BACKGROUND Cognitive-behavioural therapy has been shown to be effective in reducing psychotic symptoms, but few patients have access to these services. Group cognitive treatment may provide a less costly service with similar benefits.

AIMS To explore the effectiveness of group cognitive-behavioural therapy on insight and symptoms, particularly auditory hallucinations.

METHOD Twenty-one DSM-IV diagnosed patients with schizophrenia with treatment-resistant, distressing auditory hallucinations were referred to a group programme consisting of six sessions of cognitive treatment following a strict protocol which emphasised individual power and control as well as coping strategies.

RESULTS There were significant changes in all three main outcome measures following treatment; those changes were maintained at follow-up and were greater than changes over the waiting-list period. Specifically, there were changes in perceived power and distress as well as increases in the number and effectiveness of the coping strategies.

CONCLUSIONS Group treatment for auditory hallucinations needs further investigation but does look promising and may provide a less costly alternative to individual cognitive treatment.