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. 2022 Aug;52(11):2001-2008.
doi: 10.1017/S003329172200143X. Epub 2022 Jul 20.

A systematic review of relational-based therapies for the treatment of auditory hallucinations in patients with psychotic disorders

Laura Dellazizzo  1   2 , Sabrina Giguère  1   2 , Nayla Léveillé  1   2 , Stéphane Potvin  1   2 , Alexandre Dumais  1   2   3
Affiliations

A systematic review of relational-based therapies for the treatment of auditory hallucinations in patients with psychotic disorders

Laura Dellazizzo et al. Psychol Med. 2022 Aug.

Abstract

Background: Auditory hallucinations in patients with psychotic disorders may be very distressing. Unfortunately, a large proportion of individuals are resistant to pharmacological interventions and the gold-standard cognitive-behavioral therapy for psychosis offers at best modest effects. To improve therapeutic outcomes, several therapies have been created to establish a relationship between voice-hearers and their voices. With increasing literature, we conducted a systematic review of dialogical therapies and examined the evidence behind their efficacy.

Methods: A systematic search was performed in PubMed, PsycINFO, Web of Science, and Google Scholar. Articles were included if they discussed the effects of dialogical interventions for patients with psychotic disorders.

Results: A total of 17 studies were included within this systematic review. Cumulative evidence from various therapies has shown that entering in a dialog with voices is beneficial to patients, even those who are resistant to current pharmacological treatments. Heightened benefits have been mainly observed with Relating Therapy and Avatar Therapy/Virtual Reality assisted Therapy, with evidence generally of moderate quality. Both these interventions have shown large to very large effects on voices and voice-related distress as well as moderate to large magnitude improvements on affective symptoms. Though, cognitive-behavioral therapy for command hallucinations and making sense of voices noted no improvements on voices.

Conclusions: Literature on relational-based interventions with a strong emphasis on the relational aspects of voice hearing has shown positive effects. Results suggest that these dialogical therapies might surpass the efficacy of current gold-standard approaches.

Keywords: Auditory hallucinations; psychotic disorders; relational therapies; systematic review.

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Figures

Fig. 1.
Fig. 1.
Flow-chart depicting the search strategy to find the studies included in this review.
See this image and copyright information in PMC

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