Experiencing Psychosis: Personal and Professional Perspectives.

Hearing a voice in the absence of any speaker can be a significant feature of psychiatric illness, but is also increasingly acknowledged as an important aspect of everyday, non-pathological experience. This recognition has led to a growth of interest in voice-hearing in individuals without any psychiatric diagnosis, coupled with greater attention to the subjective experience of voice-hearing across diagnostic groups. Research has also focused on the overlap between some aspects of voice-hearing phenomenology and everyday experiences such as ‘hearing’ the voices of fictional characters and spiritual experience. In this Review, we synthesize research on the range of cognitive, neural, personal and sociocultural processes that contribute to voice-hearing as it occurs in clinical, non-clinical and everyday experience, with particular emphasis on linking mechanism to phenomenology. Heterogeneous forms of voice-hearing can be understood in terms of differing patterns of association among underlying mechanisms. We suggest an approach to hallucinatory experience that sees it as partly continuous with everyday inner experience, but which is critical regarding whether continuity of phenomenology across the clinical–non-clinical divide should be taken to entail continuity of mechanism. Hearing voices has long been associated with severe mental illness but also occurs in the general population. In this Review, Toh et al. describe the cognitive, neural, personal and sociocultural processes that contribute to voice-hearing in clinical, non-clinical and everyday experience, with emphasis on linking mechanism to phenomenology. 

http://dro.dur.ac.uk/37201/1/37201.pdf?DDC116+DDD27+vbdv77

Hearing voices as a feature of typical and psychopathological experience

Attention Training Technique and Acceptance and Commitment Therapy for Distressing auditory hallucinations: Two case examples

Despite decades of research and the development of many psychiatric medications, widespread suffering remains among people who hear voices. Hearing voices groups (HVGs) encourage an in-depth explor...

How do hearing voices peer-support groups work? A three-phase model of transformation

Introduction:
There is evidence that nurses do not routinely discuss voice-hearing experiences with mental health care consumers despite its importance for recovery-focused nursing practice. One way to address this shortcoming is the use of an experiential voice-hearing simulation workshop (VHS).
Aims:
The aims of the study were to: determine whether an experiential VHS increased nursing students’ empathy and self-efficacy to discuss consumers' experiences of voice-hearing immediately after the VHS and at six-month follow-up, and identify concerns students had about talking with consumers about their voice-hearing experiences.
Method:
A concurrent mixed methods study was undertaken with 370 final year nursing students who participated in a VHS workshop. Quantitative and qualitative data were collected from participants using a survey before and after the VHS, and at six-month follow-up. The survey instrument comprised demographic and other questions, a measure of empathy, a measure of self-efficacy to communicate, and open-ended questions related to the VHS experience. Additional qualitative data were collected via focus group three months post the VHS.
Results:
Analysis of the quantitative data revealed that nursing students’ confidence to talk about voice-hearing experiences increased significantly after participation in the VHS and at six-month follow-up, with empathy significantly increased at follow-up for: females, those in whom English was an additional language, for those whom had no prior nursing or other tertiary education qualification, and those whose family members did not have a mental illness. Prior to the VHS the participants expressed concerns about interacting with consumers who hear voices. After the VHS they reported increased awareness of the effects of voice-hearing, less concerns about consumers who hear voices, and increased feelings of empathy for them. Further, the students expressed increased confidence to talk with consumers about their voice-hearing experiences, with many practicing this during their mental health clinical placements.
Discussion and Conclusion:
The use of experiential learning principles contributed to development of the participants’ understanding of voice-hearing and its effects on consumers. The level of realism of the simulation experience aroused emotions in the participants and contributed to their development of empathy and confidence when interacting with consumers who hear voices. This study identified the need for the further development of communication skills, specifically addressing consumers’ voice-hearing experiences. This study highlights the utility of VHS to increase and sustain nursing students’ empathy for, and confidence to communicate with, consumers who hear voices, and it is recommended for the educational preparation of all health professions students.

/pdf/i-know-how-it-feels-a-voice-hearing-simulation-to-enhance-ny7hrcsqq8.pdf

I know how it feels : a voice-hearing simulation to enhance nursing students' empathy and self-efficacy

For more than two decades, the Hearing Voices Network (HVN) has provided alternative approaches to supporting voice hearers, and an emerging body of research is now confirming their value. HVN approaches present unique opportunities and challenges for mental health professionals and systems of care that work with individuals who hear voices. An overview of the HVN is presented, including its history, principles and approaches. HVN approaches are compared and contrasted with traditional mental health treatments. HVN's potential contribution to the transformation of mental health care is discussed. Directions for future research are presented.

The hearing voices network: initial lessons and future directions for mental health professionals and Systems of Care.

Building the mental health workforce and creating interest in the next generation for working in community mental health settings is a key priority for recovery-oriented practice, the organizing principle for community mental health care. There is a need for behavioral health professionals interested in working with underserved populations, and providing experiences with these populations early in the career trajectory [1]. Workforce development is an even greater focus with passage of health parity laws and the affordable care act, especially as close to one in five Americans experiences a mental illness [2]. There is a need to prime the pipeline with people interested in working in community mental health [3] and to create excitement at the undergraduate level. Opportunities to gain practical experience in mental health settings are limited, but the call for providing early exposure to behavioral health career paths is clear [4].

Lauren Utter

Papers

The hearing voices network: initial lessons and future directions for mental health professionals and Systems of Care.

A Foot in the Door: Development of a Summer College Student Internship in Community Mental Health.