Skip to main content

18-03-2013 | Mental health | Article

Internet-based CBT shows promise for auditory hallucinations


Free abstract

medwireNews: An internet-based cognitive-behavioral therapy (CBT) program could help patients with psychosis and auditory hallucinations gain access to the intervention and its clinical benefits, US study findings suggest.

"The results of this open pilot study support the feasibility and potential efficacy of the web-based Coping with Voices program for persons with psychotic disorders," say Jennifer Gottlieb (Boston University, Massachusetts) who developed the program, and colleagues.

"Despite the severe symptoms of the study sample, the rate of program completion… was high, as were participant satisfaction levels."

The Coping with Voices program is a 10-lesson internet-based self-guided program that teaches a range of CBT techniques for coping more effectively with auditory hallucinations through the use of interactive exercises and games.

In all, 17 patients with psychosis and auditory hallucinations were "exposed" to the program at one of four community mental health centers and completed at least six lessons.

Following treatment, the patients showed significant improvements on the auditory hallucinations subscale of the Psychiatric Symptom Rating Scale in overall severity (22.94 vs 26.76 at baseline), perception of voices as an outside entity (1.53 vs 2.24), negative commentary from voices (2.24 vs 2.65), and trends for reduced frequency (2.59 vs 3.12) and duration (2.06 vs 2.59) of auditory hallucinations.

The researchers note in Schizophrenia Research that in addition to improvements in auditory hallucinations, patients also showed a reduction in depression and delusion severity, despite the program not directly targeting these symptoms.

They believe that the success of the program, which the patients reported was "interesting and engaging, and easy to use," may be due to it "normalizing" auditory hallucinations and giving patients mastery over their hallucinations, as well as being skills-based and completed at the patient's own pace.

The team now calls for more rigorous evaluation of the program via controlled research. Trials already underway include a comparison of the Coping with Voices program with usual care and a feasibility and effectiveness study of the program outside of the laboratory or clinic.

"While future research is needed to address the generalizability and necessary supports to implement this program, this study strengthens the premise that web-based treatments, such as the Coping with Voices program, have the potential to increase access to empirically-supported interventions for people with schizophrenia and other serious mental illnesses," Gottlieb and co-workers conclude.

medwireNews ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013

By Lucy Piper, Senior medwireNews Reporter

Related topics