Cognitive Therapy for Auditory Hallucinations in Schizophrenia

Abstract

Cognitive therapy has established its efficacy in the United Kingdom as a companion therapy, along with medication, in the treatment of schizophrenia. Randomized controlled trials have been conducted in the UK, showing improvement in both positive and negative symptoms of schizophrenia. Yet, less work has been done testing and implementing cognitive therapy for schizophrenia in North America. This article describes the applications of cognitive therapy as a treatment for auditory hallucinations, primarily voices. Cognitive therapy for voices is predicated on the assumption that much of the distress and disability associated with hearing voices is due to the patient’s delusional interpretations of voices. The development of a cognitive therapy case conceptualization will be described, as will specific techniques for managing voices and secondary delusions. The objective of treatment is that of increasing the cognitive and behavioral repertoire available to voice hearers, not only to reduce distress, but also to increase options for living a meaningful life.