"No-one's ever asked me before": On Analysing subjective accounts of hearing voices and person- centred therapy

There has been considerable debate about the value of psychological therapies for voice hearers who suffer such distress that they seek psychiatric help. To date, however, the utility of person-centred therapy for this client group has not been investigated.

A convenience sample of ten participants who heard voices and had decided to start person-centred therapy was recruited from the researcher’s caseloads at a NHS mental health trust, an independent low-secure psychiatric unit and a counselling agency. On completion of their therapy, participants were interviewed about their experiences of therapy and of hearing voices. Data were analysed using a thematic approach informed by relational existential-phenomenological ideas. Brief consideration was also given to qualitative and quantitative outcomes.

Three themes were identified that referred to how participants recollected their experiences of voices before the therapy: i) An unwelcome intrusion; ii) “Feeling like a freak”; iii) Poignant yearning for things to be different. A fourth theme referred to participants’ accounts of their voices once that therapy had concluded: iv) Changing experiences, different views - sometimes.

Four themes related to their subjective experiences of person-centred therapy: i) Being treated like a person; ii) Being offered possibilities; iii) Forging a way through; iv) It’s not always just about the voices.

In general, participants gave positive accounts of person-centred therapy suggesting it could be a useful option for this client group. There was, however, some variation in response. Findings demonstrated the importance of engaging with individual voice hearer perspectives on their unusual experiences, and on what might alleviate their associated distress.

There was some evidence of reliable and clinically significant change which was explored in relation to qualitative findings. Issues around the use of symptom related measures to test effectiveness of therapy are discussed.

Some implications of this analysis for a person-centred understanding of the meaning of voice hearing are offered, with a focus on the potential for growth.

Limitations of the study relating to the dual therapist-researcher relationship and to the homogeneity and size of sample are discussed.