The hearing voices network: initial lessons and future directions for mental health professionals and Systems of Care (original) (raw)
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The hearing voices movement: Mental health advocacy and Recovery
2017
The Hearing Voices Movement (HVM)3, a survivor-led movement that began in the late 1980s, has grown into a worldwide phenomenon through a network of Hearing Voices support groups (HVN)4 that challenges current belief that auditory verbal hallucinations are sign and symptom of schizophrenia and best treated with lifelong medication management. This article describes the origins and history of the HVM, the philosophy that informs HVN support group work, and the HVM’s extraordinary growth, with a presence in 30 countries on six continents. The Connecticut, USA, experience is described and practical suggestions for forming HVN support groups are offered. The article concludes with a discussion of the future of the movement and a call for increased collaboration between the HVM and supportive mental health professionals to develop an evidence base for the efficacy of HVN support groups in treating those who experience auditory verbal hallucinations.
A review of hearing voices groups: Evidence and mechanisms of change
Clinical Psychology Review, 2011
As a heavily stigmatized group, voice hearers often value the chance to meet others with similar experiences. As a result, Hearing Voices Groups (HVGs) are becoming increasingly common in both inpatient and outpatient settings. Where resources are constrained, HVGs are frequently viewed as a desirable alternative to individual therapy and are often preferred by service users themselves. HVGs often vary in their content and structure, with four common approaches: CBT, skills-training, mindfulness and unstructured support groups. This review evaluates the evidence for HVGs and the mechanisms of change for successful interventions. CBT was the only approach with evidence from well-controlled studies. However, several evidence-based treatments share 'key ingredients' which evidence suggests help reduce distress. Successful groups supply a safe context for participants to share experiences, and enable dissemination of strategies for coping with voices as well as considering alternative beliefs about voices. Future research should focus on isolating mechanisms of change and predictors of outcome in order to refine HVG approaches, rather than polarizing them and setting them against one another in efficacy trials.
Emerging perspectives from the hearing voices movement: implications for research and practice
Schizophrenia bulletin, 2014
The international Hearing Voices Movement (HVM) is a prominent mental health service-user/survivor movement that promotes the needs and perspectives of experts by experience in the phenomenon of hearing voices (auditory verbal hallucinations). The main tenet of the HVM is the notion that hearing voices is a meaningful human experience, and in this article, we discuss the historical growth and influence of the HVM before considering the implications of its values for research and practice in relation to voicehearing. Among other recommendations, we suggest that the involvement of voice-hearers in research and a greater use of narrative and qualitative approaches are essential. Challenges for implementing user-led research are identified, and avenues for future developments are discussed.
Assessing the Impact and Effectiveness of Hearing Voices Network Self-Help Groups
Community Mental Health Journal
The Hearing Voices Network (HVN) is an influential service-user led organisation that promotes self-help as an important aspect of recovery. This study presents the first systematic assessment of the impact and effectiveness of HVN self-help groups. A customized 45-item questionnaire, the Hearing Voices Groups Survey, was sent to 62 groups affiliated with the English HVN. 101 responses were received. Group attendance was credited with a range of positive emotional, social and clinical outcomes. Aspects that were particularly valued included: opportunities to meet other voice hearers, provision of support that was unavailable elsewhere, and the group being a safe and confidential place to discuss difficult issues. Participants perceived HVN groups to facilitate recovery processes and to be an important resource for helping them cope with their experiences. Mental health professionals can use their expertise to support the successful running of these groups.
Although people who hear voices may dialogue with them, they are regularly caught in destructive communication patterns that disturb social functioning. This article presents an approach called Talking With Voices, derived from the theory and practice of Voice Dialogue (Stone & Stone, 1989: Embracing our selves: The voice dialogue training manual, New York: Nataraj Publishing), whereby a facilitator directly engages with the voice(s) in order to heighten awareness and understanding of voice characteristics. The method provides insight into the underlying reasons for voice emergence and origins, and can ultimately inspire a more productive relationship between hearer and voice(s). We discuss the rationale for the approach and provide guidance in applying it. Case examples are also presented.
Psychosis, 2016
Hearing Voices Network (HVN) support groups have proliferated in the last decade, with anecdotal evidence suggesting they contribute significantly to the recovery trajectory of the voice-hearer members who attend them. However, to date there remains little empirical research into the efficacy of these groups and the processes that might underpin their efficacy. This article describes a small project evaluating the HVN groups in the large Australian state of New South Wales. Twenty-nine group members completed questionnaires exploring self-reported recovery-related and clinical outcomes, aspects of group process, and the extent to which core HVN principles were promoted within the group. Results indicate that HVN groups are associated with reported improvements across a number of recovery-related outcomes including feeling less isolated and more skilled in being with others, having improved self-esteem, and having a better understanding of their voice experiences. Positive changes were also noted in outcomes that are more traditionally associated with clinical improvements, such as decreased need for emergency help and medication, and increased hope in personal recovery. Although this study is small and based on self-report, the findings are promising and contribute to the small but growing literature on peer-supported interventions for psychosis and psychotic-like experiences.
Changing Relationship with Voices: New Therapeutic Perspectives for
A growing body of research on verbal hallucinations shows the importance of beliefs about and relationships with the voices for their pathological course. In particular, beliefs about the omnipotence of the voices and the need to control them, and relationships with them that involve efforts to resist or fi ght them, have shown themselves to be more pathogenic than effective. Likewise, treatments aimed at eliminating the voices, be they based on medication or 'traditional' cognitive-behavioural therapy, have not always been successful. A series of strategies focused on changing relationships with the voices instead of trying to eliminate them-including mindfulness, acceptance, experiential role plays and re-authoring lives-is emerging as a new perspective for the treatment of hallucinations. All of these strategies are based on the person, not on the syndrome, which also represents a new conception of the problem, in a phenomenological-social perspective, alternative to the predominant medical conception.