Behavioral Management of Persistent Auditory Hallucinations in Schizophrenia: Outcomes from a 10-Week Course

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Abstract
BACKGROUND: Medication-resistant, persistent auditory hallucinations are pervasive in persons with schizophrenia. Behavior strategies are often very effective as adjunctive therapy to decrease the negative characteristics of this symptom. OBJECTIVES: The purpose of this multi-site intervention study was to examine the short-term effects of a 10-week course to teach behavior management of persistent auditory hallucinations on seven characteristics of auditory hallucinations (i.e., frequency, loudness, self-control, clarity, tone, distractibility, and distress), anxiety, and depression. STUDY DESIGN: A quasi-experimental repeated measured design was used. The sample included 62 outpatients with schizophrenia who reported daily persistent auditory hallucinations. Measures included the Characteristics of Auditory Hallucinations Questionnaire, the tension-anxiety subscale of the Profile of Mood States, and the Beck Depression Inventory II. RESULTS: Preintervention scores for the frequency (p < .001), self-control (p < .03), clarity (p < .01), tone (p < .03), distractibility (p < .006), and distress (p < .001) improved compared with preintervention scores. Postintervention scores on anxiety and depression were also significantly lower than preintervention scores (p < .02, p < .001, respectively). CONCLUSIONS: Teaching behavior management of persistent auditory hallucinations in a standardized 10-week course is clinically effective and can be incorporated into many existing outpatient programs.