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Behavioral Management of Persistent Auditory Hallucinations in Schizophrenia: Outcomes from a 10-Week Course

School of Nursing, University of San Francisco

Robin Buccheri, RN, MHNP, DNSc

School of Nursing, University of San Francisco

Glenna Dowling, RN, PhD

Institute on Aging Research Center, University of California, San Francisco

Roberta Zind, RN, CS, MS

Mather Veterans Administration Outpatient Mental Health Clinic in Sacramento, California

Kathy White, RN, FNP, MS

Veterans Administration, Northern California Health Care System in Mare Island, California

Jan Johnson Griffin, RN, CS, NP, MS

Muir Diablo Primary Care in Antioch, California

Susan Henderson, RN, BA Applied Sci. (Nursing)

Monash University, Gippsland Campus in Victoria, Australia

Lynda Suciu, RN, CS, MS

Oakland Veterans Administration Outpatient Mental Health Clinic in Oakland, California

Susan Hippe, RN, NP, MS

Cascadia Behavioral Healthcare in Portland, Oregon

Merrie J. Kaas, RN, CS, DNSc

School of Nursing, University of Minnesota in Minneapolis, Minnesota

Cheryl Covert, RN, CS, MS

Minneapolis Veterans Administration Medical Center in Minneapolis, Minnesota

Patrice Hebert, RN, MSN

Associates in Psychiatry and Psychology in Rochester, Minnesota

BACKGROUND: Medication-resistant, persistent auditory hallucinations are pervasive in persons with schizophrenia. Behavior strategies are often very effective as adjunctive therapy to decrease the negative characteristics of this symptom.

OBJECTIVES: The purpose of this multi-site intervention study was to examine the short-term effects of a 10-week course to teach behavior management of persistent auditory hallucinations on seven characteristics of auditory hallucinations (i.e., frequency, loudness, self-control, clarity, tone, distractibility, and distress), anxiety, and depression.

STUDY DESIGN: A quasi-experimental repeated measured design was used. The sample included 62 outpatients with schizophrenia who reported daily persistent auditory hallucinations. Measures included the Characteristics of Auditory Hallucinations Questionnaire, the tension-anxiety subscale of the Profile of Mood States, and the Beck Depression Inventory II.

RESULTS: Preintervention scores for the frequency (p < .001), self-control (p < .03), clarity (p < .01), tone (p < .03), distractibility (p < .006), and distress (p < .001) improved compared with preintervention scores. Postintervention scores on anxiety and depression were also significantly lower than preintervention scores (p < .02, p < .001, respectively).

CONCLUSIONS: Teaching behavior management of persistent auditory hallucinations in a standardized 10-week course is clinically effective and can be incorporated into many existing outpatient programs.

Journal of the American Psychiatric Nurses Association, Vol. 8, No. 3, 84-91 (2002)
DOI: 10.1067/mpn.2002.125223


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