Emerging Processes Within Peer-Support Hearing Voices Groups: A Qualitative Study in the Dutch Context

Schaefer, Barbara A.; Boumans, Jenny; Os, Jim van; Weeghel, Jaap van

doi:10.3389/fpsyt.2021.647969

Cited by 7 publications

(5 citation statements)

References 45 publications

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“…Our results add to this theory by suggesting that the environmental and social context facilitates PR by inducing feelings of inclusion and defying stigma. This latches on research emphasizing the importance of environmental factors in developing psychosis [e.g., ( 31 , 32 )], and the need for mental healthcare to address themes such as social participation, resilience, and the establishment of supportive therapeutic relationships ( 33 ). However, since PR is - in part - distinct from symptomatic recovery in some ways, the interplay between affect, PR, and symptomatic remission from psychosis within the context of Soteria is an interesting subject for future research.…”

Section: Discussionmentioning

confidence: 99%

Facilitating and hindering factors of personal recovery in the context of Soteria—A qualitative study among people with (early episode) psychosis

Leendertse

Hirzalla²,

Berg³

et al. 2023

Front. Psychiatry

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ObjectiveThe objective of this study was to gain insight into patients' experiences of how personal recovery (PR) is facilitated or hindered in the context of an early episode psychosis setting (Soteria). We thereby aimed to contribute to the understanding of how care settings may promote or hinder the process of PR in people with (acute) psychosis.MethodThis study used a qualitative method, consisting of semi-structured in-depth interviews with people who had been admitted to a Soteria house in the Netherlands. Interview transcripts were analyzed following the Grounded Theory approach.ResultsFive themes emerged from the data illustrating how Soteria facilitated or impeded PR. The experience of togetherness in contact with staff and peers, feeling at home, and being active facilitated PR, while the emphasis put on medication by staff was experienced as hindering, and attention to spirituality was missed.ConclusionIn addition to the literature that identified factors associated with PR in psychosis, the current study gives a sense of how this can be put into practice. By offering treatment within a normalizing, holding environment, with emphasis on equality, close contact, optimism, active structured days, open-mindedness toward spirituality, and the role of medication, PR can be facilitated without detracting from guideline-based treatment aimed at symptomatic recovery. Similarities with existing concepts are discussed.

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Section: Discussionmentioning

confidence: 99%

Facilitating and hindering factors of personal recovery in the context of Soteria—A qualitative study among people with (early episode) psychosis

Leendertse

Hirzalla²,

Berg³

et al. 2023

Front. Psychiatry

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“…Previous studies of US-based HV groups have involved qualitative interviews of group members (Hornstein et al, 2022) and a survey of group facilitators (Jones et al, 2015), largely outside of health services. Most literature on HV groups consists of smallscale cross-sectional studies and surveys of groups located both within and outside of health services, with most from the UK, Australia, and Netherlands (Branitsky et al, 2021;Schaefer et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

A pilot trial examining the effects of veteran voices and visions, an adaptation of hearing voices groups for a large public health system in the United States

Kalofonos,

Zito,

Fletcher

et al. 2023

Int J Soc Psychiatry

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Background: The Hearing Voices Approach, a community-based peer-led support group model, is generating interest as a novel way to engage with psychosis. Hearing Voices (HV) groups are run by peers, ‘experts-by-experience’, and emphasize group ownership and community-building rather than adherence to a therapist-led, predetermined structure. Diverse beliefs about experiences are respected and viewed as potentially meaningful. Groups work within each individual’s explanatory framework to reframe understandings. Aims: This paper describes the effects of participation in Veteran Voices and Visions (VVV) groups, an adaptation of the HV approach, co-led by clinicians and Veteran peer support specialists, adapted for Veterans who have experienced psychosis and receive care at the VA, a large public health system in the United States. Method: This mixed methods pilot study has a convergent parallel design, integrating quantitative and qualitative data from participants in pre-intervention and post-intervention assessments. Results: Over 16 weeks, quantitative analysis showed a statistically significant reduction in distress, due to auditory hallucinations, as measured by the Psychotic Symptom Rating Scales (PSYRATS). The Beliefs about Voices Questionnaire- Revised (BAVQ-R) results showed a reduction in malevolence and omnipotence and an increase in benevolence related to auditory hallucinations, but no change in resistance. Engagement showed a trend-level reduction. Qualitative data from midpoint (Week 8) and endpoint (Week 16) interviews revealed several perceived benefits from groups: 1) normalization and camaraderie, 2) increased hope and confidence, 3) self-understanding and reframing of experiences, and 4) building relationships outside of groups. Overall, VVV groups reduced distress due to voices, negative beliefs about voices, and perceived power of voices. Conclusions: Study findings contribute to a growing body of literature indicating HV groups support those who have experienced psychosis by reducing social isolation and fostering community, which may facilitate social integration. Overall, our findings highlight the potential benefits of adapting HV groups to health systems.

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“…This recovery movement has exerted significant influence, leading to its integration into mental health policies and influencing the design of mental health systems in various countries (96). In the Netherlands for example, the health care system for individuals with severe psychiatric disorders is increasingly shifting towards recovery-oriented care and social inclusion since the past decade (97,98). There is a growing emphasis on fostering contact with peers and promoting interaction with individuals who have lived experiences.…”

Section: Discussionmentioning

confidence: 99%

“…There is a growing emphasis on fostering contact with peers and promoting interaction with individuals who have lived experiences. Hearing Voices Groups and initiatives like @ease are examples of this focus (97,99).…”

Section: Discussionmentioning

confidence: 99%

“…The same seems to be the case with other phenomenological interventions for psychosis that focus on personal and social 165 recovery. For example, according to Schaefer et al(97), Dutch mental health practitioners seem to have difficulty referring voice-hearing individuals to Hearing Voices Groups due to the uncertainty about their evidence-based contributions to recovery and well-being. Hence, we recommend that future studies delve into the effects of traditional healing interventions and other recovery-oriented interventions by using a combination of subjective measures and evidence-based methodologies to fully recognise their therapeutic benefits.…”

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confidence: 99%

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Psychotic experiences: Gift or illness?

van der Zeijst

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Case vignetteLindiwe is a 32-year old woman of Zulu background who resides in Vulindlela, a rural area in KwaZulu-Natal, South Africa. She lives with her two teenage sons and eight family members in a house constructed from mud, cement and bricks with prepaid electricity, running water from a hose and an outdoor lavatory comprising a hole in the ground. Lindiwe is in a relationship with the father of her sons, but they live separately. She has completed her education up to the 11 th grade.At the age of 25, Lindiwe started hearing an unfamiliar voice that would give her instructions and could turn harsh if she failed to comply. She also began seeing a female person only visible to her, and felt as if she were being followed, causing anxiety and confusion. Lindiwe's condition worsened as she suffered from insomnia, isolation, weight loss and an inability to fulfil her daily responsibilities, including caring for her children. At night, she had vivid and prophetic dreams and visions. Lindiwe believed she was bewitched, while her family perceived her condition as 'madness' and took her to a general hospital. After a three week stay in the internal medicine ward and medication 'to get her mind straight' , her symptoms partially improved but did not entirely disappear. Lindiwe continued her medication at home. A few weeks after her hospital discharge, the persistent voice compelled her to walk to an unknown destination, leading her to Makhosi Bophela's house in a distant village. Makhosi Bophela, a traditional healer, revealed that her deceased grandmother, a former traditional healer, had been communicating with her all along. Her grandmother desired Lindiwe to inherit the gift of healing and 'called' her to become a traditional healer. According to Makhosi Bophela, following this calling was the only way to recover from her symptoms. Three months later, Lindiwe moved in with Makhosi Bophela, commencing her journey towards becoming a healer. She discontinued her hospital medication. After a while, her symptoms completely subsided, except for hearing her grandmother's voice. Lindiwe learned to positively value and control her contact with her grandmother through invoking her during certain rituals; for instance when diagnosing and treating patients as a healer: "I consult [my ancestor] on what to do, and she guides me and tells me which medicine I need to use for that particular case". The voice became integrated into a new role and was no longer causing distress. Two years later, at age 28, Lindiwe graduated as a traditional healer and returned to her children and family, who had supported her throughout this process. Over time, she became a successful healer with a high social standing in her village.This case vignette portrays a real-life scenario that lies at the heart of this thesis, embodying its core focus on culture, psychosis and South Africa. To establish a comprehensive context, the following introduction offers a general background to these topics and the research questions explored within this thesis.12 Ch...

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Emerging Processes Within Peer-Support Hearing Voices Groups: A Qualitative Study in the Dutch Context

Cited by 7 publications

References 45 publications

Facilitating and hindering factors of personal recovery in the context of Soteria—A qualitative study among people with (early episode) psychosis

Facilitating and hindering factors of personal recovery in the context of Soteria—A qualitative study among people with (early episode) psychosis

A pilot trial examining the effects of veteran voices and visions, an adaptation of hearing voices groups for a large public health system in the United States

Psychotic experiences: Gift or illness?

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