATAR therapy. Associations between degree of characterisation and (i) everyday behavioural engagement with voices (The Beliefs about Voices Questionnaire-Revised; n = 60); and (ii) interaction within avatar dialogue [Session 4 Time in Conversation (participant–avatar); n = 45 therapy completers] were explored.

Thirty-three per cent reported high voice characterisation, 42% medium and 25% low. There was a significant association between characterisation and behavioural engagement [H(2) = 7.65, p = 0.022, ɛ2 = 0.130] and duration of participant–avatar conversation [F(2,42) = 6.483, p = 0.004, η2 = 0.236]. High characterisation was associated with increased behavioural engagement compared with medium (p = 0.004, r = 0.34; moderate effect) and low (p = 0.027, r = 0.25; small−moderate effect) with a similar pattern observed for the avatar dialogue [high v. medium: p = 0.008, Hedges’ g = 1.02 (large effect); high v. low: p = 0.023, Hedges' g = 1.03 (large effect)]. No differences were observed between medium and low characterisation.

Complex voice characterisation is associated with how individuals interact with their voice(s) in and out of therapy. Clinical implications and future directions for AVATAR therapy and other relational therapies are discussed.

声音通常被视为与具有先天态度、意图和个性（他们自己的“性格”）的拟人化“他人”的交流。探索声音特征的现象学工作为关系疗法的新浪潮提供了信息。迄今为止，还没有研究调查表征在声音行为参与或痛苦声音心理治疗中的作用。

在开始 AVATAR 治疗之前，使用新开发的编码框架对n = 60 人的主要声音的基线特征（声音是可识别和有特征的实体的程度）进行评级（高、中或低）。表征程度与 (i) 与声音的日常行为参与之间的关联（修订后的声音信念问卷； n = 60）； (ii) 虚拟形象对话中的互动[第 4 节对话时间（参与者 - 虚拟形象）； n = 45 名治疗完成者]进行了探索。

33% 的人表示声音特征较高，42% 的人表示声音特征中等，25% 的人表示声音特征较低。特征描述和行为参与度 [ H (2) = 7.65, p = 0.022, ɛ 2 = 0.130] 和参与者与虚拟形象对话的持续时间 [ F (2,42) = 6.483, p = 0.004, η 2 之间存在显着关联= 0.236]。与中度（ p = 0.004， r = 0.34；中等效果）和低度（ p = 0.027， r = 0.25；小-中等效果）相比，高特征化与行为参与度增加相关，在头像对话中观察到类似的模式[高v.中等： p = 0.008，Hedges' g = 1.02（大效应）；高与低： p = 0.023，Hedges' g = 1.03（大效应）]。中度和低度表征之间没有观察到差异。

复杂的声音特征与个人在治疗内外如何与声音互动有关。讨论了 AVATAR 疗法和其他相关疗法的临床意义和未来方向。