CBT for Commanding Voices

CBT for Commanding Voices

Cognitive models of voices (e.g. Chadwick & Birchwood, 1994) suggest that the beliefs that individuals develop about their voices, rather than hearing voices per se, are the key drivers of distress and unhelpful safety behaviours. This is particularly important for commanding voices, which can lead to harmful compliance with risk to self and others. Meaden et al. (2010) have developed a model of command hallucinations which suggests that it is the perceived power of the voice(s), together with beliefs about the voice’s identity, intent and consequences of resisting that are the key predictors of distress and compliance with commands. Cognitive Therapy for Command Hallucinations (CTCH) aims to reduce distress and compliance by examining these key beliefs and by undermining the perceived power of the voice and empowering the voice hearer. Key components of this therapy involve addressing the relationship that the voice-hearer has with their voices as well as examining underlying schemas which may fuel beliefs about voices. This workshop will cover psychological models of voices and skills for working with voices within a cognitive-behavioural framework. There will be a particular emphasis on learning and practising CBT techniques for command hallucinations.

Meaden, A., Keen, N., Aston, R., Bucci, S., & Barton, K. (2013). Working with Command Hallucinations: An Advanced Practical Companion. London: Routledge.

Keen, N., George, D., Scragg, P., & Peters, E. (2017) The role of shame in people with a diagnosis of schizophrenia. British Journal of Clinical Psychology, 56, 115-129.

Keen, N., Hunter, E.C.M., & Peters, E. (2017) Integrated Trauma-Focused Cognitive-Behavioural Therapy for Post-traumatic Stress and Psychotic Symptoms: A Case-Series Study Using Imaginal Reprocessing Strategies. Frontiers in Psychiatry, Volume 8, Article 92 doi: 10.3389/fpsyt.2017.00092.


If you are eligible for a HEE funded place on this workshop, please do not register online, but apply using this HEE funded workshop application form which should be emailed to octc@oxfordhealth.nhs.uk



Nadine Keen

Dr Nadine Keen is a Consultant Clinical Psychologist and coordinator of the award winning Psychological Interventions Clinic for Outpatients with Psychosis (PICuP) at South London and Maudsley NHS Trust. She has specialised in psychosis for the last 14 years and spent 3 years working as a trial therapist on the MRC funded multi-centre RCT for COMMAND (CBT for distressing harmful command hallucinations). Following this she co-authored Cognitive Therapy for Command Hallucinations: an Advanced Practical Companion (2013). Dr Keen also has a particular interest and expertise working with trauma within psychosis. She previously worked at the Traumatic Stress Clinic in London and was one of the therapists on the London Bombings Screen and Treat Programme. She was also formerly a tutor on the IOPPN Postgraduate Diploma in CBT for Psychosis Course and continues to be involved in research and teaching at the IOPPN. She has conducted numerous national and international psychosis related workshops, including working with commanding voices.

Additional Information

Cancellation & changes policy

If you cancel more than 14 days prior to your booked event, we will refund your fee minus a charge of 15% to cover our administration costs. We regret that cancellations 14 days or less before the booked event cannot be refunded or changed/transferred.

If you wish to change/transfer your booking after confirmation we will do our best to accommodate you if you notify us 14 days prior to your booked event, and if there is space to do so. However there will be an administration charge of £15 per change/transfer.


Workshops often contain clinical material. This is always anonymised as far as possible but delegates are none the less reminded to respect confidentiality.

All that is discussed in your therapy sessions will be treated as confidential, with the following exceptions.
We are required to seek supervision by our professional body (The British Psychological Society or equivalent) as a means of ensuring good practice. We will usually inform your referrer of your progress, but the details that we disclose will be discussed with you. We do have a statutory obligation to break confidentiality under rare circumstances, namely, if we believe that a client is of danger to themselves or to others (under the Mental Health Act, 2001) or if we believe that a child is at actual risk of physical or sexual abuse (The Children Act, Section 47, 1989).

If we felt that it would be helpful to request additional medical, social or legal information, we could only do this with your consent. Similarly, should another medical, social or legal professional request information from us, we would not release this without your consent.


OCTC makes every effort to ensure that this programme is delivered as advertised. However, should a presenter have to cancel, we will endeavour to find another suitable presenter. We will inform attendees as soon as is reasonably practical and, if requested, will offer a refund. In the rare event that we are unable to substitute a presenter, we may cancel a workshop and refund payments already made by attendees. OCTC will not refund travel and accommodation costs that attendees may incur.
All the workshops in this programme are carried out by highly experienced therapists and trainers. The individual presenter is responsible for the content of the workshop and any views expressed do not necessarily represent those of OCTC.
Although highly informative, none of the open workshops or workshop series confer a formal qualification or assurance of competence in CBT (or a specialist area of CBT) since we are unable to assess attendee competency within the training event. However, credit and award-bearing courses that lead to formal qualifications are offered by OCTC in conjunction with the University of Oxford. More about these courses is available on our website www.octc.uk

Levels of competence

Before booking a place on a workshop, please ensure that it is pitched at the appropriate level of competence for you. The guide to levels is as follows:


Basic workshops are for people from a variety of backgrounds, who have at least one year’s clinical experience. Cognitive behavioural knowledge is not necessary for attendance at these workshops, though in practice, a number of attendees will have some skills in the area, and are refreshing/updating their knowledge.


Intermediate workshops are directed towards people who already have knowledge of CBT, and experience in using cognitive formulations and treatment methods – for instance, they are able to identify and test automatic thoughts, and design behavioural experiments. Most participants will be using CBT as part of their clinical practice, and may still be acquiring new CBT skills.


Advanced courses are directed towards those professionals who use CBT routinely as part of their clinical practice. They have probably undertaken a significant number of training courses and/or workshops, and use a broad range of cognitive behavioural strategies to work with a range of presentations at varying levels of complexity.

Making reservations

Bookings can only be considered confirmed after we have received your online registration or application form and payment (or invoicing details, including an official purchase order document). Please note that registration to workshops closes 7 days prior to the event date.

If you are booking a workshop place for someone else, you must complete your own details in the billing field, but ENTER THE WORKSHOP PARTICIPANTS NAME/ADDRESS in the shipping field. If you wish to order items using a paper order form instead of online, you can view or download an order form in Adobe Acrobat (PDF) format. Once downloaded, print it out, fill it in, and send off with your payment [cheque made payable to OXFORD HEALTH NHS FOUNDATION TRUST] to the address on the form.


The cost of the workshops includes hot drinks on arrival, mid-morning and mid-afternoon, but not usually lunch unless stated. However, for workshops that do include lunch, if you have any special dietary requirements please let us know at the time of application.

Special needs

We welcome applications from diverse backgrounds. If you have any particular needs, please contact us
prior to booking.