High levels of anxiety were found to interfere with voice hearers' ability to benefit from a 10-Session Behavioral Management of Auditory Hallucinations Course. The 10-session course was revised, adding anxiety reduction strategies to the first four classes and reinforcing those strategies in the remaining eight classes. A multi-site study (N = 27) used repeated measures to determine whether the new 12-session course would significantly reduce anxiety. Ten course leaders were trained and taught the course six times at three different outpatient mental health sites. Three measures of anxiety were used. The 12-session course was found to significantly reduce anxiety after the first four classes with further reduction at the end of the course. Eighty-eight percent of course participants reported the course was moderately to extremely helpful. They also reported that being in a group with others with similar symptoms was valuable. Course leaders reported learning about the prevalence and importance of treating voice hearers' anxiety. [Journal of Psychosocial Nursing and Mental Health Services, 55(5), 29-39.].
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