Trauma-focused imaginal exposure for auditory hallucinations: A case series

Area of Science:

• Psychiatry
• Psychology
• Trauma Studies

Background:

• Traumatic life events are increasingly linked to auditory hallucinations (AH).
• Auditory hallucinations may represent decontextualized trauma memory intrusions.
• Exposure-based trauma therapies offer a potential treatment avenue for trauma-related AH.

Purpose of the Study:

• To evaluate the feasibility and acceptability of a standard trauma-focused imaginal exposure intervention for trauma-related AH.
• To gather preliminary data on the potential effectiveness of imaginal exposure for AH.

Main Methods:

• A single-arm case series design was employed.
• The intervention consisted of a six-session (90 minutes each) imaginal exposure protocol.
• Assessments were conducted at baseline, post-therapy, and one-month follow-up.

Main Results:

• Fifteen participants completed the intervention, reporting high satisfaction.
• A significant reduction in AH severity was observed at one-month follow-up (adjusted d = 0.99), though individual responses varied.
• Participants also showed significant reductions in post-traumatic stress disorder symptoms and trauma memory intrusiveness.

Conclusions:

• Imaginal exposure is generally acceptable for trauma-related AH and can lead to substantial improvements for some individuals.
• Temporary distress and symptom exacerbation are common, potentially leading to discontinuation and highlighting feasibility challenges for standalone use.
• Further large-scale trials are necessary to confirm efficacy and identify factors influencing treatment response and acceptability, suggesting integration into broader trauma therapies may be beneficial.