Psychiatr. praxi. 2014;15(3):117-124

Cognitive behavioral therapy of chronic hallucinations

MUDr.Kristýna Vrbová1,2, prof.MUDr.Ján Praško, CSc.1,2, Mgr.Marie Ocisková1,3, Mgr.Lucie Šmejkalová1
1 Klinika psychiatrie, Fakultní nemocnice Olomouc
2 Lékařská fakulta Univerzity Palackého v Olomouci
3 Katedra psychologie, Filozofická fakulta Univerzity Palackého v Olomouci

The lifetime prevalence of schizophrenia varies according to epidemiological studies between 1–1.5 %. Although modern pharmacotherapy

led to a significant reduction of patient’s suffering, about 25 % of schizophrenic patients are described as “pharmacologically

resistant” and 20–60 % stop taking recommended medication. Except the symptoms that are resistant to the treatment, progression of

the disease is negatively influenced by other factors, such as premorbid personality, cognitive deficit, family and interpersonal problems,

drug and alcohol abuse, stigmatization. All these factors are pointing to the need to add systematic psychotherapeutic interventions to

the biological treatment. Hallucinations are the manifestation of perception disorder. The most frequent hallucinations in schizophrenia

are the auditory hallucinations, in which the patient hears voices. The patient often interprets the content of hallucinatory experiences

as delusions, which leads to negative emotional reactions and obvious maladaptive behavior. The aim of CBT is to help the patient to

use more critical approach to hallucinations and have them more like under control. The paper presents an overview of CBT approaches

for therapeutic influence on chronic hallucinations.

Keywords: schizophrenia, hallucination, Socratic dialogue, behavioral experiment, narrative approach

Published: November 1, 2014  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Vrbová K, Praško J, Ocisková M, Šmejkalová L. Cognitive behavioral therapy of chronic hallucinations. Psychiatr. praxi. 2014;15(3):117-124.
Download citation

References

  1. Wittchen HU, Jacobi F, Rehm J, Gustavsson A, Svensson M, Jönsson B, Olesen J, Allgulander C, Alonso J, Faravelli C, Fratiglioni L, Jennum P, Lieb R, Maercker A, van Os J, Preisig M, Salvador-Carulla L, Simon R, Steinhausen HC: The size and burden of mental disorders and other disorders of the brain in Europe 2010. Eur Neuropsychopharmacol 2011; 21: 655-679. Go to PubMed...
  2. Tandon R, Nasrallah HA, Keshavan MS. Schizophrenia,, ,just the facts" 5. Treatment and prevention. Past, present, and future. Schizophr Res 2010; 122: 1-23. Go to original source... Go to PubMed...
  3. Lehman AF, Kreyenbuhl J, Buchanan RW, Dickerson FB, Dixon LB, Goldberg R, et al. The schizophrenia patient outcomes research team (PORT): updated treatment recommendations. Schizophr Bull 2004; 30: 193-217. Go to original source... Go to PubMed...
  4. Lieberman JA, Stroup TS, McEvoy JP, Swartz MS, Rosenheck RA, Perkins DO, Keefe RS, Davis SM, Davis CE, Lebowitz BD, Severe J, Hsiao JK; Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Investigators: Effectiveness of antipsychotic drugs in patiens with chronic schizophrenia. N Engl J Med 2005; 353: 1209-1223. Go to original source... Go to PubMed...
  5. NICE: Schizophrenia: Core Interventions in the Treatment and Management of Schizophrenia in Adults in Primary and Secondary Care. NICE Clinical Guideline 82. National Institute for Clinical Excellence: London 2009.
  6. Hofer A, Baumgartner S, Bodner T, Edlinger M, Hummer M, Kemmler G, Rettenbacher MA, Fleischhacker WW: Patient outcomes in schizophrenia II: The impact of cognition. Eur Psychiatry 2005; 20: 395-402. Go to original source... Go to PubMed...
  7. Wegener S, Redoblado-Hodge MA, Lucas S, Fitzgerald D, Harris A, Brennan J: Relative contributions of psychiatric symptoms and neuropsychological functioning to quality of life in first-episode psychosis. Aust N Z J Psychiatry 2005; 39: 487-492. Go to original source... Go to PubMed...
  8. Chadwick P, Birchwood M, Trower P. Cognitive therapy for delusions, voices and paranoia. Chichester: Wiley 1996.
  9. Scott J, Kingdon D, Turkington D. Cognitive-behavior therapy for schizophrenia. In: Wright JH (ed): Cognitive-behavior therapy. Review of Psychiatry, American Psychiatric Press, Washington 2004: 1-24.
  10. Kingdom D, Turkington D, Carolyn J. Cognitive behaviour therapy of schizophrenia: the amenability of delusions and hallucinations to reasoning. Br J Psychiatr 1994; 164: 581-587. Go to original source... Go to PubMed...
  11. Wykes T, Parr AM, Landau S. Group treatment of auditory hallucinations. Exploratory study of effectiveness. Br J Psychiatry 1999; 175: 180-185. Go to original source... Go to PubMed...
  12. Rector NA, Beck AT. Cognitive behavioral therapy for schizophrenia: An empirical review. J Nerv Ment Dis 2001; 189: 278-287. Go to original source... Go to PubMed...
  13. Pilling S, Bebbington P, Kuipers E, Garety P, Geddes J, Orbach G, et al. Psychological treatments in schizophrenia: I. Metaanalysis of family intervention and cognitive behaviour therapy. Psychol Med 2002; 32: 763-782. Go to original source... Go to PubMed...
  14. Pinkham AE, Gloege AT, Flanagan S, Penn DL: Group cognitive behavioral therapy for auditory hallucinations: a pilot study. Cognit Behav Pract 2004;11: 93-98. Go to original source...
  15. Newton E, Landau S, Smith P, Monks P, Shergill S, Wykes T. Early psychological intervention for auditory hallucinations: an exploratory study of young people's voices groups. J Nerv Ment Dis 2005; 193(1): 58-61. Go to original source... Go to PubMed...
  16. Roder V, Muelle DR, Mueser KT, Brenner HD. Integrated Psychological Therapy (IPT) for Schizophrenia: Is it effective? Schizophrenia bulletin 2006; 32(S1): 81-93. Go to original source... Go to PubMed...
  17. Farhall J, Greenwood KM, Jackson HJ. Coping with hallucinated voices in schizophrenia: A review of self-initiated strategies and therapeutic interventions. Clin Psychol Rev 2007; 27: 476-493. Go to original source... Go to PubMed...
  18. Wykes T, Hayward P, Thomas N, Green N, Surguladze S, Fannon D, et al. What are the effects of group cognitive behaviour therapy for voices? A randomised control trial. Schizophr Res 2005; 77: 201-210. Go to original source... Go to PubMed...
  19. Látalová K, Praško J, Sigmundová Z. Schizofrenie a příbuzná onemocnění. In: Praško J, Látalová K, Ticháčková A (eds): Klinická psychiatrie. Tigis, Praha 2012: 203-234.
  20. Hoffman RE, Hawkins KA, Gueorguieva R, Boutros NN, Rachid F, Carroll K, Krystal JH: Transcranial magnetic stimulation of left temporoparietal cortex and medication-resistant auditory hallucinations. Arch Gen Psychiatry. 2003; 60(1): 49-56. Go to original source... Go to PubMed...
  21. Klirova M, Horacek J, Novak T, Cermak J, Spaniel F, Skrdlantova L, Mohr P, Höschl C. Individualized rTMS neuronavigated according to regional brain metabolism ((18)FGD PET) has better treatment effects on auditory hallucinations than standard positioning of rTMS: a double-blind, sham-controlled study. Eur Arch Psychiatry Clin Neurosci 2013; 263(6): 475-484. Go to original source... Go to PubMed...
  22. Drury V, Birchwood M, Cochrane R, MacMillan F. Cognitive therapy and recovery from acute psychosis: a controlled trial 1: impact on psychotic symptoms. Br J Psychiatry 1996; 169: 593-601. Go to original source... Go to PubMed...
  23. Garety P, Fowler D, Kuipers E, Freeman D, Dunn G, Bebbington P, Hadley C, Jones S. London-East Anglia randomised controlled trial of cognitive-behavioural therapy for psychosis. II: Predictors of outcome. Br J Psychiatry 1997; 171: 420-426. Go to original source... Go to PubMed...
  24. Zanello A, Mohr S, Merlo MC, Huguelet P, Rey-Bellet P. Effectiveness of a brief group cognitive behavioral therapy for auditory verbal hallucinations: a 6-month follow-up study. J Nerv Ment Dis 2014; 202(2): 144-153. Go to original source... Go to PubMed...
  25. Kr?kvik B, Gr?we RW, Hagen R, Stiles TC. Cognitive behaviour therapy for psychotic symptoms: a randomized controlled effectiveness trial. Behav Cogn Psychother 2013; 41(5): 511-524. Go to original source... Go to PubMed...
  26. Freeman D, Dunn G, Garety P, Weinman J, Kuipers E, Fowler D, Jolley S, Bebbington P. Patients' beliefs about the causes, persistence and control of psychotic experiences predict take-up of effective cognitive behaviour therapy for psychosis. Psychol Med. 2013; 43(2): 269-277. Go to original source... Go to PubMed...
  27. Kahraman B, Kraemer S. Cognitive behavioral psychotherapy of a schizophrenic patient with persistent auditory halucinations. Verhaltenstherapie 2002; 12: 54-62. Go to original source...
  28. Mawson A, Cohen K, Berry K. Reviewing evidence for the cognitive model of auditory hallucinations: The relationship between cognitive voice appraisals and distress during psychosis. Clin Psychol Rev 2010; 30(2): 248-258. Go to original source... Go to PubMed...
  29. Badcock JC, Chhabra S. Voices to reckon with: perceptions of voice identity in clinical and non-clinical voice hearers. Front Hum Neurosci 2013;7:114. doi: 10.3389/fnhum.2013.00114.eCollection 2013. Go to original source... Go to PubMed...
  30. Paulik G. The role of social schema in the experience of auditory hallucinations: a systematic review and a proposal for the inclusion of social schema in a cognitive behavioural model of voice hearing. Clin Psychol Psychother 2012; 19(6): 459-472. Go to original source... Go to PubMed...
  31. Bell V. A community of one: social cognition and auditory verbal hallucinations. PLoS Biol 2013; 11(12): e1001723. doi: 10.1371/journal.pbio.1001723. Go to original source... Go to PubMed...
  32. Hayward M, Berry K, Ashton A. Applying interpersonal theories to the understanding of and therapy for auditory hallucinations: a review of the literature and directions for further research. Clin Psychol Rev 2011; 31(8): 1313-1323. Go to original source... Go to PubMed...
  33. Mawson A, Berry K, Murray C, Hayward M. Voice hearing within the context of hearers' social worlds: an interpretative phenomenological analysis. Psychol Psychother 2011; 84(3): 256-272. Go to original source... Go to PubMed...
  34. Prasko J, Diveky T, Grambal A, Kamaradova D, Latalova K, Mainerova B, Vrbova K, Trcova A: Narrative cognitive behavior therapy for psychosis. Act Nerv Super Rediviva 2010; 52(1): 135-146.
  35. Rhodes J, Jakes S. Narrative CBT for Psychosis. Routledge. Taylor and Francis Group. New York 2009. Go to original source...
  36. Možný P, Španiel F, Rodriques M, Horáček J, Praško J. KBT schizofrenie. In: Praško J, Možný P, Šlepecký M (eds): Kognitivně behaviorální terapie psychických poruch. Triton, Praha 2007: 764-801.




Psychiatry for Practice

Madam, Sir,
please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

I declare:

  1. that I have met the above instruction
  2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited


No

Yes

If your statement is not true, please be aware
that brings the risk of danger to their health or the health of others.