Relating Therapy for distressing voices: A treatment protocol

To present a treatment protocol for Relating Therapy-a novel psychological intervention which supports adults to respond assertively to their distressing voice hearing experiences.

This paper reports the background to the development of Relating Therapy. Thereafter, the four phases of the therapy are described: (1) exploring the hearer's relational landscape and identification of patterns of relating; (2) selection of a difficult relationship and a specific conversation, and re-scripting of the conversation; (3) introduction to and engagement with roleplays and (4) reflection, consolidation and preparing for the continuation of learning. Implementation issues are discussed, and the evidence base is reviewed.

The findings from preliminary evaluations of Relating Therapy suggest that a definitive randomised controlled trial is feasible. Current evidence suggests that Relating Therapy is an acceptable and safe intervention that has the potential to generate benefits for hearers.

Learning to respond assertively may be beneficial to some adults who are distressed by hearing voices. A definitive randomised controlled trial is warranted to evaluate the clinical and cost-effectiveness of Relating Therapy and to explore the mechanisms through which any benefits might be generated.