Mental health
Mental health
Feature
Hearing voices can affect a person ’ s occupational performance , as it can be difficult to concentrate , people become distracted , and they experience frustration and loss of confidence .
Occupational participation is also affected , as people withdraw from activities and social environments , due to the negative impact of the voices they hear . This includes a fear of being judged , that the voice commands outcome , the consequence of threats made by the voices , and the fear of becoming upset or angry as a result of the voices .
These are all therefore barriers that prevent our clients from being able to engage in occupations and reach their goals .
With my new knowledge , I took the lead in facilitating a hearing voices workshop , which was attended by 14 people who hear voices . The evaluation forms they completed were extremely positive , which increased my confidence and belief that we , as mental health professionals , could do more to help them .
I set up a nine-week programme for people who hear voices , which I ran every Thursday afternoon with a Band 5 occupational therapist over the telephone . Using this approach , we were able to cover a wide area across Conwy and Denbighshire .
Other benefits included that if one of the occupational therapists was ill or on annual leave , the other could continue , while clients did not have to travel , which is problematic for many of them .
Our hearing voices programme
We receive referrals from consultant psychiatrists , community psychiatric nurses , occupational therapists and primary care staff . Ahead of starting the programme , each client is sent a pack that includes information about each session , an interest checklist , a diary and pen , artwork from people who hear voices and information on the support available .
The first session is called ‘ Voice profiling ’, and is an overview of what clients are experiencing . It covers what the voices say , what they may see , feel or taste , how it makes them feel , what they fear might happen , when it occurs and when it started .
We also ask if they can recognise meaning or connection to something in their life , the stresses they may be under and what helps .
The second session is focused on a person ’ s relationship with the voices . This is the area that appears most problematic , as those who tend to come into the mental health team have voices that are critical , derogatory , aggressive and nasty .
We explore different techniques they could try to work on the relationship , aiming to have a calmer , more respectful response , and increase understanding and being more compassion focused .
In this session we give the voice a name and engage in conversation to gain a deeper understanding of what they want or need – if our client feels ready for this , as the voice is a part of them .
We negotiate time to listen and time needed to be left alone , and discuss not believing everything the voices say – our clients are encouraged to look at the evidence .
We use this session to consider that angry voices may be coming from a place of fear or trauma and look at how to react neutrally to reduce the stress spiral .
We then provide a link to listen to a person who hears voices , who talks about her experience and how she worked with her voices and recovered .
Session three is where we provide each client with a diary and pen to start keeping a record of their voices , including when , where and what happened , to start identifying triggers and patterns to their voices . This can be helpful to increase understanding and avoid triggers where possible .
The session after this is all about diary feedback , where we explore any information gathered from keeping the diary and ask , can this information be useful to them to manage the voices more effectively ?
Session five is based on their use of activities . We cover what activities they are currently engaging in and the benefit of absorbing activities to focus attention away from distressing voices . We also look at creative release activities , such as art , poetry , music and drama , and use a hobbies and interest checklist to explore new activities .
In session six we explore their support network , fears in sharing their voice experience with others , and provide information on the Hearing Voices Network and the charity Intervoice , which aims to support the international hearing voices movement
Left : A client ’ s artwork ; Hearing voices felt like I was drowning
April 2024 OTnews 21