ISSN 2043-8087
Journal of Experimental Psychopathology
 Volume 3, Issue 4, 537-551, 2012
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Cognitive Theory and Therapy for Command Hallucinations

Sian Lowri Griffiths (a), Maria Michail (b), Max Birchwood (a)
(a) School of Psychology, University of Birmingham, UK
(b) School of Nursing, Midwifery & Physiotherapy, University of Nottingham, UK

Volume 3, Issue 4, 2012, Pages 537-551

Individuals who experience voices respond in a variety of ways, both emotionally and behaviourally; some individuals are greatly distressed and frightened by their experience, whereas others develop a meaningful relationship with their voices and value contact with them. The traditional approach to cognitive behavioural therapy (CBT) in the treatment of psychosis focuses on the eradication or amelioration of the symptoms. However, the cognitive model of voices emphasises the importance of cognitive appraisals and the idiosyncratic relationship that a voice hearer develops with their voices in influencing affect and behaviour. This review describes the development and refinements of the cognitive model of voices, with particular emphasis on command hallucinations; the model distinctively focuses on distress and dysfunctional behaviour rather than symptoms per se. The need to identify and modify the appraisals that lead to these consequences is highlighted.

Table of Contents
Voice Appraisals and the Development of a Cognitive Model of Voices
  Social Rank Theory
A Cognitive Model for Command Hallucinations
  Command Hallucinations
  Cognitive Model for Command Hallucinations
Cognitive Therapy for Command Hallucinations
Assessment Measures
Case Example
  Assessment Stage
  Identifying the Power Beliefs and Beliefs about Compliance
  Intervention Stage
  Exploring Beliefs about Power and Control
Exploring Compliance Beliefs
  Exploring Beliefs about Meaning and Identity
  Other Issues Addressed In Therapy
Evidence Base for Cognitive Therapy for Command Hallucinations
Limitations of the Cognitive Model and Future Directions

Correspondence to
Sian Lowri Griffiths, School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.

Cognitive model, Auditory hallucinations, Psychosis, Cognitive appraisals, Social rank, Command hallucinations.

Received 31 Oct 2011; Revised 20 Mar 2012; Accepted 16 Apr 2012; In Press 23 Sep 2012

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