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Tailoring cognitive behavioural therapy to subtypes of voice-hearing.

Smailes, D. and Alderson-Day, B. and Fernyhough, C. and McCarthy-Jones, S. and Dodgson, G. (2015) 'Tailoring cognitive behavioural therapy to subtypes of voice-hearing.', Frontiers in psychology., 6 . p. 1933.


Cognitive behavioural therapy (CBT) for voice-hearing (i.e., auditory verbal hallucinations; AVH) has, at best, small-to-moderate effects. One possible reason for this limited efficacy is that current CBT approaches tend to conceptualise voice-hearing as a homogenous experience in terms of the cognitive processes involved in AVH. However, the highly heterogeneous nature of voice-hearing suggests that many different cognitive processes may be involved in the etiology of AVH. These heterogeneous voice-hearing experiences do, however, appear to cluster into a set of subtypes, opening up the possibility of tailoring treatment to the subtype of AVH that a voice-hearer reports. In this paper, we (a) outline our rationale for tailoring CBT to subtypes of voice-hearing, (b) describe CBT for three putative subtypes of AVH (inner speech-based AVH, memory-based AVH, and hypervigilance AVH), and (c) discuss potential limitations and problems with such an approach. We conclude by arguing that tailoring CBT to subtypes of voice-hearing could prove to be a valuable therapeutic development, which may be especially effective when used in early intervention in psychosis services.

Item Type:Article
Keywords:Hallucinations, Voice-hearing, Cognitive behavioural therapy, Psychosis, Schizophrenia.
Full text:(AM) Accepted Manuscript
Available under License - Creative Commons Attribution.
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Full text:(VoR) Version of Record
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Publisher statement:© 2015 Smailes, Alderson-Day, Fernyhough, McCarthy-Jones and Dodgson. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Date accepted:01 December 2015
Date deposited:11 December 2015
Date of first online publication:21 December 2015
Date first made open access:No date available

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