A COMPARISON OF THE LONG-TERM EFFECTIVENESS OF DISTRACTION AND FOCUSING IN THE TREATMENT OF AUDITORY HALLUCINATIONS

Cognitive-behavioural interventions for patients experiencing neurolep tic resistant auditory hallucinations have fallen into two main catego ries: chose which encourage distract ion as a coping strategey, and th ose which encourage patients to focus on or expose themselves to their hallucinations. A 20-session distraction treatment was compared with an equal length focusing treatment for 19 patients who were experienci ng chronic auditory hallucinations. patients were followed-up for appr oximately 2 years. No differences were observed between the groups for outcome on symptom severity overall, although the focusers showed a g reater belief that their voices were their own thoughts at the final f ollow-up point. When the two groups were combined, there was a signifi cant reduction in the frequency of hallucinations and the disruption t o life caused by them during treatment, although this was not maintain ed at follow-up. During treatment, there was a significant increase in self-esteem for focusers bur a significant decrease for distracters. At 2-year follow-up, both focusers and distracters showed a reduction in self-esteem in comparison to the end of therapy. The results shaw n o overwhelming advantage of one treatment over the other and confirm p revious observations of the difficulty of treating hallucinations with cognitive-behaviour therapy (CBT). However, there was some indication that CBT influenced some important clinical variables and further inv estigation is warranted.