The ECHO Study: Compassion-focused Therapy for Young Voice Hearers and Their Caregivers

Overview

In this project, a 10-session treatment program was developed aimed at young people who experience voice hearing. The treatment has potential to easily be implemented in everyday clinical practice in Child and Adolescent Psychiatry, and eventually in Educational Psychological Counselling (PPR) and the newly established STIME services (low-threshold municipal treatment offers for children and young people). As part of the treatment, the young person's caregivers are involved. This means a high degree of involvement from adults who know the young person well and are part of their daily life. In addition to traditional Compassion-focuced therapy (CFT), the treatment is expanded with an intervention where an audio file is recorded with content corresponding to the adolescent's voice hearing. The parents are invited to listen to the audio file while participating in a therapy session. This will help improve the caregivers understanding of the young person's experiences and challenges.

Interventions

• Behavioral ECHO Manualized CFT treatment for young voice heares
  A manualized 10 session, intervention inspired by compassion focused therapy. A primary caretaker paticipates in 5 sessions.

Primary outcome measures

• Interpretation and relationship with the voices [Time frame: Data is collected 3 months prior to CFT treatment, immediately before the start of treatment, immediately after treatment is completed, and at 1 month follow-up.]
• Severity and phenomenological characteristics of voice hearing [Time frame: Data is collected 3 months prior to CFT treatment, immediately before the start of treatment, immediately after treatment is completed, and at 1 month follow-up.]
• Perceived ability to control or influence the voices [Time frame: Data is collected 3 months prior to CFT treatment, immediately before the start of treatment, immediately after treatment is completed, and at 1 month follow-up.]

Secondary outcome measures (5)

• Social Cognition [Time frame: Social cognition is tested 3 months before treatment and right after]
• Subjective experience of feeling safe, accepted, and soothed in social relationships. [Time frame: Data is collected 3 months prior to CFT treatment, immediately before the start of treatment, immediately after treatment is completed, and at 1 month follow-up]
• Compassion towards self. [Time frame: Data is collected 3 months prior to CFT treatment, immediately before the start of treatment, immediately after treatment is completed, and at 1 month follow-up]
• Subjective sense of interpersonal closeness and belonging [Time frame: Data is collected 3 months prior to CFT treatment, immediately before the start of treatment, immediately after treatment is completed, and at 1 month follow-up]
• Perceived availability and adequacy of social support [Time frame: Data is collected 3 months prior to CFT treatment, immediately before the start of treatment, immediately after treatment is completed, and at 1 month follow-up]

Eligibility criteria

Inclusion criteria

• The participants should have been referred to a child and adolescent psychiatric hospital in Denmark .
• The participants have heard voices within the last 2 weeks.
• The participant can hear the content of the voices. The content takes the form of spoken works.
• A caregiver who can participate in 5 sessions

Exclusion criteria

• Participants has an estimated IQ under 70
• Participants who don't speak and understand Danish,
• Current drug misuse / abuse (during sessions)
• Brain injury or neurological disorder e.g. severe epilepsy
• Impaired vision or hearing to a degree that makes participation in therapy under normal conditions impossible.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

N/A

Model

Single group

Masking

Open label

Primary purpose

Treatment

Study locations

Denmark · 1 center

• Psychiatriatric Children and Youth Hospital — Esbjerg

Publications

• Heriot-Maitland C. Position paper - CFT for psychosis. Psychol Psychother. 2024 Mar;97(1):59-73. doi: 10.1111/papt.12490. Epub 2023 Aug 14. PMID 37578215
• Zimet GD, Powell SS, Farley GK, Werkman S, Berkoff KA. Psychometric characteristics of the Multidimensional Scale of Perceived Social Support. J Pers Assess. 1990 Winter;55(3-4):610-7. doi: 10.1080/00223891.1990.9674095. PMID 2280326
• Neff KD, Toth-Kiraly I, Yarnell LM, Arimitsu K, Castilho P, Ghorbani N, Guo HX, Hirsch JK, Hupfeld J, Hutz CS, Kotsou I, Lee WK, Montero-Marin J, Sirois FM, de Souza LK, Svendsen JL, Wilkinson RB, Mantzios M. Examining the factor structure of the Self-Compassion Scale in 20 diverse samples: Support for use of a total score and six subscale scores. Psychol Assess. 2019 Jan;31(1):27-45. doi: 10.1037 PMID 30124303
• Raes F, Pommier E, Neff KD, Van Gucht D. Construction and factorial validation of a short form of the Self-Compassion Scale. Clin Psychol Psychother. 2011 May-Jun;18(3):250-5. doi: 10.1002/cpp.702. Epub 2010 Jun 8. PMID 21584907
• Gilbert, P., Introducing compassion-focused therapy. Advances in psychiatric treatment, 2009. 15(3): p. 199-208.
• Mourgues C, Hammer A, Fisher V, Kafadar E, Quagan B, Bien C, Jaeger H, Thomas R, Sibarium E, Negreira AM, Sarisik E, Polisetty V, Nur Eken H, Imtiaz A, Niles H, Sheldon AD, Powers AR. Measuring Voluntary Control Over Hallucinations: The Yale Control Over Perceptual Experiences (COPE) Scales. Schizophr Bull. 2022 May 7;48(3):673-683. doi: 10.1093/schbul/sbab144. PMID 35089361
• Woods, S. W., Parker, S., Kerr, M. J., Walsh, B. C., Wijtenburg, S. A., Prunier, N., Nunez, A. R., Buccilli, K., Mourgues-Codern, C., Brummitt, K., Kinney, K. S., Trankler, C., Szacilo, J., Colton, B.-L., Ali, M., Haidar, A., Billah, T., Huynh, K., Ahmed, U., Adery, L. L., Marcy, P. J., Allott, K., Amminger, P., Arango, C., Broome, M. R., Cadenhead, K. S., Chen, E. Y. H., Choi, J., Conus, P., Corn
• Chandwick P, Lees S, Birchwood M. The revised Beliefs About Voices Questionnaire (BAVQ-R). Br J Psychiatry. 2000 Sep;177:229-32. doi: 10.1192/bjp.177.3.229. PMID 11040883

Identifiers

NCT: NCT07314515 · 1852876

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗