Abstract
Cognitive behavioural therapy for psychosis (CBTp) is a recommended treatment for psychotic experiences, but its effectiveness has been questioned. One way of addressing this may be to tailor therapy materials to the phenomenology of specific psychotic experiences. In this study, we investigated the acceptability of a novel treatment manual for subtypes of 'voice-hearing' experiences (i.e. auditory verbal hallucinations). An uncontrolled, single-arm design was used to assess feasibility and acceptability of using the manual in routine care for people with frequent voice-hearing experiences. The manual was delivered on a smart tablet and incorporated recent research evidence and theory into its psychoeducation materials. In total, 24 participants completed a baseline assessment; 19 started treatment, 15 completed treatment and 12 participants completed a follow-up assessment (after 10 sessions of using the manual). Satisfaction with therapy scores and acceptability ratings were high, while completion rates suggested that the manual may be more appropriate for help with participants from Early Intervention in Psychosis services rather than Community Mental Health Teams. Within-group changes in symptom scores suggested that overall symptom severity of hallucinations - but not other psychosis features, or beliefs about voices - are likely to be the most appropriate primary outcome for further evaluation in a full randomised controlled trial.
Highlights
Auditory verbal hallucinations (AVH) or ‘hearing voices’ are one of the most frequent features of psychosis (e.g. Clark et al, 2017)
Group-based CBT, web-based and self-help tailored interventions for distressing voices have been found to be successful in decreasing frequency, severity and negative perception of voices (Gottlieb et al, 2013; Penn et al, 2009); and reported feelings of being controlled and distressed by voices (Chadwick et al, 2016; Dannahy et al, 2011)
The present study aimed to investigate the acceptability to service-users and staff of the treatment manual as a part of routine care within a mental health trust, across a range of services
Summary
Auditory verbal hallucinations (AVH) or ‘hearing voices’ are one of the most frequent features of psychosis (e.g. Clark et al, 2017). Alongside anti-psychotic medication and family interventions, cognitive behavioural therapy for psychosis (CBTp) is a recommended treatment in the UK for AVH (NICE, 2014). Cognitive behavioural therapy for psychosis (CBTp) is a recommended treatment for psychotic experiences, but its effectiveness has been questioned. Aim: In this study, we investigated the acceptability of a novel treatment manual for subtypes of ‘voice-hearing’ experiences (i.e. auditory verbal hallucinations). Results: Satisfaction with therapy scores and acceptability ratings were high, while completion rates suggested that the manual may be more appropriate for help with participants from Early Intervention in Psychosis services rather than Community Mental Health Teams. Conclusion: Within-group changes in symptom scores suggested that overall symptom severity of hallucinations – but not other psychosis features, or beliefs about voices – are likely to be the most appropriate primary outcome for further evaluation in a full randomised controlled trial
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