A psychological intervention for engaging dialogically with auditory hallucinations (Talking With Voices): A single-site, randomised controlled feasibility trial

Eleanor Longden; Dirk Corstens; Samantha Bowe; Melissa Pyle; Richard Emsley; Sarah Peters; Alison Branitsky; Nisha Chauhan; Nikki Dehmahdi; Wendy Jones; Natasha Holden; Amanda Larkin; Alissa Miners; Elizabeth Murphy; Ann Steele; Anthony P. Morrison

doi:10.1016/j.schres.2022.11.007

A psychological intervention for engaging dialogically with auditory hallucinations (Talking With Voices): A single-site, randomised controlled feasibility trial

Eleanor Longden^*, Dirk Corstens, Samantha Bowe, Melissa Pyle, Richard Emsley, Sarah Peters, Alison Branitsky, Nisha Chauhan, Nikki Dehmahdi, Wendy Jones, Natasha Holden, Amanda Larkin, Alissa Miners, Elizabeth Murphy, Ann Steele, Anthony P. Morrison

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

18 Citations (Scopus)

Abstract

There is growing clinical interest in addressing relationship dynamics between service-users and their voices. The Talking With Voices (TwV) trial aimed to establish feasibility and acceptability of a novel dialogical intervention to reduce distress associated with voices amongst adults diagnosed with schizophrenia spectrum disorders. The single-site, single-blind (rater) randomised controlled trial recruited 50 participants who were allocated 1:1 to treatment as usual (TAU), or TAU plus up to 26 sessions of TwV therapy. Participants were assessed at baseline and again at end of treatment (six-months). The primary outcomes were quantitative and qualitative assessments of feasibility and acceptability. Secondary outcomes involved clinical measures, including targeted instruments for voice-hearing, dissociation, and emotional distress. The trial achieved 100 % of the target sample, 24 of whom were allocated to therapy and 26 to TAU. The trial had high retention (40/50 [80 %] participants at six-months) and high intervention adherence (21/24 [87.5 %] receiving ≥8 sessions). Signals of efficacy were shown in targeted measures of voice-hearing, dissociation, and perceptions of recovery. Analysis on the Positive and Negative Syndrome Scale indicated that there were no differences in means of general psychosis symptom scores in TwV compared to the control group. There were four serious adverse events in the therapy group and eight in TAU, none of which were related to study proceedings. The trial demonstrates the acceptability of the intervention and the feasibility of delivering it under controlled, randomised conditions. An adequately powered definitive trial is necessary to provide robust evidence regarding efficacy evaluation and cost-effectiveness. Trial registration: ISRCTN 45308981.

Original language	English
Pages (from-to)	172-179
Number of pages	8
Journal	Schizophrenia Research
Volume	250
DOIs	https://doi.org/10.1016/j.schres.2022.11.007
Publication status	Published - Dec 2022

Keywords

Dissociation
Hearing Voices Movement
Psychotherapy
Schizophrenia
Treatment outcome research

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10.1016/j.schres.2022.11.007

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Longden, E., Corstens, D., Bowe, S., Pyle, M., Emsley, R., Peters, S., Branitsky, A., Chauhan, N., Dehmahdi, N., Jones, W., Holden, N., Larkin, A., Miners, A., Murphy, E., Steele, A., & Morrison, A. P. (2022). A psychological intervention for engaging dialogically with auditory hallucinations (Talking With Voices): A single-site, randomised controlled feasibility trial. Schizophrenia Research, 250, 172-179. https://doi.org/10.1016/j.schres.2022.11.007

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title = "A psychological intervention for engaging dialogically with auditory hallucinations (Talking With Voices): A single-site, randomised controlled feasibility trial",

abstract = "There is growing clinical interest in addressing relationship dynamics between service-users and their voices. The Talking With Voices (TwV) trial aimed to establish feasibility and acceptability of a novel dialogical intervention to reduce distress associated with voices amongst adults diagnosed with schizophrenia spectrum disorders. The single-site, single-blind (rater) randomised controlled trial recruited 50 participants who were allocated 1:1 to treatment as usual (TAU), or TAU plus up to 26 sessions of TwV therapy. Participants were assessed at baseline and again at end of treatment (six-months). The primary outcomes were quantitative and qualitative assessments of feasibility and acceptability. Secondary outcomes involved clinical measures, including targeted instruments for voice-hearing, dissociation, and emotional distress. The trial achieved 100 % of the target sample, 24 of whom were allocated to therapy and 26 to TAU. The trial had high retention (40/50 [80 %] participants at six-months) and high intervention adherence (21/24 [87.5 %] receiving ≥8 sessions). Signals of efficacy were shown in targeted measures of voice-hearing, dissociation, and perceptions of recovery. Analysis on the Positive and Negative Syndrome Scale indicated that there were no differences in means of general psychosis symptom scores in TwV compared to the control group. There were four serious adverse events in the therapy group and eight in TAU, none of which were related to study proceedings. The trial demonstrates the acceptability of the intervention and the feasibility of delivering it under controlled, randomised conditions. An adequately powered definitive trial is necessary to provide robust evidence regarding efficacy evaluation and cost-effectiveness. Trial registration: ISRCTN 45308981.",

keywords = "Dissociation, Hearing Voices Movement, Psychotherapy, Schizophrenia, Treatment outcome research",

author = "Eleanor Longden and Dirk Corstens and Samantha Bowe and Melissa Pyle and Richard Emsley and Sarah Peters and Alison Branitsky and Nisha Chauhan and Nikki Dehmahdi and Wendy Jones and Natasha Holden and Amanda Larkin and Alissa Miners and Elizabeth Murphy and Ann Steele and Morrison, {Anthony P.}",

note = "Funding Information: Talking With Voices was a single-site feasibility trial conducted according to a single-blind (rater), two-arm, randomised controlled design. Participants were recruited from Greater Manchester Mental Health (GMMH) National Health Service (NHS) Foundation Trust in northwest England, who also acted as the trial's sponsor. An additional participant was also recruited from the neighbouring Pennine Care NHS Trust. The study was funded by the National Institute of Health Research (PDF-2017-10-05) and prospectively registered with the ISRCTN (45308981). Ethical approvals were received from the North West–Preston Research Ethics Committee (17/NW/0633). Funding Information: The study was funded by a National Institute for Health Research (NIHR) Postdoctoral Fellowship Scheme for EL ( PDF-2017-10-050 ). RE is part funded by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London and is supported by an NIHR Research Professorship ( NIHR300051 ). The funders had no involvement in either the conduct of the research or the preparation of the article. Funding Information: We would like to thank all participants who agreed to take part in the trial and the healthcare professionals who supported their recruitment. In addition, we are extremely grateful to our combined Trial Steering and Data Monitoring and Ethics Committee (Craig Steel, Jemma Hudson, and Andrew Grundy) for their oversight; and to the Psychosis Research Unit's Service User Reference Group and Jacqui Dillon of the English Hearing Voices Network for their valuable feedback on the trial's design and research materials. The study was facilitated by the Greater Manchester Local Clinical Research Network and was funded by a National Institute for Health Research (NIHR) Postdoctoral Fellowship Scheme for EL (PDF-2017-10-050). RE is part funded by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London and is supported by an NIHR Research Professorship (NIHR300051). This article presents independent research funded by the NIHR: the views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. Publisher Copyright: {\textcopyright} 2022",

year = "2022",

month = dec,

doi = "10.1016/j.schres.2022.11.007",

language = "English",

volume = "250",

pages = "172--179",

journal = "Schizophrenia Research",

issn = "0920-9964",

publisher = "Elsevier",

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Longden, E, Corstens, D, Bowe, S, Pyle, M, Emsley, R, Peters, S, Branitsky, A, Chauhan, N, Dehmahdi, N, Jones, W, Holden, N, Larkin, A, Miners, A, Murphy, E, Steele, A & Morrison, AP 2022, 'A psychological intervention for engaging dialogically with auditory hallucinations (Talking With Voices): A single-site, randomised controlled feasibility trial', Schizophrenia Research, vol. 250, pp. 172-179. https://doi.org/10.1016/j.schres.2022.11.007

TY - JOUR

T1 - A psychological intervention for engaging dialogically with auditory hallucinations (Talking With Voices)

T2 - A single-site, randomised controlled feasibility trial

AU - Longden, Eleanor

AU - Corstens, Dirk

AU - Bowe, Samantha

AU - Pyle, Melissa

AU - Emsley, Richard

AU - Peters, Sarah

AU - Branitsky, Alison

AU - Chauhan, Nisha

AU - Dehmahdi, Nikki

AU - Jones, Wendy

AU - Holden, Natasha

AU - Larkin, Amanda

AU - Miners, Alissa

AU - Murphy, Elizabeth

AU - Steele, Ann

AU - Morrison, Anthony P.

N1 - Funding Information: Talking With Voices was a single-site feasibility trial conducted according to a single-blind (rater), two-arm, randomised controlled design. Participants were recruited from Greater Manchester Mental Health (GMMH) National Health Service (NHS) Foundation Trust in northwest England, who also acted as the trial's sponsor. An additional participant was also recruited from the neighbouring Pennine Care NHS Trust. The study was funded by the National Institute of Health Research (PDF-2017-10-05) and prospectively registered with the ISRCTN (45308981). Ethical approvals were received from the North West–Preston Research Ethics Committee (17/NW/0633). Funding Information: The study was funded by a National Institute for Health Research (NIHR) Postdoctoral Fellowship Scheme for EL ( PDF-2017-10-050 ). RE is part funded by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London and is supported by an NIHR Research Professorship ( NIHR300051 ). The funders had no involvement in either the conduct of the research or the preparation of the article. Funding Information: We would like to thank all participants who agreed to take part in the trial and the healthcare professionals who supported their recruitment. In addition, we are extremely grateful to our combined Trial Steering and Data Monitoring and Ethics Committee (Craig Steel, Jemma Hudson, and Andrew Grundy) for their oversight; and to the Psychosis Research Unit's Service User Reference Group and Jacqui Dillon of the English Hearing Voices Network for their valuable feedback on the trial's design and research materials. The study was facilitated by the Greater Manchester Local Clinical Research Network and was funded by a National Institute for Health Research (NIHR) Postdoctoral Fellowship Scheme for EL (PDF-2017-10-050). RE is part funded by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London and is supported by an NIHR Research Professorship (NIHR300051). This article presents independent research funded by the NIHR: the views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. Publisher Copyright: © 2022

PY - 2022/12

Y1 - 2022/12

N2 - There is growing clinical interest in addressing relationship dynamics between service-users and their voices. The Talking With Voices (TwV) trial aimed to establish feasibility and acceptability of a novel dialogical intervention to reduce distress associated with voices amongst adults diagnosed with schizophrenia spectrum disorders. The single-site, single-blind (rater) randomised controlled trial recruited 50 participants who were allocated 1:1 to treatment as usual (TAU), or TAU plus up to 26 sessions of TwV therapy. Participants were assessed at baseline and again at end of treatment (six-months). The primary outcomes were quantitative and qualitative assessments of feasibility and acceptability. Secondary outcomes involved clinical measures, including targeted instruments for voice-hearing, dissociation, and emotional distress. The trial achieved 100 % of the target sample, 24 of whom were allocated to therapy and 26 to TAU. The trial had high retention (40/50 [80 %] participants at six-months) and high intervention adherence (21/24 [87.5 %] receiving ≥8 sessions). Signals of efficacy were shown in targeted measures of voice-hearing, dissociation, and perceptions of recovery. Analysis on the Positive and Negative Syndrome Scale indicated that there were no differences in means of general psychosis symptom scores in TwV compared to the control group. There were four serious adverse events in the therapy group and eight in TAU, none of which were related to study proceedings. The trial demonstrates the acceptability of the intervention and the feasibility of delivering it under controlled, randomised conditions. An adequately powered definitive trial is necessary to provide robust evidence regarding efficacy evaluation and cost-effectiveness. Trial registration: ISRCTN 45308981.

AB - There is growing clinical interest in addressing relationship dynamics between service-users and their voices. The Talking With Voices (TwV) trial aimed to establish feasibility and acceptability of a novel dialogical intervention to reduce distress associated with voices amongst adults diagnosed with schizophrenia spectrum disorders. The single-site, single-blind (rater) randomised controlled trial recruited 50 participants who were allocated 1:1 to treatment as usual (TAU), or TAU plus up to 26 sessions of TwV therapy. Participants were assessed at baseline and again at end of treatment (six-months). The primary outcomes were quantitative and qualitative assessments of feasibility and acceptability. Secondary outcomes involved clinical measures, including targeted instruments for voice-hearing, dissociation, and emotional distress. The trial achieved 100 % of the target sample, 24 of whom were allocated to therapy and 26 to TAU. The trial had high retention (40/50 [80 %] participants at six-months) and high intervention adherence (21/24 [87.5 %] receiving ≥8 sessions). Signals of efficacy were shown in targeted measures of voice-hearing, dissociation, and perceptions of recovery. Analysis on the Positive and Negative Syndrome Scale indicated that there were no differences in means of general psychosis symptom scores in TwV compared to the control group. There were four serious adverse events in the therapy group and eight in TAU, none of which were related to study proceedings. The trial demonstrates the acceptability of the intervention and the feasibility of delivering it under controlled, randomised conditions. An adequately powered definitive trial is necessary to provide robust evidence regarding efficacy evaluation and cost-effectiveness. Trial registration: ISRCTN 45308981.

KW - Dissociation

KW - Hearing Voices Movement

KW - Psychotherapy

KW - Schizophrenia

KW - Treatment outcome research

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DO - 10.1016/j.schres.2022.11.007

M3 - Article

C2 - 36423442

AN - SCOPUS:85143917096

SN - 0920-9964

VL - 250

SP - 172

EP - 179

JO - Schizophrenia Research

JF - Schizophrenia Research

ER -

A psychological intervention for engaging dialogically with auditory hallucinations (Talking With Voices): A single-site, randomised controlled feasibility trial

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Keywords

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