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Journal article
Imagery-Focused Cognitive Behavioral Therapy Techniques for Auditory Verbal Hallucinations in Psychosis Spectrum Disorders: Four Experimental Case Series
Schizophrenia bulletin, Vol.51(6), pp.1702-1717
2025
PMID: 40209104
Abstract
Background
In psychosis spectrum disorders, maladaptive mental imagery is associated with auditory verbal hallucinations (AVHs). This study evaluates the feasibility, acceptability, and effectiveness of the following 4 imagery techniques in targeting mental imagery and AVHs severity: Imagery Rescripting (ImRs), Promoting positive Imagery de novo (Pos-Im), Metacognitive Imagery techniques (Meta-Im), and playing Tetris.
Study Design
Four replicated single-case series experimental designs were used. Participants were randomized to 1 of the 4 treatment conditions. Primary, we measured the severity of mental imagery and AVHs thrice daily on an 11-point VAS scale during a 2-week baseline, throughout 3 weeks of therapy, and during a 2-week follow-up phase. Randomization tests were used to examine whether daily severity levels of momentary mental imagery and AVHs decreased post-therapy. Secondary, questionnaires assessing the severity of AVHs, mental imagery characteristics, and levels of mood, anxiety, and functioning were administered at baseline, before, and posttreatment.
Results
Twenty-eight participants completed all treatment sessions. Mental imagery significantly decreased after ImRs (P < .001, d = 1.13) and Pos-Im (P = .039, d = 0.22), with no significant effects observed following Meta-Im or Tetris. AVHs significantly decreased with all treatment conditions, with largest effects for ImRs (P = .001, d = 1.39) and Pos-Im (P < .001, d = 1.99). Secondary results demonstrated reductions in the severity of AVHs, mood, anxiety, imagery frequency, and appraisals.
Conclusions
Imagery techniques appear feasible and acceptable for addressing mental imagery and AVHs in the psychosis continuum and may be valuable additions to current treatment for AVHs.
Details
- Title
- Imagery-Focused Cognitive Behavioral Therapy Techniques for Auditory Verbal Hallucinations in Psychosis Spectrum Disorders: Four Experimental Case Series
- Authors/Creators
- Hella Janssen - Maastricht UniversityKarin C van den Berg - Maastricht UniversityGer P J Keijsers - Maastricht UniversityGeorgie Paulik - Murdoch UniversityKatherine Newman-Taylor - University of SouthamptonChristopher D J Taylor - Pennine Care NHS Foundation TrustCraig Steel - Oxford Health NHS Foundation TrustMachteld C Marcelis - Maastricht University
- Publication Details
- Schizophrenia bulletin, Vol.51(6), pp.1702-1717
- Publisher
- Oxford University Press
- Number of pages
- 16
- Grant note
- Mental Health Institute Eindhoven
- Identifiers
- 991005765128907891
- Copyright
- © The Author(s) 2025.
- Murdoch Affiliation
- Murdoch University
- Language
- English
- Resource Type
- Journal article
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- Collaboration types
- Domestic collaboration
- International collaboration
- Citation topics
- 1 Clinical & Life Sciences
- 1.21 Psychiatry
- 1.21.24 Schizophrenia Research
- Web Of Science research areas
- Psychiatry
- ESI research areas
- Psychiatry/Psychology