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Developments in Cognitive-Behaviour Therapy for Persistent Psychotic Symptoms

Published online by Cambridge University Press:  06 October 2014

Gillian Haddock*
Affiliation:
University Hospital of South Manchester
William Sellwood
Affiliation:
University Hospital of South Manchester
Nicholas Tarrier
Affiliation:
University Hospital of South Manchester
Lawrence Yusupoff
Affiliation:
University Hospital of South Manchester
*
Department of Clinical Psychology, School of Psychiatry and Behavioural Sciences, University Hospital of South Manchester, Nell Lane, West Didsbury, Manchester M20 8LR, Great Britain
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Abstract

This paper is a review of studies on psychological treatments for positive psychotic symptoms, and a detailed description of two of these studies, the Manchester Symptom Project, which aimed to decrease positive symptoms by training patients in effective coping strategies, and the Liverpool Auditory Hallucination project, which aimed to provide a cognitive-behavioural treatment for individuals with persistent and distressing voices. The results from these studies indicate that enduring positive symptoms which have not responded to neuroleptic medication can be effectively treated by psychological methods.

Type
Special Issue: Behaviour Therapy and Schizophrenia — Part One
Copyright
Copyright © The Author(s) 1994

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References

REFERENCES

Allen, H.A., Halperin, J., & Friend, R. (1985). Removal and diversion tactics and the control of auditory hallucinations. Behaviour, Research and Therapy, 23, 601605.Google Scholar
Amdur, M.A. (1979). Medication compliance in outpatient psychiatry. Comprehensive Psychiatry, 20, 339346.Google Scholar
Andreasen, N. (1983). The Scale for the Assessment of Negative Symptoms (SANS). Iowa City, Iowa: University of Iowa.Google Scholar
Andreasen, N. (1984). The scale for the Assessment of Positive Symptoms (SAPS). Iowa City, Iowa: University of Iowa.Google Scholar
Bartko, G., Maylath, E., & Herczeg, I. (1987). A comparative study of schizophrenic patients relapsed on and off medication. Psychiatry Research, 22, 221227.CrossRefGoogle ScholarPubMed
Bartko, G., Herczeg, I., & Zador, G. (1988). Clinical Symptomology and drug compliance in schizophrenic patients. Acta Psychiatrica Scandinavica, 77, 7476.Google Scholar
Bentall, R.P. (1990). The illusion of reality: A review and integration of psychological research on hallucinations. Psychological Bulletin, 107, 8295.Google Scholar
Bentall, R.P., Baker, G., & Havers, S. (1991) Reality monitoring and psychotic hallucinations. British Journal of Clinical Psychology, 30, 213222.CrossRefGoogle ScholarPubMed
Bentall, R.P., Haddock, G., & Slade, P.D. (1994). Psychological treatment for auditory hallucinations: From theory to therapy. Behaviour Therapy, 25, 5166.Google Scholar
Bentall, R.P., & Slade, P.D. (1985). Reality testing and auditory hallucinations: A signal detection analysis. British Journal of Clinical Psychology, 24, 159169.CrossRefGoogle ScholarPubMed
Birchwood, M. (1986). Control of auditory hallucinations through occlusion of monaural auditory input. British Journal of Psychiatry, 149, 104107.CrossRefGoogle ScholarPubMed
Boczkowski, J.A., Zeichner, A., & DeSanto, N. (1985). Neuroleptic compliance among chronic schizophrenic outpatients. Journal of Consulting and Clinical Psychology, 53, 666671.Google Scholar
Brooker, C., Barrowclough, C., & Tarrier, N. (1992). Evaluating the impact of training community psychiatric nurses to educate relatives about schizophrenia. Journal of Clinical Nursing, 1, 1925.Google Scholar
Chadwick, P., & Birchwood, M. (1994). The omnipotence of voices. A cognitive approach to auditory hallucinations. British Journal of Psychiatry, 164, 190201.CrossRefGoogle ScholarPubMed
Chadwick, P., & Lowe, C.F. (1990). The measurement and modification of delusional beliefs. Journal of Consulting and Clinical Psychology, 58, 225232.Google Scholar
Corrigan, P.W., Liberman, R.P., & Engel, J.D. (1990). From noncompliance to collaboration in the treatment of schizophrenia. Hospital and Community Psychiatry, 41, 12031211.Google Scholar
Diamond, R. (1985). Drugs and the quality of life: The patient's point of view. Journal of Clinical Psychiatry, 46, 2935.Google Scholar
Done, D.J., Frith, C.D., & Owens, D.C. (1986). Reducing persistent auditory hallucinations by wearing an ear-plug. British Journal of Clinical Psychology, 25, 151152.Google Scholar
Eckman, T.A., Liberman, R.P., Phipps, C.C., & Blair, K.E. (1990). Teaching medication management skills to schizophrenic patients. Journal of Clinical Psychopharmacology, 10, 3338.Google Scholar
Eisenthal, S., Emery, R., Lazare, A., & Udin, H. (1979). “Adherence” and the negotiated approach to patienthood. Archives of General Psychiatry, 36, 393398.CrossRefGoogle ScholarPubMed
Falloon, I.R.H. (1984). Developing and maintaining adherence to long-term drug-taking regimens. Schizophrenia Bulletin, 10, 412417.Google Scholar
Fowler, D. (1992). Cognitive behaviour therapy in the management of patients with schizophrenia: preliminary studies. In Werbart, A. & Cullberg, J. (Eds.), Psychotherapy of schizophrenia: facilitating and obstructive factors. Oslo: Scandinavian University Press.Google Scholar
Fowler, D., & Morley, S. (1989). The cognitive-behavioural treatment of hallucinations and delusions: A preliminary study. Behavioural Psychotherapy, 17, 267282.CrossRefGoogle Scholar
Frith, C.D. (1992). The cognitive neuropsychology of schizophrenia. Hove: Lawrence Erlbaum.Google Scholar
Gallagher, A.G., Dinan, T.G., & Baker, L.J.V. (1994). The effects of varying auditory input on schizophrenic hallucinations: A replication. British Journal of Medical Psychology, 67, 6776.CrossRefGoogle ScholarPubMed
Goldstein, M.J. (1992). Psychosocial strategies for maximising the effects of psychotropic medications for schizophrenia and mood disorder. Psychopharmacology Bulletin, 28, 237240.Google Scholar
Gould, L.N. (1948). Verbal hallucinations and activity of vocal musculature. American Journal of Psychiatry, 105, 367372.CrossRefGoogle ScholarPubMed
Green, P., (1978). Defective interhemispheric transfer in schizophrenia. Journal of Abnormal Psychology, 87, 472480.CrossRefGoogle ScholarPubMed
Greene, R.J. (1978). Auditory hallucination reduction: First person singular. Journal of Contemporary Psychology, 9, 167170.Google Scholar
Haddock, G., Bentall, R.P., & Slade, P.D. (1993). Psychological treatment of auditory hallucinations: Two case studies. Behavioural and Cognitive Psychotherapy, 21, 335346.Google Scholar
Hoffman, R.E. (1986). Verbal hallucinations and language production processes in schizophrenia. The Behavioural and Brain Sciences, 9, 503548.Google Scholar
Hoge, S.K., Appelbaum, P.S., Lawler, T., Beck, J.C., Litman, R., Greer, A., Gutheil, T.G., & Kaplan, E. (1990). A prospective, multicenter study of patients' refusal of antipsychotic medication. Archives of General Psychiatry, 47, 949956.CrossRefGoogle ScholarPubMed
Hustig, H.H., Tran, D.B., Hafner, R.J., & Miller, R.J. (1990). The effect of headphone music on persistent auditory hallucinations. Behavioural Psychotherapy, 18, 273281.CrossRefGoogle Scholar
Inouye, T., & Shimizu, A. (1970). The electromyographic study of verbal hallucination. Journal of Nervous and Mental Disease, 151, 415422.Google Scholar
James, D.A.E. (1983). The experimental treatment of two cases of auditory hallucinations. British Journal of Psychiatry, 143, 515516.CrossRefGoogle ScholarPubMed
Johnson, C.H., Ross, J.M., & Mastria, M.A. (1977). Delusional behaviour: An attributional analysis of development and modification. Journal of Abnormal Psychology, 86, 421426.CrossRefGoogle ScholarPubMed
Kane, J.M. (1985). Compliance Issues in Outpatient Treatment. Journal of Clinical Psychopharmacology, 5 [Supplement], 22s27s.Google Scholar
Kelly, G.R., Mamon, J.R., & Scott, J.E. (1987). Utility of the health belief model in examining medication compliance among psychiatric out-patients. Social Science and Medicine, 25, 12051211.Google Scholar
Kingdon, D.G., & Turkington, D. (1991). The use of cognitive-behaviour therapy with a normalising rationale in schizophrenia. Journal of Nervous and Mental Disease, 179, 207211.CrossRefGoogle ScholarPubMed
Krawiecka, M., Goldberg, D., & Vaughn, M. (1977). A standardised psychiatric assessment scale for rating chronic psychiatric patients. Acta Psychiatrica Scandinavia, 55, 299308.Google Scholar
Kuipers, L., Garety, P., & Fowler, D. (in press). An outcome study of cognitive behavioural treatment for psychosis. In Haddock, G. & Slade, P.D. (Eds.), Cognitive-behavioural interventions with psychotic disorders. London: Routledge.Google Scholar
Lamontagne, Y., Audet, N., & Elie, R. (1983). Thought stopping for delusions and hallucinations: A pilot study. Behavioural Psychotherapy, 11, 177184.Google Scholar
Lin, I.H.S., Spiga, R. & Fortsch, W. (1979). Insight and adherence to medication in chronic schizophrenics. Journal of Clinical Psychiatry, 4, 430432.Google Scholar
Ludwig, W., Huber, D., Schmidt, S., & Greil, W. (1990). Assessment of compliance related attitudes in psychiatry: A comparison of two questionnaires based on the health belief model. Social Psychiatry and Psychiatric Epidemiology, 25, 298303.Google Scholar
Margo, A., Hemsley, D.R., & Slade, P.D. (1981). The effects of varying auditory input on schizophrenic hallucinations. British Journal of Psychiatry, 139, 122127.Google Scholar
McGuigan, F.J. (1978). Cognitive psychophysiology: Principles of covert behaviour (1st ed.). Englewood Cliffs, NJ: Prentice Hall.Google Scholar
Miller, W.R. (1983). Motivational interviewing with problem drinkers. Behavioural Psychotherapy, 11, 147172.Google Scholar
Miller, W.R., Benefield, R.G., & Tonigan, J.S. (1993). Enhancing motivation for change in problem drinking: A controlled comparison of two therapist styles. Journal of Consulting and Clinical Psychology, 61, 455461.Google Scholar
Miller, W.R., & Rollnick, S. (1991). Motivational interviewing: Preparing people to change addictive behaviour. New York: Guildford.Google Scholar
Miller, W.R., Sovereign, R.G., & Krege, B. (1988). Motivational interviewing with problem drinkers: II. The drinker's check-up as a preventive intervention. Behavioural Psychotherapy, 16, 251268.CrossRefGoogle Scholar
Milton, F., Patwa, V.K., & Hafner, R.J. (1978). Confrontation vs. belief modification in persistently deluded patients. British Journal of Medical Psychology, 51, 127130.CrossRefGoogle ScholarPubMed
Morley, S. (1987). Modification of auditory hallucinations: Experimental studies of headphones and ear-plugs. Behavioural Psychotherapy, 15, 252271.Google Scholar
Morrison, A.P. (1994). Cognitive behaviour therapy for auditory hallucinations without concurrent medication. Behavioural and Cognitive Psychotherapy, 22, 259264.CrossRefGoogle Scholar
Moscarelli, M., Cesana, B.M., Ciussani, S., Novati, N.C., & Cazzullo, C.L. (1989). Ventricle brain ratio and alogia in 19 young patients with chronic negative and positive schizophrenia. American Journal of Psychiatry, 14, 257258.Google Scholar
Mulhall, D.J. (1978). Manual for the Personal Questionnaire Rapid Scaling Technique (1st ed.). Windsor, UK: NFER.Google Scholar
Nelson, H.E., Thrasher, S., & Barnes, T.R.E. (1991). Practical ways of alleviating auditory hallucinations. British Medical Journal, 302, 307.Google Scholar
Nydegger, R.V. (1972). The elimination of hallucinatory and delusional behaviour by verbal conditioning and assertive training: A case study. Journal of Behaviour Therapy and Experimental Psychiatry, 3, 225227.CrossRefGoogle Scholar
Piatkowska, O., & Farnill, D. (1992). Medication – compliance or alliance? A client-centred approach to increasing adherence. In Kavanagh, D. (Ed.), Schizophrenia. An overview and practical handbook. London: Chapman & Hall.Google Scholar
Rollnick, S., Heather, N., & Bell, A. (1992). Negotiating behaviour change in medical settings: The development of brief motivational interviewing. Journal of Mental Health, 2, 2537.CrossRefGoogle Scholar
Samaan, M. (1975). Thought stopping and flooding in a case of hallucinations, obsessions and homicidal-suicidal behaviour. Journal of Behaviour Therapy and Experimental Psychiatry, 6, 6567.CrossRefGoogle Scholar
Sellwood, W., & Tarrier, N. (1994). Demographic factors associated with extreme noncompliance in schizophrenia. Social Psychiatry and Psychiatric Epidemiology, 29, 172177.Google Scholar
Seltzer, A., Roncari, I., & Garfinkel, P. (1980). Effect of patient education on medication compliance. Canadian Journal of Psychiatry, 25, 638645.Google Scholar
Sharpe, L., & Tarrier, N. (1992). A cognitive-behavioural treatment approach to problem gambling. Journal of Cognitive Psychotherapy: An International Quarterly, 6, 193203.CrossRefGoogle Scholar
Shepherd, M., Watt, D., Falloon, I., & Smeeton, N. (1989). The natural history of schizophrenia: A five year follow-up study of outcome and prediction in a representative sample of schizophrenics [Monograph]. Psychological Medicine, 15, 146.Google Scholar
Slade, P.D. (1972). The effects of systematic desensitisation on auditory hallucinations. Behaviour, Research and Therapy, 10, 8591.Google Scholar
Slade, P.D., & Bentall, R.P. (1988). Sensory Deception: A scientific analysis of hallucination. London: Croom Helm.Google Scholar
Tarrier, N. (1987). An investigation of residual psychotic symptoms in discharged schizophrenic patients. British Journal of Clinical Psychology, 26, 141143.Google Scholar
Tarrier, N. (1991). Some Aspects of Family Interventions in Schizophrenia: I. Adherence to Intervention Programmes. British Journal of Psychiatry, 159, 479480.Google Scholar
Tarrier, N. (1992a). Management and modification of residual psychotic symptoms. In Birchwood, M. & Tarrier, N. (Eds.), Innovations in the psychological management of schizophrenia. Chichester: Wiley.Google Scholar
Tarrier, N. (1992b). Psychological treatment of schizophrenic symptoms. In Kavanagh, D. (Ed.), Schizophrenia: An overview and practical handbook. London: Chapman & Hall.Google Scholar
Tarrier, N., Becket, R., Harwood, S., Baker, A., Yusupoff, L., & Ugarteburu, I. (1993). A trial of two cognitive behavioural methods of treating drug resistant residual psychotic symptoms in schizophrenic patients: I. Outcome. British Journal of Psychiatry, 162, 524532.Google Scholar
Tarrier, N., Harwood, S., Yusupoff, L., Becket, R., & Baker, A. (1990). Coping strategy enhancement (CSE): A method of treating residual schizophrenic symptoms. Behavioural Psychotherapy, 18, 283293.CrossRefGoogle Scholar
Tarrier, N., Sharpe, L., Becket, R.T., Harwood, S., Baker, A, & Yusupoff, L. (1993b). A trial of two cognitive-behavioural methods of treating drug-resistant residual psychotic symptoms: II. Changes in coping and problem-solving skills. Social Psychiatry and Psychiatric Epidemiology, 28, 510.Google Scholar
Tunnicliffe, S., Harrison, G., & Standen, P.J. (1992). Factors affecting compliance with depot injection treatment in the community. Social Psychiatry and Psychiatric Epidemiology, 27, 230233.Google Scholar
Van Bilsen, H.P.J.G., & van Emst, A.J. (1986). Heroin addiction and motivational milieu therapy. The International Journal of the Addictions, 21, 707713.Google Scholar
Van Putten, T. (1974). Why do schizophrenic patients refuse to take their medication? Archives of General Psychiatry, 31, 6772.Google Scholar
Vaughn, C.E., & Leff, J.P. (1976). The influence of family and social factors on the course of psychiatric illness. British Journal of Psychiatry, 129, 125137.Google Scholar
Watts, F.N., Powell, E.G., & Austin, S.V. (1973). The modification of abnormal beliefs. British Journal of Medical Psychology, 46, 359363.Google Scholar
Wincze, J.P., Leitenberg, H., & Agras, W.S. (1972). The effects of token reinforcement on the delusional verbal behaviour of chronic paranoid schizophrenics. Journal of Applied Behaviour Analysis, 5, 247262.Google Scholar
Wolpe, J. (1973). The Practice of Behaviour Therapy. New York: Pergamon.Google Scholar
Young, J.L., Zonana, H.V., & Shepler, L. (1986). Medication noncompliance in schizophrenia: Codification and update. Bulletin of the American Academy of Psychiatry and Law, 14, 105122.Google Scholar
Zigmond, A.S., & Snaith, R.P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67, 361370.Google Scholar
Zito, J.L., Routt, W.W., Mitchell, J.E., & Roerig, J.L. (1985). Clinical characteristics of hospitalised psychotic patients who refuse anti-psychotic drug therapy. American Journal of Psychiatry, 142, 822826.Google Scholar