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Fig 1.

SPIRIT schedule of enrolment.

Citation: Chan A-W, Boutron I, Hopewell S, Moher D, Schulz KF, et al. SPIRIT 2025 statement: updated guideline for protocols of randomised trials. BMJ 2025;389:e081477. https://dx.doi.org/10.1136/bmj-2024-081477. © 2025 Chan A-W et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Fig 2.

The creation of an avatar in Virtual Reality.

An avatar is created to correspond to the participant’s experience of the hallucinated voice by adjusting multiple features in a VR software program, developed by HekaVR.

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Fig 2 Expand

Fig 3.

The biofeedback device.

The participant will wear Shimmer GSR+ while exposed to the avatar in VR.

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Fig 3 Expand