Enhancing Self-Management of Distressing Voices Hearing Experiences Using Ecological Momentary Assessment and Intervention

Voice hearing experiences, otherwise known as auditory verbal hallucinations, involve the perception of sounds or voices in the absence of external stimuli. These experiences are a common occurrence across many mental health conditions and can be distressing, impairing, and are associated with poor quality of life. Whilst some people can effectively manage their voices independently, or even experience them positively, many seek help from mental health services. For these individuals, evidence-based treatment approaches typically include a combination of medication and psychological therapy. Psychological therapy can help people to gain a greater understanding of these experiences, improve self-management, and minimise their impact on daily living. However, existing psychological therapies show only moderate effectiveness, and can be difficult to access, with long wait times, geographical barriers, and prohibitive costs. Many individuals with persisting mental health problems face these difficulties, highlighting a need for novel and innovative interventions that are more effective and accessible for those who need them. When used in conjunction with standard therapies, otherwise known as blended therapy, digital technologies have potential to support delivery and improve the efficacy of therapeutic components. Smartphones are particularly promising given ownership is becoming ubiquitous and they tend to be carried on the person; offering an opportunity to extend the therapeutic domain to everyday life. Ecological momentary intervention (EMI) is one application of this, involving the use of mobile devices to deliver interventions at specified moments in daily life. A related approach called ecological momentary assessment (EMA) uses mobile devices to assess clinically-relevant phenomenon as it arises in natural environments. When blended with standard face-to-face therapies, EMI and EMI (EMA/I) might enhance assessment and promote the implementation of intervention