By Sarah Byrne, Max Birchwood, Peter E. Trower, Alan Meaden
Command hallucinations are a very distressing and occasionally risky kind of hallucination approximately which quite little is understood and for which no evidenced established remedy at present exists. In A Casebook of Cognitive Behaviour treatment for Command Hallucinations the advance of a brand new and cutting edge proof dependent cognitive remedy is gifted in a pragmatic structure excellent for the busy practitioner. This new technique is predicated on over a decade's examine at the position of voice hearers' ideals concerning the energy and omnipotence in their voices and the way this drives misery and 'acting on' voices. The remedy protocol is gifted in transparent steps from formula to intervention. The physique of the ebook describes its software in 8 situations illustrating the breadth of its program, together with 'complex' circumstances. The authors additionally current their interpretation of what their findings let us know approximately what works and does not paintings, and recommendations for destiny advancements. topics coated additionally comprise: figuring out command hallucinations a cognitive as opposed to a quasi-neuroleptic method of CBT in psychosis does CBT for CH paintings? findings from a randomised managed trial. This ebook presents a desirable and intensely functional precis of the 1st intervention to have an enormous effect on misery and on compliance with command hallucinations. it is going to be of significant curiosity to all psychological well-being practitioners operating with individuals with psychosis in group and forensic settings.
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Extra resources for A Casebook of Cognitive Behaviour Therapy for Command Hallucinations: A Social Rank Theory Approach
Tom predicted that he was 90 per cent likely to obey the voice at the time of assessment and in the future, thus posing a signiﬁcant risk to himself. At the time of the assessment, Tom was rated as ‘high risk of acting on the voices’ commands, with likely harm to self’, and he was rated as ‘reporting high levels of distress associated with the commands’. Beliefs about identity Tom did not know the identity of the voice, although he thought it might have been someone he had known in the past. Beliefs about meaning Tom believed that he was being punished by the voice, although he did not know why.
Then the therapist challenged the voices directly to cut oﬀ her little ﬁnger during the session, rather than telling Joan to harm her. The therapist made it clear to Joan that she was taking full responsibility for the challenge and for any harm that might come as a result. Initially, Joan was anxious about the proposal but she agreed to allow the therapist to try it. The outcome was that Joan reported that the voices became silent, and nothing happened to the therapist’s ﬁnger. Subsequently, the therapist showed Joan her little ﬁnger at the beginning of each session: Joan would appear pleased.
Practise the use of decreasing strategies within a session. Propose the notion that ‘control’ requires the demonstration that voice activity can be turned on as well as oﬀ; the analogy of learning to drive a car can be used, such that feeling in control of a car involves starting and stopping the car. The client is encouraged either to initiate or to increase voice activity for short periods, then reduce or stop it. These periods are then gradually lengthened. In the case of David, he learned to start and stop his voices at will.