The Staff Views About Assessing Voices Questionnaire: Piloting a Novel Socratic Method of Evaluating and Training Multidisciplinary Staff's Cognitive Assessment of Patients' Distressing Voices (original) (raw)
Related papers
Frontiers in Psychology, 2018
The experience of hearing voices ('auditory hallucinations') can cause significant distress and disruption to quality of life for people with a psychosis diagnosis. Psychological therapy in the form of cognitive behavior therapy (CBT) for psychosis is recommended for the treatment of positive symptoms, including distressing voices, but is rarely available to patients in the United Kingdom. CBT for psychosis has recently evolved with the development of symptom-specific therapies that focus upon only one symptom of psychosis at a time. Preliminary findings from randomized controlled trials suggest that these symptom-specific therapies can be more effective for distressing voices than the use of broad CBT protocols, and have the potential to target voices trans-diagnostically. Whilst this literature is evolving, consideration must be given to the potential for a symptom-specific approach to overcome some of the barriers to delivery of evidencebased psychological therapies within clinical services. These barriers are discussed in relation to the United Kingdom mental health services, and we offer suggestions for future research to enhance our understanding of these barriers.
BJPsych Open, 2021
Background Cognitive–behavioural therapy (CBT) is recommended for all patients with psychosis, but is offered to only a minority. This is attributable, in part, to the resource-intensive nature of CBT for psychosis. Responses have included the development of CBT for psychosis in brief and targeted formats, and its delivery by briefly trained therapists. This study explored a combination of these responses by investigating a brief, CBT-informed intervention targeted at distressing voices (the GiVE intervention) administered by a briefly trained workforce of assistant psychologists. Aims To explore the feasibility of conducting a randomised controlled trial to evaluate the clinical and cost-effectiveness of the GiVE intervention when delivered by assistant psychologists to patients with psychosis. Method This was a three-arm, feasibility, randomised controlled trial comparing the GiVE intervention, a supportive counselling intervention and treatment as usual, recruiting across two sit...
Psychological treatment for voices in psychosis
Cognitive Neuropsychiatry, 2004
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
Although people who hear voices may dialogue with them, they are regularly caught in destructive communication patterns that disturb social functioning. This article presents an approach called Talking With Voices, derived from the theory and practice of Voice Dialogue (Stone & Stone, 1989: Embracing our selves: The voice dialogue training manual, New York: Nataraj Publishing), whereby a facilitator directly engages with the voice(s) in order to heighten awareness and understanding of voice characteristics. The method provides insight into the underlying reasons for voice emergence and origins, and can ultimately inspire a more productive relationship between hearer and voice(s). We discuss the rationale for the approach and provide guidance in applying it. Case examples are also presented.
Trials
Background The National Institute for Health and Care Excellence (NICE) recommends that Cognitive Behaviour Therapy for psychosis (CBTp) is offered to all patients with a psychosis diagnosis. However, only a minority of psychosis patients in England and Wales are offered CBTp. This is attributable, in part, to the resource-intensive nature of CBTp. One response to this problem has been the development of CBTp in brief formats that are targeted at a single symptom and the mechanisms that maintain distress. We have developed a brief form of CBTp for distressing voices and reported preliminary evidence for its effectiveness when delivered by highly trained therapists (clinical psychologists). This study will investigate the delivery of this intervention by a cost-effective workforce of assistant psychologists following a brief training and evaluate the acceptability and feasibility of conducting a future, definitive, randomised controlled trial (RCT). Methods This is a feasibility stud...
Schizophrenia research, 2018
Few patients have access to cognitive behaviour therapy for psychosis (CBTp) even though at least 16 sessions of CBTp is recommended in treatment guidelines. Briefer CBTp could improve access as the same number of therapists could see more patients. In addition, focusing on single psychotic symptoms, such as auditory hallucinations ('voices'), rather than on psychosis more broadly, may yield greater benefits. This pilot RCT recruited 28 participants (with a range of diagnoses) from NHS mental health services who were distressed by hearing voices. The study compared an 8-session guided self-help CBT intervention for distressing voices with a wait-list control. Data were collected at baseline and at 12weeks with post-therapy assessments conducted blind to allocation. Voice-impact was the pre-determined primary outcome. Secondary outcomes were depression, anxiety, wellbeing and recovery. Mechanism measures were self-esteem, beliefs about self, beliefs about voices and voice-rel...
Cognitive behavioural therapy for psychosis targeting trauma, voices and dissociation: a case report
The Cognitive Behaviour Therapist
Trauma and dissociation may be important factors contributing to the experiences of distressing voice hearing. However, there is scant mention of how to target and treat such processes when working with people with psychosis. This case study reports on an initial attempt to work with dissociation and trauma memories in a person with voices. A single case approach was used, with standardized measures used before, during and after 24 sessions of cognitive therapy, and at 6-month follow-up. In addition, session-by-session measures tracked frequency and distress associated with voices and dissociation. The participant reported significant improvements in terms of reduced frequency and distress of dissociation, and voice hearing, as well as improvement in low mood at the end of treatment. At follow-up there were enduring benefits in terms of dissociation and trauma-related experiences, as well as broad recovery but not of change in voices. This case illustrated the potential benefit of t...
Beliefs about Voices and Schemas about Self and Others in Psychosis
Behavioural and Cognitive Psychotherapy, 2013
In people who experience auditory verbal hallucinations, beliefs the person holds about their voices appear to be clinically important as mediators of associated distress and disability. Whilst such beliefs are thought to be influenced by broader schematic representations the person holds about themselves and other people, there has been little empirical examination of this, in particular in relation to beliefs about voice intent and the personal meaning of the voice experience. Method: Thirty-four voice hearers with a diagnosis of schizophrenia or schizoaffective disorder completed the Psychotic Symptom Rating Scales and measures of beliefs about voices (Revised Beliefs About Voices Questionnaire, Interpretation of Voices Inventory) and schemas (Brief Core Schema Scales). Results: Beliefs about voices were correlated with both negative voice content and schemas. After controlling for negative voice content, schemas were estimated to predict between 9% and 35% of variance in the six beliefs about voices that were measured. Negative-self schemas were the strongest predictors, and positive-self and negative-other schemas also showed potential relationships with beliefs about voices. Conclusions: Schemas, particularly those regarding the self, are potentially important in the formation of a range of clinically-relevant beliefs about voices.