Attention Training With Auditory Hallucinations: A Case Study

The case presented in this paper illustrates how Attention Training (ATT; [Wells, A. (1990). Panic disorder in association with relaxation induced anxiety: An attentional training approach to treatment. Behavior Therapy, 21, 273–280.]) can be applied in an outpatient setting in the treatment of auditory hallucinations. The 25-year-old male patient presented had a 4-year history of schizophrenia and treatment-refractory auditory hallucinations. He had received cognitive behavior therapy (CBT) before starting ATT. CBT had changed his attribution of the voices, and when he started with ATT the patient no longer held the belief that “voices are dangerous,” but his processing configuration was still acting “as if” the voices were a source of threat: He would listen to them, ruminate about them, and was easily distracted by them. Eight sessions of ATT resulted in a reduction of symptoms and in a dramatic change in the perceived control and mastery of the auditory hallucinations. It is concluded that ATT may be a helpful adjunct strategy in the treatment of specific psychotic symptoms.