AVATAR Therapy: Pathopsychology of Transforming Relations with The “Voice” in Auditory Hallucinations



The paper examines the problem of the use of modern AVATAR therapy for auditory hallucinations (AH). There is a traditional asymmetry of the focus of interest in the study of AH with a bias towards the study of the final result of perception at the expense of comprehension of the process of AH development. The methodology of the cultural-activity approach and study of the patterns of the genesis of the “voices” in pathopsychology provide an adequate basis for understanding the nature of AH. Current intervention in psychosis is based on recognizing the role of psychological factors. АН are amplified in the state of anxiety, or in case of disturbed interpersonal relationships. AVATAR therapy provides the patient with psychological means of restoring deliberate mental activity, gaining control over one’s mental activity through its objectification, making the “voice” less malevolent and managing negative experiences. The method is based on a dialogue with an avatar, a visual digital image of the “voice”. It is designed in a virtual environment evoking a presence effect, which allows directed interaction with it in order to increase assertiveness. The experiments showed encouraging, but still debatable, results of the effectiveness of AVATAR therapy.

General Information

Keywords: AVATAR therapy, auditory hallucinations, “voices”, cultural-activity ap- proach, social anxiety, mediation, digital technologies in therapy

Journal rubric: Research Reviews

DOI: https://doi.org/10.17759/cpp.2021290204

For citation: Sagalakova O.A., Zhirnova O.V., Truevtsev D.V. AVATAR Therapy: Pathopsychology of Transforming Relations with The “Voice” in Auditory Hallucinations. Konsul'tativnaya psikhologiya i psikhoterapiya = Counseling Psychology and Psychotherapy, 2021. Vol. 29, no. 2, pp. 62–99. DOI: 10.17759/cpp.2021290204. (In Russ., аbstr. in Engl.)


  1. Vorontsova V.S., Shunenkov D.A., Ivanova E.M., et al. Russkoyazychnaya adaptatsiya oprosnika internalizovannoi stigmy psikhicheskogo sostoyaniya (samostigmatizatsii) ISMI-9 [Russian adaptation of the internalized stigma of the mental state (self- stigmatization) scale ISMI-9]. Nevrologicheskii vestnik = Neurology Bulletin, 2019. Vol. 51 (4), pp. 29—33. DOI:10.17816/nb16451.
  2. Vygotskii L.S. Psikhologiya razvitiya cheloveka [Psychology of human development]. Moscow: Smysl, Eksmo, 2005. 1136 p.
  3. Zaretskii V.K., Kholmogorova A.B. Mirovaya psikhologiya i pedagogika v poiskakh teorii razvitiya, adekvatnoi vyzovam nashego vremeni: vpered k Vygotskomu [World psychology and pedagogy in search of the development theory relevant to modern challenges: forward to Vygotsky]. Konsul’tativnaya psikhologiya i psikhoterapiya = Counseling Psychology and Psychotherapy, 2017. Vol. 25 (3), pp. 170—175. DOI:10.17759/cpp.2017250312. (In Russ., abstr. in Engl.).
  4. Luriya A.R. Priroda chelovecheskikh konfliktov: Ob”ektivnoe izuchenie dezorganizatsii povedeniya cheloveka [The nature of human conflicts: An objective study of human behavior disorganization]. Moscow: Kogito-Tsentr, 2002. 527 p.
  5. Nikolaeva V.V. S.Ya. Rubinshtein: o vklade razvitiya patopsikhologii [Susanna Ya. Rubinstein: The impact of the development of pathopsychology] [Elektronnyi resurs]. Klinicheskaya i spetsial’naya psikhologiya = Clinical Psychology and Special Education, 2012. Vol. 1 (1). Available at: https://psyjournals.ru/psyclin/2012/ n1/49977.shtml (Accessed: 20.05.2020). (In Russ., abstr. in Engl.).
  6. Rubinstein S.Ya. O reflektornoi prirode gallyutsinatsii [On the reflex nature of hallucinations]. Materialy soveshchaniya po psikhologii (Moskva, 1—6 iyulya 1955 g.) [The materials of psychological conference]. Moscow: APN RSFSR, 1957, pp. 646— 653.
  7. Rubinshtein S.Ya. Eksperimental’noe issledovanie obmanov slukha [Experimental study of auditory deceptions]. In Voprosy patopsikhologii [Issues of Pathopsychology]. Moscow, 1970, pp. 55—69.
  8. Rychkova O.V., Kholmogorova A.B. Osnovnye teoreticheskie podkhody k issledovaniyu narushenii sotsial’nogo poznaniya pri shizofrenii: sovremennyi status i perspektivy razvitiya [The main theoretical approaches to the study of disorders of social cognition in schizophrenia: Current status and prospects of development]. Konsul’tativnaya psikhologiya i psikhoterapiya = Counseling Psychology and Psychotherapy, 2014. Vol. 22 (4), pp. 30—43. (In Russ., abstr. in Engl.).
  9. Sagalakova O.A., Zhirnova O.V., Truevtsev D.V. Transformatsiya metodologicheskikh predstavlenii o “golosakh” i variantakh vmeshatel’stva spetsialistov pri slukhovykh gallyutsinatsiyakh [Transformation of methodological understanding about “voices” and versions of interventions by experts in the field of auditory hallucinations] [Elektronnyi resurs]. Klinicheskaya i spetsial’naya psikhologiya = Clinical Psychology and Special Education, 2020. Vol. 9 (2), pp. 34—61. Available at: https://psyjournals. ru/psyclin/2020/n2/Sagalakova_et_al.shtml (Accessed 20.05.2020). DOI:10.17759/ cpse.2020090202. (In Russ., abstr. in Engl.).
  10. Sagalakova O.A., Truevtsev D.V., Stoyanova I.Ya. Sindromno-faktornyi metod v istoricheskom i sovremennom kontekste: vozmozhnosti issledovaniya sotsial’no-trevozhnogo rasstroistva [Syndrome-factor   method   in   historical and modern context: Possibilities of studying social anxiety disorder]. Sibirskii psikhologicheskii zhurnal = Siberian Journal of Psychology, 2018, no. 70, pp. 75—91. DOI:10.17223/17267080/70/6
  11. Kholmogorova A.B., Tsarenko D.M., Moskacheva M.A. Narusheniya sotsial’nogo poznaniya pri rasstroistvakh shizofrenicheskogo i affektivnogo spektrov [The social cognition impairments of people with schizophrenia and affective spectrum disorders] [Elektronnyi resurs]. Klinicheskaya i spetsial’naya psikhologiya = Clinical Psychology and Special Education, 2016. Vol. 5 (4), pp. 103—117. Available at: https://psyjournals.ru/psyclin/2016/n4/Holmogorova_et_al.shtml             (Accessed 20.05.2020). DOI:10.17759/cpse.2016050408. (In Russ., abstr. in Engl.).
  12. Addington J., Shah H., Liu L., et al. Reliability and validity of the Calgary Depression Scale for Schizophrenia (CDSS) in youth at clinical high risk for psychosis. Schizophrenia Research, 2014. Vol. 153 (1—3), pp. 64—67. DOI:10.1016/j. schres.2013.12.014
  13. Aleman A., Larøi F. Hallucinations. The science of idiosyncratic perception. Washington, DC: American Psychological Association, 2008. 317 p. DOI:10.1037/11751-000
  14. Aleman A., Larøi F. Insights into hallucinations in schizophrenia: Novel treatment approaches. Expert Review of Neurotherapeutics, 2011. Vol. 11 (7), pp. 1007—1015. DOI:10.1586/ern.11.90
  15. Allen M.T. A computer-based avatar task designed to assess behavioral inhibition extends to behavioral avoidance but not cognitive avoidance [Elektronnyi resurs]. PeerJ, 2018. Vol. 6. Available at: https://peerj.com/articles/5330/ (Accessed 13.07.2020). DOI:10.7717/peerj.5330
  16. Aymerich-Franch L., Kizilcec R.F., Bailenson J.N. The relationship between virtual self similarity and social anxiety [Elektronnyi resurs]. Frontiers in Human Neuroscience, 2014. Vol. 8. Available at: https://doi.org/10.3389/fnhum.2014.00944 (Accessed 13.07.2020). DOI:10.3389/fnhum.2014.00944
  17. Baethge C., Baldessarini R.J., Freudenthal K., et al. Hallucinations in bipolar disorder: characteristics and comparison to unipolar depression and schizophrenia. Bipolar Disorders, 2015. Vol. 7 (2), pp. 136—145. DOI:10.1111/j.1399- 5618.2004.00175.x
  18. Beck A.T., Steer R.A., Brown G.K. Manual for the Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation, 1996. 38 p.
  19. Bighelli I., Leucht C., Huhn M., et al. Are randomized controlled trials on pharmacotherapy and psychotherapy for positive symptoms of schizophrenia comparable? A systematic review of patient and study characteristics. Schizophrenia Bulletin, 2020. Vol. 46 (3), pp. 496—504. DOI:10.1093/schbul/sbz090
  20. Birchwood M., Gilbert P., Gilbert J., et al. Interpersonal and role-related schema influence the relationship with the dominant ‘voice’ in schizophrenia: A comparison of three models. Psychological Medicine, 2004. Vol. 34 (8), pp. 1571—1580. DOI:10.1017/s0033291704002636
  21. Birchwood M., Michail M., Meaden A., et al. Cognitive behaviour therapy to prevent harmful compliance with command hallucinations (COMMAND): a randomized controlled trial. Lancet Psychiatry, 2014. Vol. 1 (1), pp. 23—33. DOI:10.1016/ S2215-0366(14)70247-0
  22. Carpendale J.I., Lewis C. Constructing an understanding of mind: The development of children’s social understanding within social interaction. Behavioral and Brain Sciences, 2004. Vol. 27 (1), pp. 79—96. DOI:10.1017/S0140525X04000032
  23. Carruthers G. The case for the comparator model as an explanation of the sense of agency and its breakdowns. Consciousness and Cognition, 2012. Vol. 21 (1), pp. 30— 45. DOI:10.1016/j.concog.2010.08.005
  24. Chadwick P., Lees S., Birchwood M. The revised Beliefs About Voices Questionnaire (BAVQ-R). The British Journal of Psychiatry, 2000. Vol. 177 (3), pp. 229—232. DOI:10.1192/bjp.177.3.229
  25. Chadwick P., Strauss C., Jones A.M., et al. Group mindfulness-based intervention for distressing voices: a pragmatic randomised controlled trial. Schizophrenia Research, 2016. Vol. 175 (1—3), pp. 168—173. DOI:10.1016/j.schres.2016.04.001
  26. Cisneros-Franco J.M., Ouellet L., Kamal B., et al. A brain without brakes: Reduced inhibition is associated with enhanced but dysregulated plasticity in the aged rat auditory cortex [Elektronnyi resurs]. eNeuro, 2018. Vol. 5 (4). Available at: https:// www.eneuro.org/content/5/4/ENEURO.0051-18.2018 (Accessed 13.07.2020). DOI:10.1523/ENEURO.0051-18.2018
  27. Craig T.K. AVATAR therapy: A promising new approach for persistent distressing voices. World Psychiatry, 2019. Vol. 18 (1), pp. 98—99. DOI:10.1002/wps.20589
  28. Craig T.K., Rus-Calafell M., Ward T., et al. AVATAR therapy for auditory verbal hallucinations in people with psychosis: A single-blind, randomised controlled trial. Lancet Psychiatry, 2018. Vol. 5 (1), pp. 31—40. DOI:10.1016/S2215- 0366(17)30427-3
  29. Craig T.K., Rus-Calafell M., Ward T., et al. The effects of an Audio Visual Assisted Therapy Aid for Refractory auditory hallucinations (AVATAR therapy): Study protocol for a randomised controlled trial [Elektronnyi resurs]. Trials, 2015. Vol. 16. Available at: https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-015- 0888-6 (Accessed 12.07.2020). DOI:10.1186/s13063-015-0888-6
  30. Dellazizzo L., du Sert P.O., Phraxayavong K., et al. Exploration of the dialogue components in Avatar Therapy for schizophrenia patients with refractory auditory hallucinations: A content analysis. Clinical Psychology and Psychotherapy, 2018. Vol. 25 (6), pp. 878—885. DOI:10.1002/cpp.2322
  31. Diemer J., Alpers G.W., Peperkorn H.M., et al. The impact of perception and presence on emotional reactions: A review of research in virtual reality [Elektronnyi resurs]. Frontiers in Psychology, 2015. Vol. 6. Available at: https://www.frontiersin. org/articles/10.3389/fpsyg.2015.00026/full (Accessed 10.07.2020). DOI:10.3389/ fpsyg.2015.00026
  32. Drake R., Haddock G., Tarrier N., et al. The Psychotic Symptom Rating Scales (PSYRATS): Their usefulness and properties in first episode psychosis. Schizophrenia Research, 2007. Vol. 89 (1—3), pp. 119—122. DOI:10.1016/j.schres.2006.04.024
  33. Elkis H. Treatment-resistant schizophrenia. The Psychiatric Clinics of North America, 2007. Vol. 30 (3), pp. 511—533. DOI:10.1016/j.psc.2007.04.001
  34. Endicott J., Nee J., Harrison W., et al. Quality of Life Enjoyment and Satisfaction Questionnaire: A new measure. Psychopharmacology Bulletin, 1993. Vol. 29 (2), pp. 321—326.
  35. Fabio R.A., Caprì T., Iannizzotto G., et al. Interactive avatar boosts the performances of children with attention deficit hyperactivity disorder in dynamic measures of intelligence. Cyberpsychology, Behavior, and Social Networking, 2019. Vol. 22 (9), pp. 588—596. DOI:10.1089/cyber.2018.0711
  36. Fernández-Caballero A., Martínez-Rodrigo A., Pastor J., et al. Smart environment architecture for emotion recognition and regulation. Journal of Biomedical Informatics, 2016. Vol. 64, pp. 55—73. DOI:10.1016/j.jbi.2016.09.015
  37. Fernández-Caballero A., Navarro E., Fernández-Sotos P., et al. Human-avatar symbiosis for the treatment of auditory verbal hallucinations in schizophrenia through virtual/augmented reality and brain-computer interfaces [Elektronnyi resurs]. Frontiers in Neuroinformatics, 2017. Vol. 11. Available at: https://www. frontiersin.org/articles/10.3389/fninf.2017.00064/full (Accessed 25.06.2020). DOI:10.3389/fninf.2017.00064
  38. Fernández-Sotos A., Fernández-Caballero A., Latorre J. Influence of tempo and rhythmic unit in musical emotion regulation [Elektronnyi resurs]. Frontiers in Computational Neuroscience, 2016. Vol. 10. Available at: https://www.frontiersin. org/articles/10.3389/fncom.2016.00080/full (Accessed 13.07.2020). DOI:10.3389/ fncom.2016.00080
  39. Fielding-Smith S.F., Hayward M., Strauss C., et al. Bringing the “self” into focus: Conceptualising the role of self-experience for understanding and working with distressing voices [Elektronnyi resurs]. Frontiers in Psychology, 2015. Vol. 6. Available at: https://www.frontiersin.org/articles/10.3389/fpsyg.2015.01129/full (Accessed 19.06.2020). DOI:10.3389/fpsyg.2015.01129
  40. Fuentes-Claramonte P., Soler J., Hinzen W., et al. The interfering effects of frequent auditory verbal hallucinations on shadowing performance in schizophrenia. Schizophrenia Research, 2019. Vol. 208, pp. 488—489. DOI:10.1016/j.schres.2019.01.019
  41. Gallese V. The roots of empathy: The shared manifold hypothesis and the neural basis of intersubjectivity. Psychopathology, 2003. Vol. 36 (4), pp. 171—180. DOI:10.1159/000072786
  42. Hayward M., Fuller E. Relating therapy for people who hear voices: Perspectives from clients, family members, referrers and therapists. Clinical Psychology and Psychotherapy, 2010. Vol. 17 (5), pp. 363—373. DOI:10.1002/cpp.672
  43. Hayward M., Jones A.M., Bogen-Johnston L., et al. Relating Therapy for distressing auditory hallucinations: A pilot randomized controlled trial. Schizophrenia Research, 2017. Vol. 183, pp. 137—142. DOI:10.1016/j.schres.2016.11.019
  44. Johns L.C., Hemsley D., Kuipers E. A comparison of auditory hallucinations in a psychiatric and non psychiatric group. The British Journal of Clinical Psychology, 2002. Vol. 41 (1), pp. 81—86. DOI:10.1348/014466502163813
  45. Kay S.R., Fiszbein A., Opler L.A. The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 1987. Vol. 13 (2), pp. 261—276. DOI:10.1093/schbul/13.2.261
  46. Kingdon D.G., Ashcroft K., Bhandari B., et al. Schizophrenia and borderline personality disorder: Similarities and differences in the experience   of auditory hallucinations, paranoia, and childhood trauma. The Journal of Nervous and Mental Disease, 2010. Vol. 198 (6), pp. 399—403. DOI:10.1097/ NMD.0b013e3181e08c27
  47. Kingdon D.G., Turkington D., John C. Cognitive behaviour therapy of schizophrenia. The amenability of delusions and hallucinations to reasoning. The British Journal of Psychiatry, 1994. Vol. 164 (5), pp. 581—587. DOI:10.1192/bjp.164.5.581
  48. Lacro J.P., Dunn L.B., Dolder C.R., et al. Prevalence of and risk factors for medication nonadherence in patients with schizophrenia: A comprehensive review of recent literature. The Journal of Clinical Psychiatry, 2002. Vol. 63 (10), pp. 892— 909. DOI:10.4088/jcp.v63n1007
  49. Leff J., Williams G., Huckvale M.A., et al. Computer-assisted therapy for medication-resistant auditory hallucinations: Proof-of-concept study. The British Journal of Psychiatry, 2013. Vol. 202 (6), pp. 428—433. DOI:10.1192/bjp. bp.112.124883
  50. Lloyd J., Lloyd H., Fitzpatrick R., et al. Treatment outcomes in schizophrenia: Qualitative study of the views of family carers [Elektronnyi resurs]. BMC Psychiatry, 2017. Vol. 17. Available at: https://bmcpsychiatry.biomedcentral.com/ articles/10.1186/s12888-017-1418-8 (Accessed 07.07.2020). DOI:10.1186/s12888- 017-1418-8
  51. Luhrmann T.M., Padmavati R., Tharoor H., et al. Differences in voice-hearing experiences of people with psychosis in the U.S.A., India and Ghana: Interview- based study. The British Journal of Psychiatry, 2015. Vol. 206 (1), pp. 41—44. DOI:10.1192/bjp.bp.113.139048
  52. Maimone A., Georgiou A., Kollin J. Holographic near-eye displays for virtual and augmented reality [Elektronnyi resurs]. ACM Transactions on  Graphics, 2017. Vol. 36 (4). Available at: https://dl.acm.org/doi/10.1145/3072959.3073624 (Accessed 13.07.2020). DOI:10.1145/3072959.3073624
  53. Mauritz M., van Meijel B. Loss and grief in patients with schizophrenia: On living in another world. Archives of Psychiatric Nursing, 2009. Vol. 23 (3), pp. 251—260. DOI:10.1016/j.apnu.2008.06.006
  54. Mawson A., Berry K., Murray C., et al. Voice hearing within the context of hearers’ social worlds: An interpretative phenomenological analysis. Psychology and Psychotherapy: Theory, Research and Practice, 2011. Vol. 84 (3), pp. 256—272. DOI:10.1348/147608310X524883
  55. McCarthy-Jones S., Marriott M., Knowles R., et al. What is psychosis? A meta- synthesis of inductive qualitative studies exploring the experience of psychosis. Psychosis, 2013. Vol. 5 (1), pp. 1—16. DOI:10.1080/17522439.2011.647051
  56. Moritz S., Larøi F. Differences and similarities in the sensory and cognitive signatures of voice hearing, intrusions and thoughts. Schizophrenia Research, 2008. Vol. 102 (1—3), pp. 96—107. DOI:10.1016/j.schres.2008.04.007
  57. Morrison A.P., French P., Wells A. Metacognitive beliefs across the continuum of psychosis: Comparisons between patients with psychotic disorders, patients at ultra- high risk and non-patients. Behaviour Research and Therapy, 2007. Vol. 45 (9), pp. 2241—2246. DOI:10.1016/j.brat.2007.01.002
  58. Morrison A.P. The interpretation of intrusion in psychosis. An integrative cognitive approach to hallucinations and delusions. Behavioural and Cognitive Psychotherapy, 2001. Vol. 29 (3), pp. 257— 276. DOI:10.1017/S1352465801003010
  59. Pennisi P.,  Tonacci  A.,  Tartarisco  G.,  et  al.  Autism  and  social  robotics: A systematic review. Autism Research, 2016. Vol. 9 (2), pp. 165—183. DOI:10.1002/aur.1527
  60. Rossell S.L., Schutte M.J.L., Toh W.L., et al. The Questionnaire for Psychotic Experiences: An examination of the validity and reliability. Schizophrenia Bulletin, 2019. Vol. 45 (1), pp. 78—87. DOI:10.1093/schbul/sby148
  61. Salvatore G., Ottavi P., Popolo R., et al. An inter-subjective multi-factorial model of auditory verbal hallucinations in schizophrenia [Elektronnyi resurs]. New Ideas in Psychology, 2020. Vol. 58. Available at: https://www.sciencedirect.com/science/ article/abs/pii/S0732118X15300258 (Accessed 13.07.2020). DOI:10.1016/j. newideapsych.2020.100783
  62. du Sert O.P., Potvin S., Lipp O., et al. Virtual reality therapy for refractory auditory verbal hallucinations in schizophrenia: A pilot clinical trial. Schizophrenia Research, 2018. Vol. 197, pp. 176—181. DOI:10.1016/j.schres.2018.02.031
  63. Shawyer F., Farhall J., Thomas N., et al. Acceptance and commitment therapy for psychosis: Randomised controlled trial. British Journal of Psychiatry, 2017. Vol. 210 (2), pp. 140—148. DOI:10.1192/bjp.bp.116.182865
  64. Shawyer F., Ratcliff K., Mackinnon A., et al. The Voices Acceptance and Action Scale (VAAS): Pilot data. Journal of Clinical Psychology, 2007. Vol. 63 (6), pp. 593— 606. DOI:10.1002/jclp.20366
  65. Siskind D., McCartney L., Goldschlager R., et al. Clozapine v. first- and second- generation antipsychotics in treatment-refractory schizophrenia: Systematic review and meta-analysis. The British Journal of Psychiatry, 2016. Vol. 209 (5), pp. 385— 392. DOI:10.1192/bjp.bp.115.177261
  66. Smailes D., Meins E., Fernyhough C. Associations between intrusive thoughts, reality discrimination, and hallucination-proneness in healthy young adults. Cognitive Neuropsychiatry, 2015. Vol. 20 (1), pp. 72—80. DOI:10.1080/13546805. 2014.973487
  67. Sorokosz K., Stefaniak I., Janicki A. Synthetic speech in therapy of auditory hallucinations. Text, Speech, and Dialogue: 20th International Conference (Prague, Czech Republic, August 27—31, 2017). Proceedings. Cham, Switzerland: Springer International, 2017, pp. 83—91.
  68. Stefaniak I., Sorokosz K., Janicki A., et al. Therapy based on avatar-therapist synergy for patients with chronic auditory hallucinations: A pilot study. Schizophrenia Research, 2019. Vol. 211, pp. 115—117. DOI:10.1016/j.schres.2019.05.036
  69. Tully S., Wells A., Morrison A.P. An exploration of the relationship between use of safety-seeking behaviours and psychosis: A systematic review and meta- analysis. Clinical Psychology and Psychotherapy, 2017. Vol. 24 (6), pp. 1384—1405. DOI:10.1002/cpp.2099
  70. Waters F., Allen P., Aleman A., et al. Auditory hallucinations in schizophrenia and nonschizophrenia populations: a review and integrated model of cognitive mechanisms. Schizophrenia Bulletin, 2012. Vol. 38 (4), pp. 683—693. DOI:10.1093/ schbul/sbs045

Information About the Authors

Olga A. Sagalakova, PhD in Psychology, docent, Researcher, Laboratory of Experimental Pathopsychology, Moscow State University of Psychology & Education, Moscow, Russia, ORCID: https://orcid.org/0000-0001-9975-1952, e-mail: olgasagalakova@mail.ru

Olga V. Zhirnova, Student, Department of Clinical Psychology, Altai State University, Barnaul, Russia, ORCID: https://orcid.org/0000-0002-6680-8286, e-mail: olga.zhirnova.2015@mail.ru

Dmitry V. Truevtsev, PhD in Psychology, Associate Professor, Researcher, Experimental Psychology Laboratory, Moscow State University of Psychology and Education, Moscow, Russia, ORCID: https://orcid.org/0000-0003-4246-2759, e-mail: truevtsev@gmail.com