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Cognitive Behavioural Therapy for Auditory Hallucinations: Effectiveness and Predictors of Outcome in a Specialist Clinic

Published online by Cambridge University Press:  10 November 2010

Neil Thomas ,
Susan Rossell ,
John Farhall ,
Frances Shawyer  and
David Castle
Neil Thomas*
Affiliation:
Monash Alfred Psychiatry Research Centre and La Trobe University, Australia
Susan Rossell
Affiliation:
Monash Alfred Psychiatry Research Centre and Swinburne University, Australia
John Farhall
Affiliation:
La Trobe University, Australia
Frances Shawyer
Affiliation:
La Trobe University, Australia
David Castle
Affiliation:
University of Melbourne, Australia
*
Reprint requests to Neil Thomas, Monash Alfred Psychiatry Research Centre, Level 1, Old Baker Building, The Alfred, Commercial Road, Melbourne, Victoria 3004, Australia. E-mail: neil.thomas@monash.edu
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Abstract

Background: Cognitive behavioural therapy has been established as an effective treatment for residual psychotic symptoms but a substantial proportion of people do not benefit from this treatment. There has been little direct study of predictors of outcome, particularly in treatment targeting auditory hallucinations. Method: The Psychotic Symptom Rating Scales (PSYRATS) and Positive and Negative Syndrome Scale (PANSS) were administered pre- and post-therapy to 33 people with schizophrenia-related disorders receiving CBT for auditory hallucinations in a specialist clinic. Outcome was compared with pre-therapy measures of insight, beliefs about the origin of hallucinations, negative symptoms and cognitive disorganization. Results: There were significant improvements post-treatment on the PSYRATS and PANSS Positive and General Scales. Improvement on the PSYRATS was associated with lower levels of negative symptoms, but was unrelated to overall insight, delusional conviction regarding the origins of hallucinations, or levels of cognitive disorganization. Conclusions: Lack of insight and presence of formal thought disorder do not preclude effective cognitive-behavioural treatment of auditory hallucinations. There is a need to further understand why negative symptoms may present a barrier to therapy.

Keywords

Schizophreniapsychosisauditory hallucinationscognitive behavioural therapypredictorsinsightnegative symptoms
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 39 , Issue 2 , March 2011 , pp. 129 - 138
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2010

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