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January 2002 - present
Publications
Publications (32)
Background
The National Institute for Health and Care Excellence (NICE) recommends that cognitive behaviour therapy (CBT) is offered to all patients with a psychosis diagnosis. However, only a minority of psychosis patients in England and Wales are offered CBT. This is attributable, in part, to the resource-intensive nature of CBT. One response to...
Introduction:
Individuals who access at-risk mental state (ARMS) services often have unusual sensory experiences and levels of distress that lead them to seek help. The Managing Unusual Sensory Experiences (MUSE) treatment is a brief symptom targeted intervention that draws on psychological explanations to help account for unusual experiences. Pra...
Hallucinations can occur in single or multiple sensory modalities. Greater attention has been paid to single sensory experiences with a comparative neglect of hallucinations that occur across two or more sensory modalities (multisensory hallucinations). This study explored how common these experiences were in people at risk of transition to psychos...
Voices in Psychosis: Interdisciplinary Perspectives deepens and extends the understanding of hearing voices in psychosis in a striking way. For the first time, this collection brings multiple disciplinary, clinical, and experiential perspectives to bear on an original and extraordinarily rich body of testimony: transcripts of forty in-depth phenome...
Voices in Psychosis: Interdisciplinary Perspectives deepens and extends the understanding of hearing voices in psychosis in a striking way. For the first time, this collection brings multiple disciplinary, clinical, and experiential perspectives to bear on an original and extraordinarily rich body of testimony: transcripts of forty in-depth phenome...
Introduction
Hallucinations (hearing or seeing things that others do not) are a common feature of psychosis, causing significant distress and disability. Existing treatments such as cognitive–behavioural therapy for psychosis (CBTp) have modest benefits, and there is a lack of CBTp-trained staff. Shorter, targeted treatments that focus on specific...
Objectives:
Making sense of voice-hearing-exploring the purpose, cause, and relationship with voices-is seen as therapeutically valuable for adults, but there is a paucity of research with adolescents. Family intervention is recommended for young people, yet little is known about families' perspectives on, or role in, a child's voice-hearing. This...
Auditory verbal hallucinations (AVHs) are typically associated with schizophrenia but also occur in individuals without any need for care (nonclinical voice hearers [NCVHs]). Cognitive models of AVHs posit potential biases in source monitoring, top-down processes, or a failure to inhibit intrusive memories. However, research across clinical/nonclin...
Objectives:
To conduct a feasibility study on a new, tablet-delivered treatment for unusual sensory experiences in service-users with an At Risk Mental States for psychosis.
Design:
A mixed method design was employed, using content analysis to investigate whether service-users and therapists found the new treatment acceptable and helpful. We als...
Auditory verbal hallucinations (AVH) are typically associated with schizophrenia but also occur in individuals without any need for care (non-clinical voice-hearers; NCVH). Cognitive models of AVH posit potential biases in source-monitoring, top-down processes, or a failure to inhibit intrusive memories. However, research across clinical/non-clinic...
Background:
Cognitive behavioural therapy for psychosis (CBTp) is a recommended treatment for psychotic experiences, but its effectiveness has been questioned. One way of addressing this may be to tailor therapy materials to the phenomenology of specific psychotic experiences.
Aim:
In this study, we investigated the acceptability of a novel trea...
Recent therapeutic approaches to auditory verbal hallucinations (AVH) exploit the person-like qualities of voices. Little is known, however, about how, why, and when AVH become personified. We aimed to investigate personification in individuals’ early voice-hearing experiences. We invited Early Intervention in Psychosis (EIP) service users aged 16–...
Background: Recent therapeutic approaches to auditory verbal hallucinations (AVH) exploit the person-like qualities of voices. Little is known, however, about how, why and when AVH become personified. We aimed to investigate personification in individuals’ early voice experiences. Methods: We invited users of Early Intervention in Psychosis (EIP) s...
A recently popular framework in the cognitive sciences takes the human nervous system to be a hierarchically arranged Bayesian prediction machine. In this paper, we examine psychological trauma through the lens of this framework. We suggest that this can help us to understand the nature of trauma, and the different effects that different kinds of t...
Cognitive behavioral therapy (CBT) for voice-hearing (i.e., auditory verbal hallucinations; AVH) has, at best, small to moderate effects. One possible reason for this limited efficacy is that current CBT approaches tend to conceptualize voice-hearing as a homogenous experience in terms of the cognitive processes involved in AVH. However, the highly...
The phenomenological diversity of auditory verbal hallucinations (AVH) is not currently accounted for by any model based around a single mechanism. This has led to the proposal that there may be distinct AVH subtypes, which each possess unique (as well as shared) underpinning mechanisms. This could have important implications both for research desi...
This report from the International Consortium on Hallucinations Research considers the current status and future directions in research on psychological therapies targeting auditory hallucinations (hearing voices). Therapy approaches have evolved from behavioral and coping-focused interventions, through formulation-driven interventions using method...
A recent model of a subtype of auditory verbal hallucinations (AVHs) has proposed such experiences may result from increased arousal altering auditory threat perception.
This study considered this theory using undergraduate students who undertook a new experimental paradigm, the Auditory Threat Discrimination Task (ATDT). This examined the effects...
This article explores ways in which young people can be supported in their development and personal, focusing on the significance of their narrative, the dilemmas they face and the potential value of understanding underlying mechanisms. The following perspectives originate within a research project where young people developed inner speech to deal...
Background:
The phenomenological heterogeneity of auditory hallucinations (AHs) means individual models struggle to account for all aspects of the experience. One alternative is that distinct subtypes of AHs exist, with each requiring their own unique explanatory model and tailored cognitive behavioural intervention strategies.
Aims:
This explor...
Aim: To investigate the effectiveness of an early intervention in psychosis (EIP) service on engagement and hospital bed usage, post-discharge. A secondary aim was to identify if there was a subgroup of patients with ‘poor outcomes’.
Method: A naturalistic study comparing engagement and hospital bed day usage of individuals who received treatment f...
IntroductionCore principlesA summary of the evidenceEstablishing early intervention teams in practiceModels of service delivery in EIPImplications and conclusionsSuggested further readingReferences
A number of studies have demonstrated that Early Intervention in Psychosis (EIP) services can produce improved outcomes for service users. However, the essential elements that produce these results remain elusive. This paper considers a number of hypotheses, with a particular focus on one service in the UK, which was designed according to policy gu...
A key process in Cognitive Therapy (CT) is the development and sharing of a formulation. How clinicians develop formulations is under-researched, particularly in working with people with psychosis.
This study investigated agreement between clinicians, when conceptualizing an individual's psychotic beliefs. It also explored whether agreement was dep...
Background: Improved detection and clear referral systems are prerequisites for effective early intervention. Although specialist early intervention services are being introduced in Britain, changes are still required in the practice of existing primary and secondary care staff. Aims: This paper describes an exploratory evaluation of a partnership...
Background: The proposed new Mental Health Act for England and Wales places a premium on identifying substantial clinical risk. This raises the question of how justifiable judgements about risk can be made when the evidence in this area is based upon frequentist statistical analysis which is of limited value in clinical practice. Aims: To develop a...
This paper draws on cognitive psychology research and clinical observation to propose a model for the formation of auditory hallucinations that are located externally, and experienced in noisy environments.
This model highlights a series of cognitive processes that may make an individual prone to detecting false positives, i.e. believing they have...
A key component of cognitive therapy for psychosis is the development of a meaningful and shared formulation of the onset of the psychosis. Therapists bring an understanding of the development of psychotic symptoms based on theoretical models and try to marry these with the person's own experience and explanations. However, an important question is...
Aims and Method
To investigate the effects of a standard National Health Service early intervention in psychosis service on bed days and engagement with services. We conducted a naturalistic before-and-after study comparing outcomes of individuals who received treatment from the service ( n =75) with outcomes of individuals who presented to mental...
Schizophrenic subjects who experience delusions have been found to request less information and are more certain about the correctness of their decision than control subjects when performing abstract probability judgment tasks (Huq, Garety & Hemsley, 1988). The present study employed an inductive reasoning task using familiar contextual stimuli to...
