The Formation and Maintenance of Causal Beliefs around Voice-Hearing, within Hearing Voices Network Groups

Background:
Understanding how acceptable casual beliefs for voice-hearing are formed is relevant to voice-hearers and clinicians due to the apparent impact of causal beliefs on outcome, and the dissonance between views held by clinicians and voice-hearers. Previous research has highlighted social sense-making as a potentially important factor in forming causal attributions for voice-hearing.
This study posed the following questions:
1. How is shared sense-making involved in developing causal models (including in Hearing Voices Network groups (HVGs))?
2. How do voice-hearers navigate multiple potential models?
Method:
10 participants self-identified as voice-hearers, had attended at least three Hearing Voices Network group sessions, and were UK residents. Semi-structured interviews were analysed using reflexive Thematic Analysis.
Results:
Nine themes were developed, encompassing construction and evolution of explanatory models for voice-hearing (seven themes, six with subthemes); and the role of HVGs in the sense-making process (two themes, both with subthemes).
Conclusions:
This thesis develops understanding of how explanatory models are evaluated by voice-hearers (through weighing up costs and benefits, and appraising different forms of evidence including qualitative aspects of the voices themselves) and how this leads to shifts between preferred explanatory models, with novel insights into the accommodation of multiple explanatory models for different voice-hearing experiences. Social sense-making is enhanced by the HVGs, with important qualities including commonality, authenticity, understanding, and non-judgement, and the freedom to talk about voices without external pressure.