Identifying specific interpretations and exploring the nature of safety behaviours for people who hear voices: An exploratory study

The concept of safety (seeking) behaviours has been very important in cognitive behavioural models of anxiety disorders. Morrison (1998) considered how a similar process may be involved in the development and maintenance of auditory hallucinations; however there has been no research that specifically explores safety behaviours in people who hear voices. The S-REF model (Wells and Matthews, 1994) proposed that compensatory beliefs mediate the choice of coping mechanism. The aim of this study was to explore whether people who hear voices have interpretations about the experience of hearing voices and if this interpretation threatens their physiological or psychological wellbeing, do they engage in safety behaviours to prevent this feared outcome. The study also considered whether the choice of behaviour was cognitively mediated. Twelve participants who had heard voices in the previous 2 weeks completed the study; 11 participants reported catastrophic interpretations and 12 reported using safety behaviours. The theoretical and clinical implications are discussed.