Tailoring Cognitive Behavioral Therapy to Subtypes of Voice-Hearing

David Smailes, Ben Alderson-Day, Charles Fernyhough, Simon McCarthy-Jones, Guy Dodgson

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    34 Citations (Scopus)
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    Cognitive behavioral 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 conceptualize 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.

    Original languageEnglish
    Article number01933
    JournalFrontiers in Psychology
    Issue numberDEC
    Publication statusPublished - 2015


    • Cognitive behavioral therapy
    • Hallucinations
    • Psychosis
    • Schizophrenia
    • Voice-hearing


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