acceptance and negotiation, positive labeling of
symptoms and behaviour for enhancing compliance,
and reliance on patient expertise and responsibility
(see for more detail,6,7, 27). The cognitive
interventions focus on triggering events,cognitions,
emotional and behavioural (re)actions,and consequential
reactions of others. Patients are encouraged
to develop coping strategies and to monitor
their voices and triggering events,the intensity of
experienced interference,the efficacy of actual
coping behaviour and,finally,the reactions of
others. Relatives are invited to attend the meetings
and to take an active part in the treatment process.
The treatment is carried out according to the study
protocol (29) but individually tailored,which
means that specific elements may vary in duration
or intensity. The median duration of HIT is about
9 months with a median number of contacts of 11.
Variation in duration (SD ¼ 9) and contacts
(SD ¼ 12) can be large if need persists.
Treatment was carried out by three psychologists
and two residents of psychiatry. Treatment
fidelity was maintained by regular meetings of
weekly case reviews and biweekly groups supervision
(by author JAJ) through one-way mirror,with
additional consultations when therapists faced
difficulties in keeping the protocol.