School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, Queensland, Australia.
Perth Voices Clinic, Murdoch, Western Australia, Australia.
Psychol Psychother. 2022 Sep;95(3):807-819. doi: 10.1111/papt.12399. Epub 2022 May 6.
People who experience distressing voices frequently report negative (e.g. abusive or threatening) voice content and this is a key driver of distress. There has also been recognition that positive (e.g. reassuring, or guiding) voice content contributes to better outcomes. Despite this, voice content has been neglected as a standalone outcome in evaluations of psychological therapies for distressing voices. We aimed to examine whether a modular cognitive-behavioural therapy (CBT) intervention for voices led to changes in negative and positive voice content.
DESIGN/METHODS: In a naturalistic, uncontrolled pre- and post- service evaluation study, 32 clients at an outpatient psychology service for distressing voices received eight sessions of CBT for distressing voices and completed self-report measures of negative and positive voice content at pre-, mid- and post- therapy.
There was no significant change in positive voice content. There was no significant change in negative voice content from pre- to post-therapy; however, there was a significant change in negative voice content between mid and post-treatment in which the cognitive therapy component was delivered. The CBT treatment was also associated with significant changes in routinely reported outcomes of voice-related distress and voice severity.
The cognitive component of CBT for distressing voices may be associated with changes in negative, but not positive, voice content. There may be benefit to enhancing these effects by developing treatments targeting specific processes involved in negative and positive voice content and further exploring efficacy in well-powered, controlled trials with more comprehensive measures of voice content.
经常体验到令人痛苦的声音的人会报告负面的（例如辱骂或威胁）声音内容，这是痛苦的主要驱动因素。人们也已经认识到，积极的（例如安慰或指导）声音内容有助于改善结果。尽管如此，在评估针对痛苦声音的心理治疗时，声音内容作为一个独立的结果仍被忽视。我们旨在研究针对声音的模块化认知行为疗法（CBT）干预是否会导致负面和正面声音内容发生变化。
设计/方法：在一项自然主义的、非对照的服务前和服务后评估研究中，32 名在门诊接受痛苦声音的心理学服务的患者接受了 8 节针对痛苦声音的 CBT，并在治疗前、中期和后期完成了自我报告的负面和正面声音内容的测量。
正面声音内容没有显著变化。从治疗前到治疗后，负面声音内容没有显著变化；然而，在中期和后期治疗中，即提供认知疗法部分时，负面声音内容发生了显著变化。CBT 治疗还与与声音相关的困扰和声音严重程度的常规报告结果的显著变化相关。
针对痛苦声音的 CBT 的认知成分可能与负面但不是正面的声音内容的变化有关。通过开发针对涉及负面和正面声音内容的特定过程的治疗方法，并在更全面的声音内容测量下，在更有力、对照试验中进一步探索疗效，可能会从中受益。
