A qualitative study exploring how Practitioners within Early Intervention in Psychosis Services engage with Service Users’ experiences of voice hearing?

Abstract

Accessible Summary What is known on the subject? The experience of hearing distressing voices is commonly reported by service users with a diagnosis of first‐episode psychosis, but their access to formal conversations about voices in the form of psychological therapies can be limited. Service users within Early Intervention in Psychosis (EIP) services can benefit from informal opportunities to talk about their voice hearing experiences. However, they can be reluctant to engage with these conversations. Little is known about the experiences of EIP practitioners as they try to engage service users in conversations about their voices. What does the paper add to existing knowledge? Despite EIP Services specializing in the treatment of the symptoms of psychosis such as voice hearing, practitioners can still be reluctant to initiate and continue informal conversations about voices. What are the implications for practice? EIP practitioners may benefit from the introduction of interview guides and brief interventions to assist them with the initiation and continuation of conversations about voices. Abstract IntroductionHearing voices is a common and distressing symptom of first‐episode psychosis. Formal and informal conversations about voices are helpful, but service users within Early Intervention in Psychosis (EIP) Services can be reluctant to discuss their voice hearing experiences. There is currently no literature that explores the experiences of EIP practitioners as they try to facilitate conversations about distressing voices. Aim/QuestionA qualitative methodology was used to investigate how EIP practitioners work with service users who hear voices. Ten practitioners were interviewed, and interviews were analysed using template analysis. ResultsTwo themes that offer novel insights are presented: “starting a conversation about voices” and “continuing the conversation about voices.” DiscussionStarting and continuing a conversation about voices was considered important but not all practitioners were confident in this respect. The initiation and continuation of these conversations may need to be systematically supported. Implications for practiceTo support the initiation of informal conversations, a standardized interview guide for voice hearing could be introduced and systematically utilized. The continuation of these conversations could be supported by practitioners being given the opportunity to receive training in and the opportunity to deliver brief symptom‐specific therapies for distressing voices.

The feeling, embodiment and emotion of hallucinations in first episode psychosis: A prospective phenomenological visual-ecological study using novel multimodal unusual sensory experience (MUSE) maps

“…The utility of this study's methods in generating data on the sensory, emotional and embodied aspects of hallucinations, may have clinical and research implications for information gathering. Perhaps broader concepts and information gathering methods such as those used here (visual, ecological and prospective) may overcome some of the difficulties service-users and clinicians encounter when trying to talk about hallucinations [ 35 , 36 ].…”

Coping strategy enhancement for the treatment of distressing voices in young people: A service evaluation within routine clinical practice

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‘It’s like having a core belief that’s able to speak back to you’: Therapist accounts of dialoguing with auditory hallucinations

“…Indeed, in this regard, our findings suggest that several recommendations to enhance staff’s clinical confidence for supporting voice‐hearers within routine practice may also be applicable to psychologists who work directly with the voices themselves. In addition to the ‘greater subjective understanding’ that comes from involving service‐users in training (Kramarz, Lyles, Fisher, & Riches, 2020, p. 1), this also included the importance of supportive workplace cultures (White et al., 2019); providing standardized materials to help guide and structure one’s practice (Bogen‐Johnston, deVisser, Strauss, & Hayward, 2020); and access to appropriate training/supervision (McCluskey & de Vries, 2021), including reflective practice groups to help manage the work’s emotional impact (McMullan et al., 2018).…”