A tale of two outcomes: Remission and exacerbation in the use of trauma-focused imaginal exposure for trauma-related voice-hearing. Key learnings to guide future practice

Abstract

Objective: Many people who hear voices (also termed auditory-verbal hallucinations) have experienced traumatic or adverse life events. There is growing evidence that, for a number of people, these events are an important contributing factor to voice-hearing experiences. Psychological mechanisms implicated in the trauma-voice-hearing relationship overlap with those involved in posttraumatic stress disorder, giving a strong rationale for the use of exposure-based trauma-focused therapies for distressing voices. There is currently limited clinical guidance in this area and, despite preliminary evidence of effectiveness, clinicians report reluctance to deliver these therapies. We believe that tw..