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Changes in positive and negative voice content in cognitive-behavioural therapy for distressing voices
Journal article   Open access   Peer reviewed

Changes in positive and negative voice content in cognitive-behavioural therapy for distressing voices

Rachel M Brand, Johanna C Badcock and Georgie Paulik
Psychology & Psychotherapy, Vol.95(3), pp.807-819
2022
PMCID: PMC9542164
PMID: 35523677
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Changes in positive and negative voice content in cognitive-behavioural therapy for distressing voices286.83 kBDownloadView
Published Version Open Access CC BY V4.0
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https://doi.org/10.1111/papt.12399View
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Abstract

cognitive-behavioural therapy hallucinations hearing voices treatment
Objective: People who experience distressing voices frequently report negative (e.g. abusive or threatening) voice content and this is a key driver of distress. There has also been recognition that positive (e.g. reassuring, or guiding) voice content contributes to better outcomes. Despite this, voice content has been neglected as a standalone outcome in evaluations of psychological therapies for distressing voices. We aimed to examine whether a modular cognitive-behavioural therapy (CBT) intervention for voices led to changes in negative and positive voice content. Design/Methods: In a naturalistic, uncontrolled pre- and post- service evaluation study, 32 clients at an outpatient psychology service for distressing voices received eight sessions of CBT for distressing voices and completed self-report measures of negative and positive voice content at pre-, mid- and post- therapy. Results: There was no significant change in positive voice content. There was no significant change in negative voice content from pre- to post-therapy; however, there was a significant change in negative voice content between mid and post-treatment in which the cognitive therapy component was delivered. The CBT treatment was also associated with significant changes in routinely reported outcomes of voice-related distress and voice severity. Conclusions: The cognitive component of CBT for distressing voices may be associated with changes in negative, but not positive, voice content. There may be benefit to enhancing these effects by developing treatments targeting specific processes involved in negative and positive voice content and further exploring efficacy in well-powered, controlled trials with more comprehensive measures of voice content.

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Psychiatry
Psychology
Psychology, Clinical

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