Psychological treatment for voices in psychosis (original) (raw)

Hearing voices is often one of the most distressing aspects associated with a diagnosis of psychosis. These voices are often resistant to medication treatments. This review article discusses the development of complementary approaches to the treatment of voicesÐpsychological and particularly cognitive treatments. It is clear that there are psychological rather than merely physical factors associated with the occurrence of, and distress caused by, voices. These factors can be engaged in the process of psychological therapy in order to reduce the distress that they cause and improve quality of life. Psychological therapies have produced some improvements but very few have shown durable effects. Most psychological therapies have been individual with an emphasis on cognitive behavioural approaches. This paper describes the development of a new approachÐgroup cognitive treatmentÐthat might provide further success either as a single therapy for voices or as a complement to individual approaches. This type of therapy builds on the therapies and supports provided within the consumer movement as well as harnessing group and cognitive facilitators for change in beliefs. Some evidence is provided about the usefulness of such therapy in the health services. In addition, the evaluation of treatments for specific symptoms, particularly the appropriate outcome measures is discussed. Apart from cognitive deficits, hearing voices is one of the earliest signs of likely psychosis and one of the main causes of distress to people with a diagnosis of schizophrenia. There is evidence that these voices can persist even after adequate levels of medication have been prescribed in 25±50% patients (Pantellis & Barnes, 1996) and these treatment-resistant voices are a major concern to both patients and their relatives. This paper is concerned with the developments of complementary psychological approaches to the treatment of voices, which have mainly been investigated in groups of people with treatmentresistant voices. Psychological treatment options are popular with both patients and their relatives and although this review is not a systematic meta-analysis it will draw together the evidence on the efficacy of the various treatments in order that a more measured approach to provision can be taken. Assessing the effects