Efficacy of treatment for resistant command hallucinations.

Funded Activity Summary

Auditory hallucinations (AHs), often described as voices, are a common symptom of schizophrenia and psychoses. Command hallucinations (CHs) are a type of AH in which the voice heard by the patient commands him or her to perform a particular action. The nature of the directive may vary from inconsequential actions to commands to harm the patient or others. There is widespread public concern about the danger individuals with schizophrenia or related disorders pose to themselves and to the community. There is firm evidence pointing to the important role that CHs play in propelling psychotic individuals into serious and damaging actions. We have found, however, that most individuals who comply with dangerous CHs do so, not because they are angry, violent, antisocial or wish to cause harm, but because they feel powerless to resist. Though CHs are one of the most disturbing symptoms of psychosis, standard treatment has proved to be of limited benefit. This study will evaluate the effectiveness of Treatment of Resistant Command Hallucinations (TORCH), an innovative treatment for CHs. TORCH is an extension of an existing treatment for psychosis that we previously developed. TORCH aims to reduce the distress, worry and harmful or self-defeating behaviour associated with CHs by arming the patient with effective strategies that will enhance resistance and reduce compliance. The project has clear implications for improved clinical and therapeutic management of CHs with major public health, clinical and forensic repercussions. The consequences of being formally assessed as being at risk of acting violently result in the potential for substantial restrictions on the freedom of the individual. The availability of TORCH may prompt a less restrictive management of individuals at risk of dangerous behaviour and promote a more optimistic attitude amongst clinicians. Relatives and carers also stand to benefit through reduction in perplexing and fear-inducing behaviours.

Funded Activity Details

Start Date: 01-01-2003

End Date: 01-01-2005

Funding Scheme: NHMRC Project Grants

Funding Amount: $343,875.00

Funder: National Health and Medical Research Council

Research Topics

ANZSRC Field of Research (FoR)

Psychiatry

ANZSRC Socio-Economic Objective (SEO)

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Other Keywords

cognitive behaviour | command hallucinations | command hallucinations (new keyword) | effectivness study | psychiatry and forensic psychiatry | psychological treatment | schizophrenia | therapy

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