Attitudes 2 voices: interactions between clinicians and voice hearers

Research has shown that voice hearers wish to discuss their voices, but often feel ashamed of disclosing their voice-hearing experience. Interactions with clinicians can be destigmatising, but unhelpful responses may exacerbate stigma.

A systematic review of qualitative studies used a thematic synthesis to explore voice hearers’ and clinicians’ perspectives on helpful and unhelpful care. A large-scale mixed-methods study explored clinician attitudes to voice hearers and self-reported responses in interactions.
Clinicians in both parts of the MRP reported difficulties working with voice hearers, including fears and a risk focus, frustration with dominance of the medical paradigm and a lack of availability of other approaches and lacking knowledge of helpful techniques. In addition to these frustrations, research reported that patients thought that unavailable services and coercive or paternalistic practices undermined trust.

Voice hearers and clinicians described helpful approaches, including hopefulness, honesty, empathy, respect and common ground, validation, psychoeducation and normalising. Supervision and reflective practice, values-based work and creativity helped clinicians cope. Training, personal experience with voice hearers and psychosocial professional training were associated with less stigma.
Recommendations include expansion of the peer role, increased staff support and specific voice hearing training, especially for staff in biomedical professions or support worker roles.