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The Acceptability, Feasibility and Potential Outcomes of an Individual Mindfulness-Based Intervention for Hearing Voices

Published online by Cambridge University Press:  09 July 2018

Stephanie Louise ,
Susan L. Rossell  and
Neil Thomas
Stephanie Louise*
Affiliation:
Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia Monash Alfred Psychiatry Research Centre (MAPrc), Central Clinical School, Monash University and The Alfred Hospital, Melbourne, VIC, Australia
Susan L. Rossell
Affiliation:
Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia Monash Alfred Psychiatry Research Centre (MAPrc), Central Clinical School, Monash University and The Alfred Hospital, Melbourne, VIC, Australia Psychiatry, St Vincent's Hospital, Melbourne, VICAustralia
Neil Thomas
Affiliation:
Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia Monash Alfred Psychiatry Research Centre (MAPrc), Central Clinical School, Monash University and The Alfred Hospital, Melbourne, VIC, Australia
*
*Correspondence to Stephanie Louise, Centre for Mental Health, Swinburne University of Technology, Mail H99, PO Box 218, Hawthorn, VIC, Australia3122. E-mail: slouise@swin.edu.au
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Abstract

Background: A prominent area of advancement in the psychological treatment for people with persisting psychosis has been the application of mindfulness-based therapies. Recent literature has recommended the investigation of focused mindfulness interventions for voices (auditory hallucinations) as a specific experience. To date, only mindfulness programs in group format have been examined. Aims: This non-randomized pilot study aimed to assess the acceptability, feasibility and potential outcomes of an individual mindfulness program for persistent voices on the negative impact of voices on the subjective experience of mental health and wellbeing, depression and voice-related distress and disruption. Also, it aimed to identify potential psychological and neurocognitive mechanisms of change. Method: A new 4-week individual Mindfulness Program for Voices (iMPV) was developed, and piloted with a group of 14 participants with a schizophrenia-spectrum disorder and persisting voices. Participants completed clinical and neurocognitive measures pre- and post-intervention and at 2-month follow-up. Results: Results revealed low attrition rates, high formal practice engagement levels and positive participant feedback. Pre–post outcomes suggested small to moderate effects for a reduction in the negative impact of voices on experience, depression and disruption. Large effects for changes in mindful responding and attentional switching were also identified. Conclusions: Our findings suggest that this novel treatment protocol is appropriate, engaging and safe for persistent voice hearers. Findings for mindful responding and attentional switching suggest these to be potential mechanisms of change for further investigation. Further RCTs are warranted to ascertain the feasibility and efficacy for focused mindfulness interventions for voices of individual format.

Keywords

mindfulnessmeditationpsychosisauditory verbal hallucinationsvoicesvoice-hearingattention
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 47 , Issue 2 , March 2019 , pp. 200 - 216
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2018 

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References

Addington, D., Addington, J. and Maticka-Tyndale, E. (1993). Assessing depression in schizophrenia: the Calgary Depression Scale. British Journal of Psychiatry, suppl 22, 39–44.Google Scholar
Addington, D., Addington, J., Maticka-Tyndale, E. and Joyce, J. (1992). Reliability and validity of a depression rating scale for schizophrenics. Schizophrenia Research, 6, 201–208. doi: 10.1016/0920-9964(92)90003-NGoogle Scholar
Bacon, T., Farhall, J. and Fossey, E. (2014). The active therapeutic processes of acceptance and commitment therapy for persistent symptoms of psychosis: clients’ perspectives. Behavioural and Cognitive Psychotherapy, 42, 402–420.Google Scholar
Birchwood, M., Michail, M., Meaden, A., Tarrier, N., Lewis, S., Wykes, T. et al. (2014). Cognitive behaviour therapy to prevent harmful compliance with command hallucinations (COMMAND): a randomised controlled trial. The Lancet Psychiatry, 1, 23–33.Google Scholar
Brand, R. M., Rossell, S. L., Bendall, S. and Thomas, N. (2017). Can we use an interventionist-causal paradigm to untangle the relationship between trauma, PTSD and psychosis? Frontiers in psychology, 8, 306.Google Scholar
Burns, A. M., Erickson, D. H. and Brenner, C. A. (2014). Cognitive-behavioral therapy for medication-resistant psychosis: a meta-analytic review. Psychiatric Services, 65, 874–880.Google Scholar
Chadwick, P., Hember, M., Symes, J., Peters, E., Kuipers, E. and Dagnan, D. (2008). Responding mindfully to unpleasant thoughts and images: reliability and validity of the Southampton mindfulness questionnaire (SMQ). British Journal of Clinical Psychology, 47, 451–455. doi: 10.1348/014466508X314891Google Scholar
Chadwick, P., Strauss, C., Jones, A.-M., Kingdon, D., Ellett, L., Dannahy, L. and Hayward, M. (2016). Group mindfulness-based intervention for distressing voices: a pragmatic randomised controlled trial. Schizophrenia Research, 175, 168–173. doi: 10.1016/j.schres.2016.04.001Google Scholar
Chambers, R., Lo, B. C. Y. and Allen, N. B. (2008). The impact of intensive mindfulness training on attentional control, cognitive style, and affect. Cognitive Therapy and Research, 32, 303–322.Google Scholar
Chien, W. T. and Lee, I. Y. M. (2013). The mindfulness-based psychoeducation program for Chinese patients with schizophrenia. Psychiatric Services, 64, 376–379.Google Scholar
Chien, W. T. and Thompson, D. R. (2014). Effects of a mindfulness-based psychoeducation programme for Chinese patients with schizophrenia: 2-year follow-up. British Journal of Psychiatry, 205, 52–59. doi: 10.1192/bjp.bp.113.134635Google Scholar
Davis, L. W., Strasburger, A. M. and Brown, L. F. (2007). Mindfulness: an intervention for anxiety in schizophrenia. Journal of Psychosocial Nursing and Mental Health Services, 45, 23–29.Google Scholar
Delis, D. C., Kaplan, E. and Kramer, J. H. (2001). Delis-Kaplan Executive Function System: Technical Manual. San Antonio, TX: Harcourt Assessment Company.Google Scholar
Eldridge, S. M., Lancaster, G. A., Campbell, M. J., Thabane, L., Hopewell, S., Coleman, C. L. et al. (2016). Defining feasibility and pilot studies in preparation for randomised controlled trials: development of a conceptual framework. PLoS ONE, 11, e0150205. doi: 10.1371/journal.pone.0150205Google Scholar
Elkis, H. (2007). Treatment-resistant schizophrenia. Psychiatric Clinics of North America, 30, 511–533.Google Scholar
Farrelly, S., Peters, E., Azis, M., David, A. and Hunter, E. C. (2016). A brief CBT intervention for depersonalisation/derealisation in psychosis: study protocol for a feasibility randomised controlled trial. Pilot and Feasibility Studies, 2, 47.Google Scholar
Freeman, D. (2011). Improving cognitive treatments for delusions. Schizophrenia Research, 132, 135–139.Google Scholar
Haddock, G., McCarron, J., Tarrier, N. and Faragher, E. (1999). Scales to measure dimensions of hallucinations and delusions: the psychotic symptom rating scales (PSYRATS). Psychological Medicine, 29, 879–889.Google Scholar
Haddock, G., Wood, L., Watts, R., Dunn, G., Morrison, A. P. and Price, J. (2011). The Subjective Experiences of Psychosis Scale (SEPS): psychometric evaluation of a scale to assess outcome in psychosis. Schizophrenia Research, 133, 244–249. doi: 10.1016/j.schres.2011.09.023Google Scholar
Hugdahl, K. (2009). ‘Hearing voices’: auditory hallucinations as failure of top-down control of bottom-up perceptual processes. Scandinavian Journal of Psychology, 50, 553–560. doi: 10.1111/j.1467-9450.2009.00775.xGoogle Scholar
Jacobson, N. S. and Truax, P. (1991). Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12.Google Scholar
Jha, A. P., Krompinger, J. and Baime, M. J. (2007). Mindfulness training modifies subsystems of attention. Cognitive, Affective and Behavioral Neuroscience, 7, 109–119. doi: 10.3758/CABN.7.2.109Google Scholar
Kabat-Zinn, J. (1994). Whenever You Go There You Are. New York: Hyperion.Google Scholar
Kay, S. R., Fiszbein, A. and Opler, L. A. (1987). The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13, 261–276. doi: 10.1093/schbul/13.2.261Google Scholar
Khoury, B., Lecomte, T., Gaudiano, B. A. and Paquin, K. (2013). Mindfulness interventions for psychosis: a meta-analysis. Schizophrenia Research, 150, 176–184.Google Scholar
Lakens, D. (2013). Calculating and reporting effect sizes to facilitate cumulative science: a practical primer for t-tests and ANOVAs. Frontiers in Psychology, 4, 863.Google Scholar
Lancaster, G. A., Dodd, S. and Williamson, P. R. (2004). Design and analysis of pilot studies: recommendations for good practice. Journal of Evaluation in Clinical Practice, 10, 307–312.Google Scholar
Langer, Á. I., Cangas, A. J., Salcedo, E. and Fuentes, B. (2012). Applying mindfulness therapy in a group of psychotic individuals: a controlled study. Behavioural and Cognitive Psychotherapy, 40, 105–109. doi: 10.1017/S1352465811000464Google Scholar
López-Navarro, E., Del Canto, C., Belber, M., Mayol, A., Fernández-Alonso, O., Lluis, J. et al. (2015). Mindfulness improves psychological quality of life in community-based patients with severe mental health problems: a pilot randomized clinical trial. Schizophrenia Research, 168, 530–536. doi: https://doi.org/10.1016/j.schres.2015.08.016Google Scholar
Newman Taylor, K., Harper, S. and Chadwick, P. (2009). Impact of mindfulness on cognition and affect in voice hearing: evidence from two case studies. Behavioural and Cognitive Psychotherapy, 37, 397–402. doi: 10.1017/S135246580999018XGoogle Scholar
National Institute for Clinical Excellence (NICE) (2014). Psychosis and Schizophrenia in Adults: Prevention and Management. London: NICE.Google Scholar
Nuechterlein, K. H., Green, M. F., Kern, R. S., Baade, L. E., Barch, D. M., Cohen, J. D., Essock, S., Fenton, W. S., Frese III, P. D., Frederick, J. and Gold, J. M. (2008). The MATRICS Consensus Cognitive Battery, part 1: test selection, reliability, and validity. American Journal of Psychiatry, 165, 203–213.Google Scholar
Reitan, R. M. (1992). Trail Making Test: Manual for Administration and Scoring. Reitan Neuropsychology Laboratory.Google Scholar
Riccio, C. A., Reynolds, C. R., Lowe, P. and Moore, J. J. (2002). The continuous performance test: a window on the neural substrates for attention? Archives of Clinical Neuropsychology, 17, 235–272.Google Scholar
Segal, Z. V., Williams, J. M. G. and Teasdale, J. D. (2002). Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse. New York: Guilford Press.Google Scholar
Siddi, S., Petretto, D. R., Burrai, C., Scanu, R., Baita, A., Trincas, P. et al. (2017). The role of set-shifting in auditory verbal hallucinations. Comprehensive Psychiatry, 74, 162–172. doi: https://doi.org/10.1016/j.comppsych.2017.01.011Google Scholar
Strauss, C., Thomas, N. and Hayward, M. (2015). Can we respond mindfully to distressing voices? A systematic review of evidence for engagement, acceptability, effectiveness and mechanisms of change for mindfulness-based interventions for people distressed by hearing voices. Frontiers in Psychology, 6, 1154.Google Scholar
Strauss, E., Sherman, E. M. S. and Spreen, O. (2006). A Compendium of Neuropsychological Tests: Administration, Norms, And Commentary. New York: Oxford University Press.Google Scholar
Tang, Y.-Y., Ma, Y., Wang, J., Fan, Y., Feng, S., Lu, Q. et al. (2007). Short-term meditation training improves attention and self-regulation. Proceedings of the National Academy of Sciences, 104, 17152–17156.Google Scholar
Thomas, N. (2015). What's really wrong with cognitive behavioral therapy for psychosis? Frontiers in Psychology, 6, 323.Google Scholar
Thomas, N., Hayward, M., Peters, E., van der Gaag, M., Bentall, R. P., Jenner, J. et al. (2014). Psychological therapies for auditory hallucinations (voices): current status and key directions for future research. Schizophrenia Bulletin, 40, S202–212.Google Scholar
Thomas, N., Morris, E., Shawyer, F. and Farhall, J. (2013). Acceptance and commitment therapy for voices, in Morris, E., Johns, L. C. and Oliver, J. E. (eds), Acceptance and Commitment Therapy and Mindfulness for Psychosis, pp. 95–111. West Sussex, UK: John Wiley & Sons.Google Scholar
Trower, P., Birchwood, M., Meaden, A., Byrne, S., Nelson, A. and Ross, K. (2004). Cognitive therapy for command hallucinations: randomised controlled trial. British Journal of Psychiatry, 184, 312–320.Google Scholar
van der Gaag, M., Valmaggia, L. R. and Smit, F. (2014). The effects of individually tailored formulation-based cognitive behavioural therapy in auditory hallucinations and delusions: a meta-analysis. Schizophrenia Research, 156, 30–37. doi: 10.1016/j.schres.2014.03.016Google Scholar
Wagner, S., Helmreich, I., Dahmen, N., Lieb, K. and Tadić, A. (2011). Reliability of three alternate forms of the trail making tests a and B. Archives of Clinical Neuropsychology, 26, 314–321. doi: 10.1093/arclin/acr024Google Scholar
Waters, F., Allen, P., Aleman, A., Fernyhough, C., Woodward, T. S., Badcock, J. C. et al. (2012). Auditory hallucinations in schizophrenia and nonschizophrenia populations: a review and integrated model of cognitive mechanisms. Schizophrenia Bulletin, 38, 683–693. doi: 10.1093/schbul/sbs045Google Scholar
Wechsler, D. (2001). Wechsler Test of Adult Reading. New York: Psychological Corporation.Google Scholar
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