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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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References

Bell, M., Milstein, R., Beam-Goulet, J., Lysaker, P. and Cicchetti, D. (1992). The Positive and Negative Syndrome Scale and the Brief Psychiatric Rating Scale: reliability, comparability, and predictive validity. Journal of Nervous and Mental Disease, 180, 723–728.CrossRefGoogle ScholarPubMed
Brabban, A., Tai, S. and Turkington, D. (2009). Predictors of outcome in brief cognitive behavior therapy for schizophrenia. Schizophrenia Bulletin, 35, 857–858.CrossRefGoogle ScholarPubMed
Chadwick, P. D. J. and Birchwood, M. (1994). The omnipotence of voices: a cognitive approach to auditory hallucinations. British Journal of Psychiatry, 164, 190–201.CrossRefGoogle ScholarPubMed
David, A. S., Buchanan, A., Reed, A. and Almeida, O. (1992). The assessment of insight in psychosis. British Journal of Psychiatry, 161, 599–602.CrossRefGoogle ScholarPubMed
Drake, R., Haddock, G., Tarrier, N., Bentall, R. and Lewis, S. (2007). The Psychotic Symptom Rating Scales (PSYRATS): their usefulness and properties in first episode psychosis. Schizophrenia Research, 89, 119–122.CrossRefGoogle ScholarPubMed
Durham, R. C., Chambers, J. A., Power, K. G., Sharp, D. M., MacDonald, R. R., Major, K. A., Dow, M. G. and Gumley, A. (2005). Long-term outcome of cognitive behaviour therapy clinical trials in central Scotland. Health Technology Assessment, 9 (42).CrossRefGoogle ScholarPubMed
Farhall, J., Greenwood, K. M. and Jackson, H. J. (2007). Coping with hallucinated voices in schizophrenia: a review of self-initiated strategies and therapeutic interventions. Clinical Psychology Review, 27, 476–493.CrossRefGoogle ScholarPubMed
Favrod, J., Vianin, P., Pomini, V. and Mast, F. W. (2006). A first step toward cognitive remediation of voices: a case study. Cognitive Behaviour Therapy, 35, 159–163.CrossRefGoogle ScholarPubMed
Fowler, D., Garety, E. and Kuipers, E. (1995). Cognitive Behaviour Therapy for Psychosis. Chichester: Wiley.Google Scholar
Garety, P. A., Fowler, D., Kuipers, E., Freeman, D., Dunn, G., Bebbington, P., Hadley, C. and Jones, S. (1997). London–East Anglia randomised controlled trial of cognitive-behavioural therapy for psychosis: II. predictors of outcome. British Journal of Psychiatry, 171, 420–426.CrossRefGoogle ScholarPubMed
Garety, P. A., Fowler, D. and Kuipers, E. (2000). Cognitive-behavioral therapy for medication-resistant symptoms. Schizophrenia Bulletin, 26, 1–14.CrossRefGoogle ScholarPubMed
Gaudiano, B. A. and Herbert, J. D. (2006). Acute treatment of inpatients with psychotic symptoms using Acceptance and Commitment Therapy: pilot results. Behaviour Research and Therapy, 44, 415–437.CrossRefGoogle ScholarPubMed
Haddock, G., McCarron, J., Tarrier, N. and Faragher, E. B. (1999). Scales to measure dimensions of hallucinations and delusions: the Psychotic Symptom Rating Scales (PSYRATS). Psychological Medicine, 29, 879–889.Google Scholar
Haddock, G., Slade, P. D., Bentall, R. P., Reid, D. and Faragher, E. B. (1998). A comparison of the long-term effectiveness of distraction and focusing in the treatment of auditory hallucinations. British Journal of Medical Psychology, 71, 339–349.CrossRefGoogle ScholarPubMed
Hayward, M., Overton, J., Dorey, T. and Denney, J. (2009). Relating therapy for people who hear voices: a case series. Clinical Psychology and Psychotherapy, 16, 216–227.CrossRefGoogle ScholarPubMed
Kay, S., Opler, L. and Lindenmayer, J. P. (1987). The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13, 261–275.CrossRefGoogle ScholarPubMed
Kay, S., Opler, L. and Lindenmayer, J. P. (1988). Reliability and validity of the positive and negative syndrome scale for schizophrenics. Psychiatry Research, 23, 99–110.CrossRefGoogle ScholarPubMed
Kirkpatrick, B., Buchanan, R. W., Ross, D. E. and Carpenter, W. T. (2001). A separate disease within the syndrome of schizophrenia. Archives of General Psychiatry, 58, 165–171.CrossRefGoogle ScholarPubMed
Liddle, P. F. (1987). The symptoms of chronic schizophrenia: a re-examination of the positive–negative dichotomy. British Journal of Psychiatry, 151, 145–151.CrossRefGoogle ScholarPubMed
McGowan, J. F., Lavender, T. and Garety, P. A. (2005). Factors in outcome of cognitive-behavioural therapy for psychosis: users’ and clinicians’ views. Psychology and Psychotherapy: Theory, Research and Practice, 78, 513–529.CrossRefGoogle ScholarPubMed
Morrison, A. P. and Renton, J. C. (2001). Cognitive therapy for auditory hallucinations: a theory-based approach. Cognitive and Behavioral Practice, 8, 147–160.CrossRefGoogle Scholar
Morrison, A. P., Renton, J., Dunn, H., Williams, S. and Bentall, R. (2004). Cognitive Therapy for Psychosis: a formulation-based approach. London: Brunner-Routledge.CrossRefGoogle Scholar
Naeem, F., Kingdon, D. and Turkington, D. (2008). Predictors of response to cognitive behavior therapy in the treatment of schizophrenia: a comparison of brief and standard interventions. Cognitive Therapy and Research, 32, 651–656.Google Scholar
National Institute for Clinical Excellence (2009). Schizophrenia: core interventions in the treatment and management of schizophrenia in primary and secondary care (update). London: Department of Health.Google Scholar
Rector, N. A., Beck, A. T. and Stolar, N. (2005). The negative symptoms of schizophrenia: a cognitive perspective. Canadian Journal of Psychiatry, 50, 247–257.CrossRefGoogle ScholarPubMed
Shawyer, F., Farhall, J., Sims, E. and Copolov, D. (2005). Command hallucinations in psychosis: acceptance and disengagement as a focus of treatment. In Jackson, M. and Murphy, G. (Eds.), Theory and Practice in Contemporary Australian Cognitive and Behaviour Therapy: proceedings of the 28th AACBT conference (pp. 5–14). Melbourne: Australian Association for Cognitive and Behaviour Therapy.Google Scholar
Tarrier, N. (1992). Management and modification of residual positive psychotic symptoms. In Birchwood, M. and Tarrier, N. (Eds.), Innovations in the Psychological Management of Schizophrenia. Chichester: Wiley.Google Scholar
Tarrier, N., Beckett, R., Harwood, S., Baker, A., Yusupoff, L. and Ugarteburu, I. (1993). A trial of two cognitive-behavioural methods of treating drug-resistant residual psychotic symptoms in schizophrenic patients. I: outcome. British Journal of Psychiatry, 162, 524–532.Google Scholar
Tarrier, N., Yusupoff, L., Kinney, C., McCarthy, E., Gledhill, A., Haddock, G. and Morris, J. (1998). Randomised controlled trial of intensive cognitive behaviour therapy for patients with chronic schizophrenia. British Medical Journal, 317, 303–307.CrossRefGoogle ScholarPubMed
Tarrier, N., Kinney, C., McCarthy, E., Wittkowski, A., Yusupoff, L., Gledhill, A., Morris, J. and Humphreys, L. (2001). Are some types of psychotic symptoms more responsive to cognitive-behaviour therapy? Behavioural and Cognitive Psychotherapy, 29, 45–55.CrossRefGoogle 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
Turkington, D., Kingdon, D. and Turner, T. (2002). Effectiveness of a brief cognitive-behavioural therapy intervention in the treatment of schizophrenia. British Journal of Psychiatry, 180, 523–527.CrossRefGoogle ScholarPubMed
Wykes, T., Steel, C., Everitt, B. and Tarrier, N. (2008). Cognitive behavior therapy for schizophrenia: effect sizes, clinical models, and methodological rigor. Schizophrenia Bulletin, 34, 523–537.CrossRefGoogle ScholarPubMed
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