Relating Therapy for voices: Evaluating a relationally-based therapy for people who hear distressing voices

Psychotic Symptoms Rating Scale (PSYRATS: Auditory hallucinations scale – AHRS) - an 11-item rating scale designed to measure the severity of different dimensions of the voice hearing experience (Haddock et al, 1999). Items include frequency, duration, loudness, intensity of distress and controllability. Each item is measured by the rater on a 5-point scale ranging from 0-4. The items relating to intensity of distress and controllability of voices on the AHRS are the most often cited in the voice hearing literature and will be the focus of this study.

Assessment data at Time 0 (baseline) will be collected pre-randomisation by a research assistant. Assessments at Times 1 (post-therapy) and 2 (3-month follow-up) will be collected by a research assistant who is blind to allocation.

1. CHOICE (Greenwood et al, 2009) - a 21 item self report questionnaire developed with service users to assess goals for CBT for psychosis that are relevant to recovery, e.g. self confidence, ways of dealing with unpleasant feelings and emotions, positive ways of relating to people, knowing I am not the only person who has unusual experiences, a positive purpose and direction in life. CHOICE has been found to be reliable and valid (Greenwood et al, 2009).
2. Voice and You (VAY) - the VAY is a 28-item measure of interrelating between the hearer and their predominant voice (Hayward et al, 2008). Relating is measured across four scales; two concerning the hearer's perception of the relating of the voice - voice dominance and voice intrusiveness; and two concerning the relating of the hearer - hearer distance and hearer dependence. Each item is measured on a four-point scale (0-3) generating the following range of scores for each scale: Voice Dominance 0-21; Voice Intrusiveness 0-15; Hearer Distance 0-21; and Hearer Dependence 0-27. The VAY has good internal consistency (α > .80 for all scales) and acceptable test-retest reliability (r > .7 for all scales).
3. Persons Relating to Others Questionnaire (PROQ3) - the PROQ3 is a 40 item questionnaire that assesses relating across eight scales which correspond to the relating positions within Birtchnell's Interpersonal Octogan . Response options are `Nearly always true', `Quite often true', `Sometimes true' and `Rarely true', which carry a score of 3, 2, 1 or 0. Thus each scale has a score range of 0 -15, and there is a maximum total score of 120 (Birtchnell et al, in press).
4. Hospital anxiety and depression scale (HADS) – the HADS is a 16 item measure of symptoms of anxiety and depression that has well established psychometric properties (Zigmund & Snaith,1983).

Assessment data at Time 0 (baseline) will be collected pre-randomisation by a research assistant. Assessments at Times 1 (post-therapy) and 2 (3-month follow-up) will be collected by a research assistant who is blind to allocation.