A randomised controlled pilot study of Experience Focused Counselling with voice hearers

Background: There is a need for improved psychosocial interventions for distressed voice hearers. Aims: To evaluate a novel approach to hearing voices: Experience Focussed Counselling (EFC) aka Making Sense of Voices. Study design and methods: 12 voice hearers were randomly assigned to a 44-week EFC or Treatment As Usual intervention as part of a pilot study design. Results: At the end of intervention EFC showed clinically large treatment effect improvements on the Brief Psychiatric Rating Scale – Expanded Version psychotic symptoms (Cohen’s d=1.6) and overall psychopathology domains (d=1.3), and the Psychotic Symptom Rating Scales voices (d=1) and delusions (aka non-shared reality) (d=1) scales. EFC voice hearers also felt more able to do first trauma disclosures (n=4) than TAU group voice hearers (n=1). Discussion: EFC improvements may have been related to the focus on reducing voices related distress. EFC holds some promise as a safe and effective intervention for voice hearers, with possible improvements in general psychopathology, psychosis, voices, and non-shared reality (aka delusions) related distress. This will need replicating in more powerful studies