The effect of trauma-focused therapy on voice-hearing: An experience sampling study

Simone R. Burger; Amy Hardy; Inez Verdaasdonk; Berber van der Vleugel; Philippe Delespaul; Catherine van Zelst; Paul A.J. de Bont; Anton B.P. Staring; Carlijn de Roos; Ad de Jongh; Machteld Marcelis; Agnes van Minnen; Mark van der Gaag; David van den Berg

doi:10.1111/papt.12556

The effect of trauma-focused therapy on voice-hearing: An experience sampling study

Simone R. Burger^*
, Amy Hardy
, Inez Verdaasdonk
, Berber van der Vleugel
, Philippe Delespaul
, Catherine van Zelst
, Paul A.J. de Bont
, Anton B.P. Staring
, Carlijn de Roos
, Ad de Jongh
, Machteld Marcelis
, Agnes van Minnen
, Mark van der Gaag
, David van den Berg

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Trauma and post-traumatic stress are involved in the aetiology and maintenance of voice-hearing. It has been proposed that trauma-focused therapy (TFT) might affect voice-hearing, but previous studies are limited and remain undecided. Objectives: We aimed to investigate the effect of TFT on voice-hearing in people with PTSD and psychosis using experience sampling method (ESM). A secondary aim was to explore how changes in voice-hearing are related to changes in PTSD. Design: This is an adjunct longitudinal ESM study of a sub-group of participants (N = 39) from a randomised controlled trial that compared TFT to a waiting-list control group. Methods: Voice-hearing participants filled in 10 daily voice-hearing-related questionnaires for six consecutive days at baseline and post-treatment at pseudo-random times during the day. PTSD symptom severity was assessed at baseline and post-treatment. Multilevel linear regression was used to test the effect of TFT on voice-hearing and to analyse the relationship between changes in voice-hearing and changes in PTSD. Results: The intention-to-treat analysis showed a significant interaction effect between time and treatment condition (p <.00001) with a small effect size (dppc2 = −0.27), indicating a larger decrease in voice-hearing in the TFT group than in the waiting-list control group. Also, a significant association was observed between changes in PTSD symptoms and changes in voice-hearing (p <.00001). Conclusions: Our findings tentatively suggest that, even when voices are not targeted directly, TFT for PTSD can alleviate distressing voices.

Original language	English
Pages (from-to)	25-39
Number of pages	15
Journal	Psychology and Psychotherapy-theory Research and Practice
Volume	98
Issue number	1
Early online date	1 Jan 2024
DOIs	https://doi.org/10.1111/papt.12556
Publication status	Published - Mar 2025

Keywords

auditory hallucinations
psychosis
PTSD
trauma-focused therapy
voices

Access to Document

10.1111/papt.12556Licence: CC BY-NC-ND

Cite this

Burger, S. R., Hardy, A., Verdaasdonk, I., van der Vleugel, B., Delespaul, P., van Zelst, C., de Bont, P. A. J., Staring, A. B. P., de Roos, C., de Jongh, A., Marcelis, M., van Minnen, A., van der Gaag, M., & van den Berg, D. (2025). The effect of trauma-focused therapy on voice-hearing: An experience sampling study. Psychology and Psychotherapy-theory Research and Practice, 98(1), 25-39. https://doi.org/10.1111/papt.12556

@article{2a4ae731837f40ee96f17c5035f70e10,

title = "The effect of trauma-focused therapy on voice-hearing: An experience sampling study",

abstract = "Trauma and post-traumatic stress are involved in the aetiology and maintenance of voice-hearing. It has been proposed that trauma-focused therapy (TFT) might affect voice-hearing, but previous studies are limited and remain undecided. Objectives: We aimed to investigate the effect of TFT on voice-hearing in people with PTSD and psychosis using experience sampling method (ESM). A secondary aim was to explore how changes in voice-hearing are related to changes in PTSD. Design: This is an adjunct longitudinal ESM study of a sub-group of participants (N = 39) from a randomised controlled trial that compared TFT to a waiting-list control group. Methods: Voice-hearing participants filled in 10 daily voice-hearing-related questionnaires for six consecutive days at baseline and post-treatment at pseudo-random times during the day. PTSD symptom severity was assessed at baseline and post-treatment. Multilevel linear regression was used to test the effect of TFT on voice-hearing and to analyse the relationship between changes in voice-hearing and changes in PTSD. Results: The intention-to-treat analysis showed a significant interaction effect between time and treatment condition (p <.00001) with a small effect size (dppc2 = −0.27), indicating a larger decrease in voice-hearing in the TFT group than in the waiting-list control group. Also, a significant association was observed between changes in PTSD symptoms and changes in voice-hearing (p <.00001). Conclusions: Our findings tentatively suggest that, even when voices are not targeted directly, TFT for PTSD can alleviate distressing voices.",

keywords = "auditory hallucinations, psychosis, PTSD, trauma-focused therapy, voices",

author = "Burger, \{Simone R.\} and Amy Hardy and Inez Verdaasdonk and \{van der Vleugel\}, Berber and Philippe Delespaul and \{van Zelst\}, Catherine and \{de Bont\}, \{Paul A.J.\} and Staring, \{Anton B.P.\} and \{de Roos\}, Carlijn and \{de Jongh\}, Ad and Machteld Marcelis and \{van Minnen\}, Agnes and \{van der Gaag\}, Mark and \{van den Berg\}, David",

note = "Funding Information: The authors wish to thank the participants, therapists, research assistants and all others who contributed to this study. This research was supported by a grant awarded to Mark van der Gaag and David van den Berg by the Dutch Support Foundation Stichting tot Steun VCVGZ. Amy Hardy was funded in part by the NIHR Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. These funding organisations had no part in the design or administration of the study or decisions about this report. Publisher Copyright: {\textcopyright} 2024 The Author(s). Psychology and Psychotherapy: Theory, Research and Practice published by John Wiley \& Sons Ltd on behalf of The British Psychological Society.",

year = "2025",

month = mar,

doi = "10.1111/papt.12556",

language = "English",

volume = "98",

pages = "25--39",

journal = "Psychology and Psychotherapy-theory Research and Practice",

issn = "1476-0835",

publisher = "Wiley-Blackwell",

number = "1",

}

Burger, SR, Hardy, A, Verdaasdonk, I, van der Vleugel, B, Delespaul, P, van Zelst, C, de Bont, PAJ, Staring, ABP, de Roos, C, de Jongh, A, Marcelis, M, van Minnen, A, van der Gaag, M & van den Berg, D 2025, 'The effect of trauma-focused therapy on voice-hearing: An experience sampling study', Psychology and Psychotherapy-theory Research and Practice, vol. 98, no. 1, pp. 25-39. https://doi.org/10.1111/papt.12556

TY - JOUR

T1 - The effect of trauma-focused therapy on voice-hearing

T2 - An experience sampling study

AU - Burger, Simone R.

AU - Hardy, Amy

AU - Verdaasdonk, Inez

AU - van der Vleugel, Berber

AU - Delespaul, Philippe

AU - van Zelst, Catherine

AU - de Bont, Paul A.J.

AU - Staring, Anton B.P.

AU - de Roos, Carlijn

AU - de Jongh, Ad

AU - Marcelis, Machteld

AU - van Minnen, Agnes

AU - van der Gaag, Mark

AU - van den Berg, David

N1 - Funding Information: The authors wish to thank the participants, therapists, research assistants and all others who contributed to this study. This research was supported by a grant awarded to Mark van der Gaag and David van den Berg by the Dutch Support Foundation Stichting tot Steun VCVGZ. Amy Hardy was funded in part by the NIHR Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. These funding organisations had no part in the design or administration of the study or decisions about this report. Publisher Copyright: © 2024 The Author(s). Psychology and Psychotherapy: Theory, Research and Practice published by John Wiley & Sons Ltd on behalf of The British Psychological Society.

PY - 2025/3

Y1 - 2025/3

N2 - Trauma and post-traumatic stress are involved in the aetiology and maintenance of voice-hearing. It has been proposed that trauma-focused therapy (TFT) might affect voice-hearing, but previous studies are limited and remain undecided. Objectives: We aimed to investigate the effect of TFT on voice-hearing in people with PTSD and psychosis using experience sampling method (ESM). A secondary aim was to explore how changes in voice-hearing are related to changes in PTSD. Design: This is an adjunct longitudinal ESM study of a sub-group of participants (N = 39) from a randomised controlled trial that compared TFT to a waiting-list control group. Methods: Voice-hearing participants filled in 10 daily voice-hearing-related questionnaires for six consecutive days at baseline and post-treatment at pseudo-random times during the day. PTSD symptom severity was assessed at baseline and post-treatment. Multilevel linear regression was used to test the effect of TFT on voice-hearing and to analyse the relationship between changes in voice-hearing and changes in PTSD. Results: The intention-to-treat analysis showed a significant interaction effect between time and treatment condition (p <.00001) with a small effect size (dppc2 = −0.27), indicating a larger decrease in voice-hearing in the TFT group than in the waiting-list control group. Also, a significant association was observed between changes in PTSD symptoms and changes in voice-hearing (p <.00001). Conclusions: Our findings tentatively suggest that, even when voices are not targeted directly, TFT for PTSD can alleviate distressing voices.

AB - Trauma and post-traumatic stress are involved in the aetiology and maintenance of voice-hearing. It has been proposed that trauma-focused therapy (TFT) might affect voice-hearing, but previous studies are limited and remain undecided. Objectives: We aimed to investigate the effect of TFT on voice-hearing in people with PTSD and psychosis using experience sampling method (ESM). A secondary aim was to explore how changes in voice-hearing are related to changes in PTSD. Design: This is an adjunct longitudinal ESM study of a sub-group of participants (N = 39) from a randomised controlled trial that compared TFT to a waiting-list control group. Methods: Voice-hearing participants filled in 10 daily voice-hearing-related questionnaires for six consecutive days at baseline and post-treatment at pseudo-random times during the day. PTSD symptom severity was assessed at baseline and post-treatment. Multilevel linear regression was used to test the effect of TFT on voice-hearing and to analyse the relationship between changes in voice-hearing and changes in PTSD. Results: The intention-to-treat analysis showed a significant interaction effect between time and treatment condition (p <.00001) with a small effect size (dppc2 = −0.27), indicating a larger decrease in voice-hearing in the TFT group than in the waiting-list control group. Also, a significant association was observed between changes in PTSD symptoms and changes in voice-hearing (p <.00001). Conclusions: Our findings tentatively suggest that, even when voices are not targeted directly, TFT for PTSD can alleviate distressing voices.

KW - auditory hallucinations

KW - psychosis

KW - PTSD

KW - trauma-focused therapy

KW - voices

U2 - 10.1111/papt.12556

DO - 10.1111/papt.12556

M3 - Article

SN - 1476-0835

VL - 98

SP - 25

EP - 39

JO - Psychology and Psychotherapy-theory Research and Practice

JF - Psychology and Psychotherapy-theory Research and Practice

IS - 1

ER -

The effect of trauma-focused therapy on voice-hearing: An experience sampling study

Abstract

Keywords

Access to Document

Fingerprint

Cite this