What have we learnt about the ability of cognitive behavioural therapy to help with voice-hearing?

Although voice-hearing, also referred to as auditory verbal hallucinations (AVHs), is experienced by a diverse range of people (McCarthy-Jones, 2012 ), it can be one of the most distressing and impairing experiences in people with a psychotic diagnosis (e.g., schizophrenia, bipolar disorder). Despite the apparent successes of antipsychotics in helping a signifi cant number of such people with their voices, many hearers are not helped by this approach. Not only has antipsychotic medication been estimated to have limited effectiveness for the voices, helping only between a tenth and a third of people diagnosed with schizophrenia (Shergill et al., 1998 ; Sommer et al., 2012 ), but recent systematic reviews have actually questioned the evidence base for the effectiveness of antipsychotics for experiences such as hallucinations and delusions, when compared to placebo (Adams et al., 2009; Rattehalli et al., 2010 ). Furthermore, discontinuation rates for atypical antipsychotic medications (e.g., olanzapine, risperidone) are as high as 70% (McEvoy et al., 2007 ) for reasons including the medication’s side-effects on health and self-worth (Johnstone et al., 2009 ). There hence remains the need for either alternative or adjunct interventions, depending on one’s viewpoint, to help people with psychotic diagnoses who are distressed by their voices.