The experience of hearing voices has recently been conceptualized within a relational framework. Birtchnell's Relating Theory offers a framework capable of exploring the power and intimacy within the relationship between the hearer and the voice. However, measures of relationships with voices derived from the theory, such as the Hearer to Voice (HTV) and Voice to Hearer (VTH) by Vaughan and Fowler, have lacked robust psychometric properties. Data were available from 71 participants who completed the HTV and VTH, and analysis of these data generated a new 29-item measure, the Voice and You (VAY), capable of assessing the 'interrelating' between the hearer and the voice. The VAY was completed by a further 30 participants and was found to be internally consistent, stable over time and associated with other measures of the voice-hearing experience. The VAY offers a psychometrically stable measure of the relationship between the hearer and the voice. It may be used as an adjunct to the clinical interview and/or a measure of outcome.
This paper presents a series of cases to explore the development and value of a form of relating therapy for people who hear voices. The therapy is theoretically underpinned by Birtchnell's Relating Theory and offers a therapeutic space where hearers can explore and seek to change the relationship with their predominant voice. Five cases are presented to illustrate the processes of: (1) exploring similarities between relating to the voice and relating socially; (2) enhancing awareness of reciprocity with the voice-hearer relationship; and (3) using assertiveness training and empty chair work to facilitate change. Results were encouraging as change in control and/or distress was apparent for four of the cases. Changes in patterns of relating to voices were also apparent.
Approximately one in four adults in the UK will experience a mental health difficulty at some point in their life. This figure is approximately 400 million people worldwide.[1] Depression alone is currently estimated to cost the UK 1.7% of GDP and is one of the largest causes of ill health in the world.[2] For conditions like psychosis, evidence tells us that people have poorer quality of life outcomes, are more likely to die early, become obese, smoke, be unemployed, and have long term physical conditions than average.[3] People's social situation is also likely to be more complex, with housing needs, social isolation, stigma, and poverty.[4] All of these factors can make it hard for a person with a long-term mental health condition, or those supporting them, to hold onto a sense of hope that positive change is possible or that “recovery” towards a life that holds optimum meaning to them is achievable.An innovative “pop up” Recovery College model was co-produced, delivered, and evaluated by a team of people with lived experience of mental health difficulties, known as peer trainers. The Recovery College offered courses containing the best evidence-based knowledge about recovery in mental health, self-care and self-management. Each learning session included theory, personal testament from peer trainers, and volunteers and demonstrations of practical self-care skills and techniques.The courses were open to people experiencing mental health difficulties, their families, friends, and professionals. After the college course finished each student was offered up to three individual coaching sessions to help support putting the lessons learnt from the college into practice.The project aimed to test whether this innovative educational and coaching model could offer hope, knowledge and practical skills in self-management to support resilience and recovery. The project was underpinned by quality improvement methodologies to develop, deliver, and refine the model.
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