The Content and Topography of Auditory Verbal Hallucinations in Adult Psychosis Patients: What Does a Voice Say, and How Does It Say It? An Umbrella Review and Collation.

October 2025Clinical Psychology & Psychotherapy 32(5) Background: Auditory verbal hallucinations ('voices') in clinical psychosis are associated with significant distress and disability, but the efficacy of CBT for voices is modest. Greater phenomenological understanding is crucial for the development of theoretical models and more tailored CBT interventions. Aim: This work aimed to produce an evidence-based empirical framework of features of voice content and topography in adult psychosis. Method: Electronic databases, journal pages and book publishers were systematically searched. Identified reviews were screened against inclusion criteria and included reviews critically appraised. Study characteristics and data relating to voice content/topography were extracted and collated. Results: Forty-two reviews were identified. A framework of 172 features of voice content and topography was produced. Conclusions: This paper offers the most comprehensive evidence-based dissection of voice content and topography to date. Many features have been overlooked and should be tested for theoretical and clinical significance in order to further develop CBT and related interventions for voices. DOI: 10.1002/cpp.70145