A psychological intervention for engaging dialogically with auditory hallucinations (Talking With Voices): A single-site, randomised controlled feasibility trial.

There is growing clinical interest in addressing relationship dynamics between service-users and their voices. The Talking With Voices (TwV) trial aimed to establish feasibility and acceptability of a novel dialogical intervention to reduce distress associated with voices amongst adults diagnosed with schizophrenia spectrum disorders. The single-site, single-blind (rater) randomised controlled trial recruited 50 participants who were allocated 1:1 to treatment as usual (TAU), or TAU plus up to 26 sessions of TwV therapy. Participants were assessed at baseline and again at end of treatment (six-months). The primary outcomes were quantitative and qualitative assessments of feasibility and acceptability. Secondary outcomes involved clinical measures, including targeted instruments for voice-hearing, dissociation, and emotional distress. The trial achieved 100 % of the target sample, 24 of whom were allocated to therapy and 26 to TAU. The trial had high retention (40/50 [80 %] participants at six-months) and high intervention adherence (21/24 [87.5 %] receiving ≥8 sessions). Signals of efficacy were shown in targeted measures of voice-hearing, dissociation, and perceptions of recovery. Analysis on the Positive and Negative Syndrome Scale indicated that there were no differences in means of general psychosis symptom scores in TwV compared to the control group. There were four serious adverse events in the therapy group and eight in TAU, none of which were related to study proceedings. The trial demonstrates the acceptability of the intervention and the feasibility of delivering it under controlled, randomised conditions. An adequately powered definitive trial is necessary to provide robust evidence regarding efficacy evaluation and cost-effectiveness. Trial registration: ISRCTN 45308981.

What does recovery mean to young people with mental health difficulties? - "It's not this magical unspoken thing, it's just recovery".

Background: There is extensive literature documenting the nature of recovery in mental health in adult populations, but there is very little exploring its nature and meaning for young people.Aims: To gain a detailed understanding from the perspective of young people about the concept of recovery in young people's mental health.Method: Semi structured interviews were conducted with 23 young people. Interviews were transcribed verbatim and analysed using thematic analysis.Results: Themes emerging from the interviews included young people's dynamic conceptualisations of recovery, awareness of others views of recovery, polarised goals of recovery, and facilitators and barriers of recovery.Conclusions: To be relevant for young people, the mental health recovery model must incorporate individual needs, developmental considerations and fluctuations in goals. It must also be embedded within the young person's ecological system such as family, friends and school, and be focussed around an explicit and collaborative recovery discussion with the young person.