1. Imagery-Enhanced Cognitive Behaviour Therapy (IE-CBT)

The behavioural aspect of this therapy helps the voice hearer to develop a greater understanding of the patterns in their voice hearing experience – such as what things may trigger the experience and what things make the experience less intense. This understanding translates to simple daily activities that can help improve how we cope with and respond to our voices. The imagery and cognitive aspects of this therapy helps us understand how our beliefs and thoughts about ourselves and our voices can impact on our emotions and behaviours and to help modify those beliefs that are causing us distress or impairment.

2. Imagery Rescripting

Many people who report hearing voices also report having a history of trauma or neglect. It is possible that this trauma may play a significant role in the voice hearing experience, and thus warrants psychological treatment to help resolve such underlying issues. Perth Voices Clinic is now offering a psychological therapy named Imagery Rescripting to people who hear voices and report a history of trauma or neglect. Unlike typical trauma therapies, this intervention helps empower the individual without requiring them to re-live the highly distressing elements of traumatic memories. This approach enables the individual to modify the meaning of the trauma, and reduce distress when recalling the traumatic memories, by getting the individual to first imagine the start of the memory and then rewrite a new, safer ending with the help of the therapist. The rescripting process is said to increase a sense of control and empowerment, as well as promote self-soothing. This therapy will be delivered by Dr Georgie Paulik-White, a registered clinical psychologist who has extensive experience delivering and developing psychological therapies for voice hearers. The assessment and therapy will be run over 10, fifty-minute sessions. Seeing a provisional psychologist (trainee) as your therapist is not offered for this therapy (unlike CBT), and thus you must have your 10 Medicare sessions available for use unless you chose to pay privately.

3. Imagery-Focused Therapy for Visions

Seeing visions (or “visual hallucinations”) is a common, and often – though not always – distressing experience. This could be a range of experiences, from simple flashes of light to things like shapes, dots, patterns, people, or figures. This can sometimes be a confusing or frightening experience. At Perth Voices Clinic we are now offering a new therapy stream targeting these experiences, with the aim to reduce their occurrence and the distress accompanying them. This treatment approach mostly works with mental imagery, helping you with the support of your therapist to modify and take control over the content of the visions and other mental images in your mind that may make you feel unsafe or paranoid. The therapy may involve techniques including imagery re-scripting of past events or imagined future events (imaging an image or memory and changing the ending to change the meaning), working with nightmares, and creating positive imagery.

4. Other interventions

If you have already completed CBT at the clinic or elsewhere you may elect to do other voice-focused therapies. Schema Mode Therapy (SMT) for voices works on understanding how our life experiences led us to develop core beliefs about ourselves, others and the world around us (“schemas”), and how we have different parts (or “modes”, sometimes represented by voices) to help guide us and cope with life, though while some of these may have been functional when we were younger, they may now be hurting us more than helping us: SMT aims to explore and change these patterns. This approach is particularly helpful for people with difficulties regulating emotions and with complex trauma.  Compassion-Focused Therapy for voices helps the client to understand the origin and function of the voices, especially with regards to having a potentially protective function (despite seeming to be the opposite at first glance). This therapy helps the client to foster compassion both for themselves and their voices, leading to more mutually respectful communication. Relating Therapy is a psychological approach to working with voice hearers which focuses on improving the relationship between the voice hearer and their voice(s), as well as improving other social relationships in the voice hearer’s life. Clients are encouraged to take responsibility for their own relating and to develop more assertive ways of responding to the voices they hear. Person-Based Cognitive Therapy integrates cognitive therapy and mindfulness to target distinct sources of distress in voice hearers. This approach can be delivered in individual therapy and is also the type of therapy that Perth Voices Clinic offers in their groups (for more information see the section on groups).

1. Group Therapy

Perth Voices Clinic runs groups twice a year. These groups are complimentary to Hearing Voices Network support groups, but are different in that they are structured evidence-based therapy groups. The groups are run over 10 weeks and are 1.5 hours (with a tea break). The type of therapy being delivered in our groups is Person-Based Cognitive Therapy, which integrates cognitive therapy and mindfulness. The mindfulness component aims to help the individual to develop an accepting approach to thoughts, feelings and voices, and through understanding these experiences develop more detachment and choice about how they influence us. Mindfulness aims to anchor the mind in ‘the here and now’ and promote a warm and compassionate approach to difficult events and experiences. The cognitive element helps us understand how our beliefs and thoughts about ourselves and our voices can impact on our emotions and behaviours and to help modify those beliefs that are causing us distress or impairment.

Note. Everyone is eligible for 10 individual therapy sessions and 10 group therapy sessions through Medicare MHCP per year, so attending a group will not impact your ability to access one-on-one therapy.