How should psychological interventions for distressing voices be delivered: a comparison of outcomes for patients who received interventions remotely or face-to-face within routine clinical practice?

Aims This service evaluation aimed to compare the outcomes for interventions for distressing voices that were delivered face-to-face (F2F) or remotely. It was hypothesised that F2F interventions would generate greater reductions in the primary outcome of the negative impact of voices, relative to remote delivery. Methods Sixty-three patients (33 F2F; 30 remote) completed a baseline assessment, 4-8 sessions of intervention and a post-intervention assessment. At both assessments, patients completed questionnaires that measured voice hearing experiences, recovery, depression and anxiety. The primary outcome was negative impact of voices measured by the Hamilton Programme for Schizophrenia Voices Questionnaire-Emotional Subscale (HPSVQ-ES). Results A non-significant difference was found between groups. The Minimum Clinically Important Difference for the primary outcome was met for remote delivery and was within the confidence intervals for F2F. Given a larger sample size, these findings suggest that interventions may have generated clinically meaningful benefits, irrespective of the mode of delivery. Discussion Given the small sample size, it may be premature to draw any conclusions from this evaluation. However, the promising outcomes across modes of delivery suggest that it may be appropriate to offer patients a choice of how they wish to receive interventions for distressing voices.