Imagery Interventions for Auditory Vocal Hallucinations

This study explores the feasibility, acceptability, and effectiveness of four imagery intervention techniques (metacognitive imagery intervention, imagery rescripting, promoting positive imagery and competing imagery task) for auditory vocal hallucinations using four single case series with an A-B-A within subject design.

Inclusion Criteria:Age 16-65Experiencing subclinical or clinical psychotic auditory vocal hallucinations as confirmed by a clinician and as indicated by an intensity score of 4 or more on subscale 1.3 (perceptual abnormalities) of the Comprehensive Assessment of At Risk Mental States (CAARMS) or as indicated by a score of 3 or more on item P3 (hallucinatory behavior) of the Positive and Negative Syndrome Scale (PANSS).A Diagnostic and Statistical Manual-5 (DSM-5; American Psychiatric Association, 2013) diagnosis in the psychosis spectrum (codes: DSM-5 codes: 297.1; 298.8; 295.40; 295.90; 295.70; 298.8; 298.9) or defined as Ultra High Risk/At Risk Mental State (ARMS or UHR) according to the CAARMS estimated by a clinician.Willing to complete daily monitoring throughout the duration of the study.Willing to be assigned to a specific imagery intervention.Able to attend 3 consecutive weekly session of imagery intervention and during this period 3 online check-ups.Able and willing to sign informed consentExclusion Criteria:Any current or previous neurological disorder or organic brain disease.Acute confusional state or delirium not caused by the psychotic disorder.Unwillingness to participateIntelligence quotient (IQ) < 70 estimated by clinician.Current severe substance or alcohol misuse impacting treatment (clinicians assessment).