Cognitive behaviour therapy with coping training for persistent auditory hallucinations in schizophrenia: a naturalistic follow-up study of the durability of effects

Objective: To investigate the durability of positive effects of cognitive b ehaviour therapy (CBT) with coping training on psychotic symptoms and socia l functioning. Method: Forty patients with schizophrenia or related psychotic disorders an d refractory auditory hallucinations were given CBT and coping training in an integrated single family treatment programme. In a naturalistic study pa tients were followed after 2 and 4 years since the start of treatment. Results: The treatment improved overall burden of 'hearing voices', with a generalization into daily functioning. Improvement with regard to fear, los s of control, disturbance of thought and interference with thinking was sus tained by 60% of the patients while one-third improved further. Complete di sappearance of hallucinations occurred in 18% of the patients. Conclusion: CBT with coping training can improve both overall symptomatolog y and quality of life, even over longer periods of time, but a status of pe rsistent disablement indicates a continuing need for mental health care.