Relating Therapy for distressing voices: A treatment protocol.

Purpose: To present a treatment protocol for Relating Therapy-a novel psychological intervention which supports adults to respond assertively to their distressing voice hearing experiences.

Method: This paper reports the background to the development of Relating Therapy. Thereafter, the four phases of the therapy are described: (1) exploring the hearer's relational landscape and identification of patterns of relating; (2) selection of a difficult relationship and a specific conversation, and re-scripting of the conversation; (3) introduction to and engagement with roleplays and (4) reflection, consolidation and preparing for the continuation of learning. Implementation issues are discussed, and the evidence base is reviewed.

Results: The findings from preliminary evaluations of Relating Therapy suggest that a definitive randomised controlled trial is feasible. Current evidence suggests that Relating Therapy is an acceptable and safe intervention that has the potential to generate benefits for hearers.

Conclusion: Learning to respond assertively may be beneficial to some adults who are distressed by hearing voices. A definitive randomised controlled trial is warranted to evaluate the clinical and cost-effectiveness of Relating Therapy and to explore the mechanisms through which any benefits might be generated.