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A Graded Exposure Intervention for Distressing Visual Hallucinations in Schizophrenia

Published online by Cambridge University Press:  28 February 2013

Paul O'Brien  and
Louise Johns
Paul O'Brien*
Affiliation:
North East London NHS Foundation Trust, UK
Louise Johns
Affiliation:
South London and Maudsley NHS Foundation Trust, UK
*
Reprint requests to Paul O'Brien, North East London NHS Foundation Trust, Psychological Services, Goodmayes Hospital, Barley Lane, Goodmayes, Essex IG3 8XJ, UK. E-mail: [email protected]
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Abstract

Background: Distressing visual hallucinations (VH) are frequently present in schizophrenia. Despite their prevalence, limited research exists regarding effective clinical interventions. Cognitive models of VH state that distress results from threat appraisals of the hallucination. Method: This individual case study describes the use of a graded exposure approach following the discovery of phobic anxiety associated with visual hallucinatory content. Treatment involved 20 sessions of individual cognitive behaviour therapy (CBT), of which 12 sessions focused on graded exposure. Results: A reduction in frequency of visions and associated distress was reported and these changes were maintained at a 3-month follow-up. Conclusions: The findings are consistent with the cognitive model of VH. Through exposure to the hallucinatory content, the client re-appraised her VH as non-threatening, and her fear of them reduced. This reduction in anxiety led to a decrease in the occurrence of the VH.

Keywords

Cognitive behaviour therapyphobiapsychosisschizophreniavisual hallucination
Type
Brief Clinical Reports
Information
Behavioural and Cognitive Psychotherapy , Volume 41 , Issue 4 , July 2013 , pp. 495 - 499
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2013 

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