Coping with Auditory Hallucinations Worksheet

Use our Coping with Auditory Hallucinations Worksheet to help your patients manage and differentiate real sensations from hallucinations effectively.

By Karina Jimenea on May 15, 2024.

Fact Checked by Nate Lacson.

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What are auditory hallucinations?

Auditory hallucinations are perceptions of sounds, voices, or noises that occur without any external stimulus. These cognitive distortions are experienced as real by the person hearing them, even though they are not actually present in the environment. It is possible that people hear voices speaking to them or about them, music, noises, or other sounds that others cannot hear when they are having auditory hallucinations.

Auditory hallucinations are a common symptom in various mental health conditions, particularly in schizophrenia, bipolar disorder, and severe depression. Understanding the nature and types of these hallucinations is crucial for mental health professionals to provide appropriate treatment and support.

Types of auditory hallucinations

Auditory hallucinations can vary in their content and presentation. Here are some common types:

  • Voices conversing: Individuals may hear two or more voices engaging in a conversation, often discussing the person's thoughts or actions.
  • Command hallucinations: These involve hearing voices that instruct the individual to perform specific, often harmful, actions.
  • Commentary hallucinations: Voices provide a running commentary on the person's thoughts or behaviors, as if narrating their actions.
  • Musical hallucinations: People hear music, songs, or melodies that are not actually playing in the environment.

These types of hallucinations can significantly impact a person's daily life and well-being.

Possible causes

The causes of auditory hallucinations are diverse and can be linked to various factors, including psychological medicine, neurological conditions, and substance use. Here are some of the most common factors:

  • Mental health disorders: Conditions like schizophrenia, bipolar disorder, and major depressive disorder are commonly associated with auditory hallucinations.
  • Neurological conditions: Issues such as epilepsy, brain tumors, and dementia can lead to hallucinations.
  • Substance use: Withdrawal from alcohol or drugs, as well as intoxication, can trigger hallucinations.
  • Medications: Certain medications may have side effects that include hallucinations.
  • Sleep deprivation: Lack of sleep can lead to hallucinations in some individuals.
  • Stress and trauma: Experiencing severe stress or traumatic events can sometimes result in hallucinations.

Identifying the underlying cause is essential for effectively managing and treating auditory hallucinations. In the next section, we will explore coping strategies to help individuals manage these challenging experiences.

Printable Coping with Auditory Hallucinations Worksheet

Download this Coping with Auditory Hallucinations Worksheet to help individuals gain control over their experiences and improve their quality of life.

Coping strategies for auditory hallucinations

Managing auditory hallucinations can be challenging, but there are several coping mechanisms and strategies that individuals can use to reduce their impact. These strategies can help individuals gain control over their experiences and improve their quality of life.

Identifying the hallucinations

The first step in coping with auditory hallucinations is to recognize and acknowledge them as hallucinations. This involves being mindful of when and where the hallucinations occur, as well as what sounds or voices are heard. By identifying these details, individuals can start to understand their triggers and patterns.

Sensory grounding

Sensory grounding involves focusing on physical sensations to anchor oneself in the present moment. This strategy helps to redirect attention away from the hallucinations and towards the external environment. For example, an individual might concentrate on the feeling of their feet on the ground or the texture of an object they are holding.


Differentiating between real sensations and hallucinations is crucial. Individuals can practice comparing their sensory experiences with the hallucinations, noting how they differ in terms of clarity, volume, and emotional impact. This can help them distinguish between what is real and what is a product of the hallucinations.


Engaging in activities that distract from the hallucinations can be beneficial. This might include listening to music, watching a movie, drawing, playing games, or any other activity that requires focus and attention. Distraction can provide a temporary break from the intensity of the hallucinations, especially if the activity requires deep focus or is extremely enjoyable.

Reality testing

Reality testing is a cognitive strategy that involves questioning the validity of the hallucinations and seeking evidence that supports or contradicts their content. This strategy helps individuals recognize that the voices or sounds are not based in reality. For instance, they might ask themselves, "Is there any proof that these sounds are real?" or "Have others heard these sounds too?"

Relaxation techniques

Practicing relaxation techniques such as deep breathing, meditation, or progressive muscle relaxation can help reduce stress and anxiety, which may in turn decrease the frequency or intensity of the hallucinations.

Seeking support

Building a support network and developing a relapse prevention planning are essential for individuals coping with auditory hallucinations. This can include mental health professionals, support groups, and loved ones who can provide understanding, encouragement, and practical assistance.

Cognitive restructuring

Cognitive restructuring involves challenging and changing unhelpful beliefs or thoughts related to the hallucinations. It's a way of modifying the cognitive aspect of the experience, which can influence the emotional response to the hallucinations. For example, if an individual believes that the voices have power over them, they can work on developing a more empowering belief, such as "I have control over my reactions to these voices."

Mindfulness and acceptance

Mindfulness and acceptance involve observing the hallucinations without judgment or fear, accepting the experience as it is, without trying to fight or suppress it. This approach is different from relaxation techniques, which focus on reducing physical tension and calming the mind. Mindfulness is about being present with whatever is happening, including the hallucinations.

By employing these coping strategies, individuals can develop a toolkit for managing their auditory hallucinations and enhancing their overall well-being.

How to use this template

Our printable Coping with Auditory Hallucinations Worksheet is designed to help mental health professionals guide their clients through managing auditory hallucinations. Here's a step-by-step guide on how to use the template:

Step 1: Access the template

The first step is for mental health professionals to access or download the "Coping with Auditory Hallucinations Worksheet" from Carepatron. Ensure you have a copy ready for use during your session with the client.

Step 2: Explain the worksheet to the client

Before the client begins filling out the worksheet, take the time to explain each section and its purpose. This ensures that the client understands the requested information and how it will be used to manage their symptoms.

Step 3: Guide the client through the worksheet

Work through the worksheet with the client, providing support and advice as they fill out each section, and emphasize the importance of early intervention for managing symptoms effectively. This can be done during a therapy session or by providing instructions for the client to complete the worksheet independently before discussing it together in the next session.

Step 4: Assess the responses and develop a plan

Once the client has completed the worksheet, review their responses together. Use this information to assess their coping strategies and develop a personalized treatment plan. This may involve refining existing strategies, introducing new techniques, or exploring additional therapeutic options.

By following these steps, mental health professionals can effectively use the worksheet to support clients in managing their auditory hallucinations and improving their overall well-being. This template works best when combined with a Hallucination Diary and the Auditory Vocal Hallucination Rating Scale.

Coping with Auditory Hallucinations Worksheet example (sample)

To provide mental health professionals with a practical tool for assisting clients who experience auditory hallucinations, Carepatron has created a sample Coping with Auditory Hallucinations Worksheet. This template includes fictitious information to illustrate how it can be used in a clinical setting. The worksheet is structured to help clients identify their hallucinations, ground themselves in reality, and develop effective coping strategies.

Download this free Coping with Auditory Hallucinations Worksheet example here.

Coping with Auditory Hallucinations Worksheet example (sample)

Clinical interventions and treatment

Managing auditory hallucinations often requires a comprehensive treatment plan that includes both pharmacological and non-pharmacological approaches. Here are some key clinical interventions and treatment options for individuals experiencing auditory hallucinations:


Antipsychotic medications are commonly prescribed to help reduce the intensity and frequency of auditory hallucinations. These medications work by targeting neurotransmitter systems in the brain and can be effective in psychosis treatment and management. Still, it's important to monitor potential side effects such as weight gain

Cognitive behavioral therapy (CBT)

CBT is a widely used therapeutic approach that helps individuals understand the relationship between their thoughts, feelings, and behaviors. In the context of auditory hallucinations, CBT can assist clients in challenging and changing unhelpful beliefs associated with their experiences.


Educating individuals about their condition can empower them to better understand and cope with their symptoms. Psychoeducation can provide insight into the nature of auditory hallucinations and offer strategies for managing them effectively. It also assists in personal development.

Family therapy

Involving family members in the treatment process can provide additional support for the individual and help family members understand the challenges associated with auditory hallucinations. Family therapy can improve communication and coping strategies within the family unit.

Support groups

Participating in peer support groups or group therapy can offer individuals a sense of community and an opportunity to share experiences and coping strategies with others who have similar experiences.

Art and music therapy

Engaging in creative activities such as art and music therapy sessions can provide a therapeutic outlet for expression and help individuals process the emotions associated with auditory hallucinations.

How do you respond to auditory hallucinations?
How do you respond to auditory hallucinations?

Commonly asked questions

How do you respond to auditory hallucinations?

To respond to auditory hallucinations, it's important to stay calm, practice grounding techniques, and use coping strategies like reality testing or distraction to manage the experience.

How to avoid hallucinations?

Avoiding hallucinations involves managing stress, adhering to prescribed medication regimens, maintaining a regular sleep schedule, and avoiding substances that can trigger hallucinations.

What can trigger hallucinations?

Hallucinations can be triggered by stress, sleep deprivation, substance use, mental health disorders like schizophrenia, and certain medical conditions such as epilepsy or brain tumors.

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