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Cognitive therapy for command hallucinations: randomised controlled trial.

Peter Trower1, Max Birchwood, Alan Meaden

  • 1School of Psychology, University of Birmingham and Birmingham and Solihull Mental HealthTrust, UK.

The British Journal of Psychiatry : the Journal of Mental Science
|April 2, 2004
PubMed
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Cognitive therapy for command hallucinations (CTCH) significantly reduced compliance with distressing voices. This effective treatment improved beliefs about voices and reduced distress, with benefits maintained at 12 months.

Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Cognitive Behavioral Therapy

Background:

  • Command hallucinations are poorly understood, high-risk symptoms with limited treatment options.
  • Social rank theory offers potential insights for developing effective therapies.
  • Cognitive therapy for command hallucinations (CTCH) is a novel approach.

Purpose of the Study:

  • To test the efficacy of CTCH in reducing compliance with command hallucinations.
  • To assess CTCH's impact on beliefs regarding the power of voices.

Main Methods:

  • A single-blind, randomized controlled trial was conducted.
  • 38 patients with recent serious compliance with command hallucinations were recruited.
  • Participants were allocated to either CTCH or treatment as usual, with follow-ups at 6 and 12 months.

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Main Results:

  • CTCH led to significant reductions in compliance behavior (effect size 1.1).
  • The CTCH group showed reduced conviction in the voices' power and superiority, and less need to comply.
  • Improvements in distress and depression were observed in the CTCH group, maintained at 12 months.

Conclusions:

  • Cognitive therapy for command hallucinations (CTCH) is an effective treatment.
  • CTCH reduces compliance and associated distress in patients experiencing command hallucinations.