It seems clear that many, possibly all, patients develop natural ways of coping with distressing hallucinations. Most
strategies are not unique to hallucinations, overlapping considerably with those used for other symptoms and with those
reported by non-clinical populations for other stressors. The effectiveness of these natural coping strategies is variable
across individuals and the more effective strategies are not necessarily used. Only about a third of hallucinators are rated as
having good adaptation to their voices. Experimental studies confirm that various hallucination-specific techniques of
coping are efficacious, and intervention trials have shown that it is possible to teach general and specific strategies in a
therapeutic program. In this context, the rationale of basing therapeutic interventions on coping enhancement for
hallucinations or including coping interventions in broader treatments has general support. However, the current
widespread clinical application of coping enhancement for hallucinations across a variety of CBT for psychosis programs is
neither specifically supported, nor contra-indicated, by the research evidence reviewed. The fieldmay benefit fromresearch focussed on the dynamics of the process of coping, aided by coherent theory, tighter measurement and idiographic studies.