Despite hearing voices affecting a person ’ s occupations and performance , the only current intervention I could see ... appeared to be medication , with the aim of eliminating the voices , which is not always successful .”
Despite hearing voices affecting a person ’ s occupations and performance , the only current intervention I could see ... appeared to be medication , with the aim of eliminating the voices , which is not always successful .”
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It is known that the more stressed or anxious a person is , the worse the voices they hear become , that is , louder and more aggressive . In session seven , we learn about how to reduce stress and anxiety , which can be beneficial , and we cover stress triggers , relaxation exercises , relaxed breathing , activities and environments that promote relaxation .
The penultimate session is focused on health and wellbeing . A major topic is sleep management , as most people who hear voices complain that the voices are worse at night , as there are no distractions , and therefore they can feel louder and more intense .
We explore ways to manage this , both activities and environmental , and we provide an information sheet created by the hearing voices movement . We also cover diet and exercise , with further information provided in the pack .
The ninth and final session is where there is an opportunity for people to meet others who hear voices from the programme . So many clients identify feeling alone with their voices and often refrain from telling others , fearing a negative response .
We therefore offer the opportunity for everyone on this programme , who want to , to meet the other voice hearers to come together for the final session , as a means of reducing isolation and providing mutual support in a safe space . This is held in a mental health team base and run by two occupational therapists .
Evaluation and feedback
All clients completed an evaluation form , to enable us to adapt and improve the programme following their feedback . So far , everyone has given us positive feedback , with the sessions they have found most helpful being working on the relationship with the voices and use of activities as a means of absorbing the mind away from the voices and as a creative release .
No one identified a ‘ least helpful ’ session , with everyone saying all sessions had been of benefit in different ways . One participant said that , following the programme , they felt less scared , more in control and had more techniques to manage their voice .
This client said they were no longer checking their wardrobe for their voice , and they were now able to use the bus to go to the gym and swimming and their social life had improved .
Three participants suggested ways we could improve the programme , including to finish sessions with a message of hope , that the sessions could go on for longer , and that we might cover how to help family members as well .
I also liaise with psychology staff regarding those clients who realise that past trauma is the root of their voices , for if they want to work on this .
The way ahead
Having had such positive evaluation forms from clients involved in the first set of sessions , it has inspired me to run the programme again , and 14 new referrals have already been received .
I am developing my knowledge and skills to help clients with working on their relationship with their voices , including attending the virtual Intervoice World Hearing Voices Day in October last year , which increased my knowledge of what is happening in this field around the world , with latest research and developments .
I am also planning to map out where the support groups are in or near North Wales , to inform our clients , as well as exploring the idea of making a display of voice hearers sharing their stories through art .
Finally , I am training new occupational therapy staff in how to work with people who hear voices .
Words NIA WILLIAMS , Band 6 Occupational Therapist , Conwy and Denbighshire Community Mental Health Teams , Betsi Cadwaladr University Health Board Trust , email nia . a . williams @ wales . nhs . uk
22 OTnews April 2024