title: A graded exposure intervention for distressing visual hallucinations in schizophrenia.
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.
  
  
  METHODS
  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.
authors: North East London NHS Foundation Trust, UK. pfobrien@gmail.com
authors: Paul
authors: P
authors: O'Brien
authors: Louise
authors: L
authors: Johns
mesh_terms: D000223:Adaptation, Psychological; D001143:Arousal; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D005239:Fear / Q000523:psychology; D005260:Female; D006212:Hallucinations / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D006801:Humans; D007171:Implosive Therapy / Q000379:methods*; D008875:Middle Aged; D008960:Models, Psychological; D010698:Phobic Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D011936:Reality Testing; D012559:Schizophrenia / Q000175:diagnosis / Q000628:therapy*; D012565:Schizophrenic Psychology