Technology-enhanced psychological assessment and treatment of distressing auditory hallucinations: a systematic review

Abstract

Purpose Auditory hallucinations (“hearing voices”) are a relatively common experience, which is often highly distressing and debilitating. As mental health services are under increasing pressures, services have witnessed a transformative shift with the integration of technology into psychological care. This study aims to narratively synthesise evidence of technology-enhanced psychological assessment and treatment of distressing voices (PROSPERO 393831). Design/methodology/approach This review was carried out according to the preferred reporting items for systematic reviews and meta-analyses. Embase, MEDLINE, PsycINFO and Web of Science were searched until 30th May 2023. The Effective Public Health Practice Project (EPHPP) tool assessed methodological quality of studies. Findings Searching identified 9,254 titles. Fourteen studies (two assessment studies, twelve treatment studies, published 2010–2022, n = 1,578) were included in the review. Most studies were conducted in the UK, the USA or Canada. Technologies included avatar therapy, mobile apps, virtual reality, a computerised Web-based programme and a mobile-assisted treatment. Overall, technology-enhanced psychological assessments and treatments appear feasible, acceptable and effective, with avatar therapy the most used intervention. EPHPP ratings were “strong” (n = 8), “moderate” (n = 5) and “weak” (n = 1). Originality/value To the best of the authors’ knowledge, this is the first systematic review to investigate these technologies, specifically for distressing voices. Despite the relatively small number of studies, findings offer promising evidence for the clinical benefits of these technologies for enhancing mental health care for individuals with distressing voices. More high-quality research on a wider range of technologies is warranted.