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Deane A, Ellett L, Hayward M. A Psychoeducational Workshop for the Parents of Young Voice Hearers: A Preliminary Investigation into Acceptability and Outcomes in an NHS Child and Adolescent Mental Health Service. Clin Child Psychol Psychiatry 2024; 29:882-896. [PMID: 37276046 PMCID: PMC11188564 DOI: 10.1177/13591045231167969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Hearing voices is a common experience in young people and can be associated with distress, self-harm, and an increased risk of attempting suicide. Many parents lack confidence in supporting young people who are distressed by voices. However, there are currently no evidence-based interventions to support the parents of young voice hearers. METHOD This was an uncontrolled study exploring the preliminary acceptability and outcomes of a psychoeducation workshop for the parents of young people experiencing distressing voices within a Child and Adolescent Mental Health Service (CAMHS) in the UK's National Health Service. RESULTS A total of 21 parents consented to participate, 15 attended a workshop and 10 provided complete data sets. Five workshops were delivered across a seven-month period. Qualitative feedback was suggestive of acceptability and highlighted possible adaptations in relation to inclusivity, content focus and delivery format. Participants reported increased confidence and improved attitudes and beliefs towards voice hearing. CONCLUSIONS The findings from this study suggest that a psychoeducational workshop within a CAMHS context can be acceptable and helpful for parents of young people with distressing voice hearing experiences. Adaptations to the workshop are required to maximise inclusion, engagement, and outcomes.
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Affiliation(s)
- Annabelle Deane
- School of Psychology, Royal Holloway University of London, London, UK
| | - Lyn Ellett
- School of Psychology, University of Southampton, Southampton, UK
| | - Mark Hayward
- R&D Department, Sussex Education Centre, Sussex Partnership NHS Foundation Trust, Hove, UK
- School of Psychology, University of Sussex, Brighton, UK
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2
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Rodell S, Parry S. Family members' experiences of seeking help for a young person with symptoms associated with the psychosis spectrum: A narrative review and synthesis. Clin Child Psychol Psychiatry 2024; 29:897-912. [PMID: 37188330 PMCID: PMC11188561 DOI: 10.1177/13591045231176701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Young people often rely on family carers to access support for their mental health. However, stigma can be a barrier to help seeking for young people and families. Little research has been undertaken with young people who experience highly stigmatised symptoms, such as psychosis spectrum symptoms, and even less research has been conducted with parents and carers, meaning barriers to help go unchallenged. Therefore, this narrative review aimed to explore stories of family experiences of seeking help for young people with symptoms associated with the psychosis spectrum. Sources searched were PsycINFO and PubMed. Reference lists of the selected papers were also cross-checked to ensure the search had not missed potential papers for inclusion. Searches returned 139 results, of which 12 were identified for inclusion. A narrative analytic approach was adopted to synthesise qualitative findings to provide a nuanced interpretation of help-seeking experiences. The narrative synthesis provided an opportunity to identify differences, similarities, and patterns across the studies to tell a cumulative emancipatory narrative of family experiences of seeking help for psychosis spectrum symptoms. Help-seeking experiences had a relational impact on families, with stress adding to conflict and anxieties inhibiting hopefulness, although families could emerge stronger and assertively with compassionate support.
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Affiliation(s)
- Sadie Rodell
- Doctorate of Clinical Psychology, Lancaster University, Lancaster, United Kingdom
| | - Sarah Parry
- Division of Health Research, Lancaster University, Lancaster, LA1 4YW, United Kingdom
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3
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Branitsky A, Longden E, Bucci S, Morrison AP, Varese F. Group Cohesion and Necessary Adaptations in Online Hearing Voices Peer Support Groups: Qualitative Study With Group Facilitators. JMIR Form Res 2024; 8:e51694. [PMID: 38701439 PMCID: PMC11102034 DOI: 10.2196/51694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 02/23/2024] [Accepted: 03/07/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Face-to-face hearing voices peer support groups (HVGs), a survivor-led initiative that enables individuals who hear voices to engage with the support of peers, have a long-standing history in community settings. HVGs are premised on the notion that forming authentic, mutual relationships enables the exploration of one's voice hearing experiences and, in turn, reduces subjective distress. As such, group cohesion is assumed to be a central mechanism of change in HVGs. The rise of digital mental health support, coupled with the COVID-19 pandemic, has resulted in many HVGs adapting to online delivery. However, to date no studies have examined the implementation of these online groups and the adaptations necessary to foster cohesion. OBJECTIVE This study aims to understand the experience of group cohesion among HVG facilitators in online groups compared with face-to-face groups. Specifically, we examined the ways in which the medium through which groups run (online or face-to-face) impacts group cohesion and how facilitators adapted HVGs to foster group cohesion online. METHODS Semistructured qualitative interviews were conducted with 11 facilitators with varied experience of facilitating online and face-to-face HVGs. Data were analyzed using reflexive thematic analysis. RESULTS The findings are organized into 3 themes and associated subthemes: nonverbal challenges to cohesion (lack of differentiation, transitional space, inability to see the whole picture, and expressions of empathy); discursive challenges to cohesion (topic-based conversation and depth of disclosure); and necessary adaptations for online groups (fostering shared experience and using the unique context to demonstrate investment in others). Despite challenges in both the setting and content of online groups, facilitators felt that group cohesion was still possible to achieve online but that it had to be facilitated intentionally. CONCLUSIONS This study is the first to specifically investigate group cohesion in online HVGs. Participants noted numerous challenges to group cohesion when adapting groups to run online, including the unnaturally linear narrative flow of dialogue in online settings; lack of transitional spaces, and associated small talk before and after the session; ease of disengagement online; inhibited sharing; and absence of shared physical presence online. Although these challenges were significant, facilitators nevertheless emphasized that the benefits provided by the accessibility of online groups outweighed these challenges. Necessary adaptations for cultivating group cohesion online are outlined and include capitalizing on moments of humor and spontaneity, using group activities, encouraging information sharing between participants using the chat and screen-sharing features, and using objects from participants' environments to gain deeper insight into their subjective worlds.
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Affiliation(s)
- Alison Branitsky
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
- Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
- Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Eleanor Longden
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
- Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
- Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Sandra Bucci
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
- Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Anthony P Morrison
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
- Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Filippo Varese
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
- Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
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4
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Park SW, Lee NY, Jeong HY, Chung IW, Kim YS, Jeong SH. The Mediating Role of Anxiety/Depression Between Auditory Verbal Hallucinations and the Level of Insight in Schizophrenia. Psychiatry Investig 2024; 21:403-414. [PMID: 38695048 PMCID: PMC11065532 DOI: 10.30773/pi.2023.0396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/17/2024] [Accepted: 01/31/2024] [Indexed: 05/04/2024] Open
Abstract
OBJECTIVE Auditory verbal hallucination (AVH) is a prominent symptom of schizophrenia causing profound distress. The influence of AVHs on insight appears to be intricate and contingent on other accompanying symptoms. This study investigated the relationship and possible mediators between AVHs and the degree of insight. METHODS One hundred patients with schizophrenia participated in the study. Scales were used to evaluate the hallucinatory experience, the level of insight and other psychopathology. Complex relationships between variables were envisaged as a path model, whose initial structure was constructed via Gaussian Graphical Model. The validity of the final model was verified by Structural Equation Modeling. Separate analyses were performed for self-reported and clinician-rated data to enhance the model's robustness. RESULTS The greater the severity of the physical aspects of AVHs, the lower the level of insight observed. Conversely, higher emotional distress was associated with increased insight. These relationships were only evident in the self-reported results and were not reflected in the clinician-rated results. The path model suggested that the Positive and Negative Syndrome Scale (PANSS) anxiety/depression factor was an important mediator that linked the found association. Notably, the PANSS negative symptom had the opposite effect on the PANSS anxiety/depression factor and insight, making it difficult to define its overall effect. CONCLUSION The findings of this study provided one possible route for the positive influence of AVH experience in gaining insight. The mediating role of anxiety/depression modified by negative symptoms emerged as a valuable concept for clarifying this intricate relationship.
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Affiliation(s)
- Sang Won Park
- Inarae Psychiatry Clinic, Cheongju, Republic of Korea
| | - Nam Young Lee
- Department of Psychiatry, Dongguk University Ilsan Hospital, Dongguk University School of Medicine, Goyang, Republic of Korea
| | - Hee Yeon Jeong
- Department of Psychiatry, SNU SMG Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - In Won Chung
- Department of Psychiatry and Yong-In Psychiatric Institute Yong-In Mental Hospital, Yongin, Republic of Korea
| | - Yong Sik Kim
- Department of Psychiatry, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Republic of Korea
| | - Seong Hoon Jeong
- Department of Psychiatry, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Republic of Korea
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da Cunha Koch C, Coughlan H, Cannon M. Representations of hallucinations and dissociation in young adult literature: using literature to challenge stigma about psychosis. Ir J Psychol Med 2024; 41:125-131. [PMID: 36189612 DOI: 10.1017/ipm.2022.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
This paper explores the role that sensitively portrayed literary representations of hallucinations and dissociation may have in counteracting stigma associated with these experiences. In it, we focus on narratives of young people experiencing hallucinatory and dissociative phenomena in two award-winning, young adult novels: How It Feels to Float by Helena Fox and A Monster Calls by Patrick Ness. We identify and discuss three literary devices in these two novels that promote empathy for the characters and their experiences. The narrative accounts in both novels challenge conceptions of hallucinations and dissociation as unknowable and unrelatable experiences with their empathic portrayals of relatable characters that create comprehensible accounts of adolescents grappling with their sense of reality. Importantly, they highlight the potential role that literature can play in stigma reduction by positively shaping young peoples' understandings of unfamiliar mental health experiences.
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Affiliation(s)
- C da Cunha Koch
- Department of Psychiatry, RCSI University of Medicine and Health Sciences, Dublin 2, Ireland
| | - H Coughlan
- Department of Psychiatry, RCSI University of Medicine and Health Sciences, Dublin 2, Ireland
| | - M Cannon
- Department of Psychiatry, RCSI University of Medicine and Health Sciences, Dublin 2, Ireland
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6
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Radez J, Johns L, Waite F. Understanding unusual sensory experiences: a randomised experimental study of a school-based intervention for adolescents. Child Adolesc Ment Health 2024; 29:14-21. [PMID: 36959519 PMCID: PMC10877969 DOI: 10.1111/camh.12651] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/22/2023] [Indexed: 03/25/2023]
Abstract
BACKGROUND One in ten young people experience unusual sensory experiences (USE), such as hallucinations. From a cognitive perspective, the appraisal of USE determines the impact of these experiences. Negative appraisal, as well as other psychological processes (e.g. thinking flexibility, maladaptive schemas, anxiety/depression), is associated with more distress. Our aim was to (a) develop a universal single-session school-based intervention on USE for adolescents and (b) evaluate the effect of the intervention on appraisals of and help seeking intentions for USE. METHODS A randomised controlled experimental design with a one-month follow-up was used to test the effectiveness of the intervention in one school. Students (n = 223) aged 12-13 were randomised by class to a single-session intervention on USE or a control intervention (generic mental wellbeing). Participants completed measures of appraisals of and help-seeking intentions for USE at pre- and postintervention and at one-month follow-up. They also completed measures of schemas, thinking flexibility and anxiety/depression at preintervention. RESULTS Overall, 190 adolescents completed the main outcome measures at all three points. The intervention on USE led to a significant (p < .05) increase of positive appraisals of USE compared with the control, with effects sustained at one-month follow-up. The intervention on USE did not lead to significantly greater help-seeking intentions for USE (p = .26). Adolescents' schemas were associated with appraisals and slow thinking and anxiety/depressive symptoms with help-seeking behaviour for USE. CONCLUSIONS A single-session universal school-based intervention shows promise by improving appraisals of USE. Further research is required across different school populations.
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Affiliation(s)
- Jerica Radez
- Oxford Institute of Clinical Psychology Training and Research, Medical Sciences DivisionUniversity of OxfordOxfordUK
- Oxford Health NHS Foundation TrustOxfordUK
| | - Louise Johns
- Oxford Institute of Clinical Psychology Training and Research, Medical Sciences DivisionUniversity of OxfordOxfordUK
- Oxford Health NHS Foundation TrustOxfordUK
- Department of PsychiatryUniversity of OxfordOxfordUK
| | - Felicity Waite
- Oxford Health NHS Foundation TrustOxfordUK
- Department of PsychiatryUniversity of OxfordOxfordUK
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Mayer C, Dodgson G, Woods A, Alderson‐Day B. "Figuring out how to be normal": Exploring how young people and parents make sense of voice-hearing in the family context. Psychol Psychother 2022; 95:600-614. [PMID: 35049128 PMCID: PMC9303802 DOI: 10.1111/papt.12381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 12/17/2021] [Accepted: 01/04/2022] [Indexed: 01/05/2023]
Abstract
OBJECTIVES Making sense of voice-hearing-exploring the purpose, cause, and relationship with voices-is seen as therapeutically valuable for adults, but there is a paucity of research with adolescents. Family intervention is recommended for young people, yet little is known about families' perspectives on, or role in, a child's voice-hearing. This study therefore aimed to explore how both young people and parents had made sense of voice-hearing in the family context. METHOD Semi-structured interviews were conducted with seven young people who hear voices (six females, one male, age M = 17 years) and six parents of young people who hear voices (five females, one male). Data were analysed using interpretative phenomenological analysis. RESULTS The young people struggled to reconcile their voice-hearing experiences within themselves, wanted control, 'normality', and not to let their mental health hold them back. Parents saw the voices as separate to their child, who they were protective of, and came to an acceptance and hope for the future amidst continued uncertainty. Pragmatism, and shame, ran through parents' and young people's accounts. Tensions between them, such as autonomy versus involvement, were also apparent. CONCLUSIONS Few participants had made sense of their experiences in any concrete form, yet hope, control, and getting on with their lives were not conditional on having done so. Young people valued the family as a safe, non-enquiring space to be 'normal' and not to talk about their experiences. While all had been challenged by their experiences, an energy and strength ran through their accounts.
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Affiliation(s)
- Claire Mayer
- Department of PsychologyNewcastle UniversityNewcastle upon TyneUK,Cumbria, Northumberland, Tyne and Wear NHS Foundation TrustNewcastle upon TyneUK
| | - Guy Dodgson
- Cumbria, Northumberland, Tyne and Wear NHS Foundation TrustNewcastle upon TyneUK
| | - Angela Woods
- Institute for Medical Humanities, Pharmacy and HealthDurham UniversityDurhamUK
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8
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Burr C, Schnackenberg JK, Weidner F. Talk-based approaches to support people who are distressed by their experience of hearing voices: A scoping review. Front Psychiatry 2022; 13:983999. [PMID: 36299547 PMCID: PMC9589913 DOI: 10.3389/fpsyt.2022.983999] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/14/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The positive effects of both antipsychotic medication and cognitive behavioral therapy in psychosis (CBTp) for people who are distressed by their experience of hearing voices remain limited. As a result, there has been a recent surge in talk-based individual approaches. Many of these continue not to be very well known nor implemented in practice. Some of the approaches may focus more on understanding and dealing constructively with voices, an element that has been identified as potentially helpful by voice hearers. Existing barriers to a wider implementation include both the widespread pathologization of hearing voices and a lack of mental health professionals who have been trained and trusted to carry out these new interventions. METHODS This scoping review aimed to identify and describe a current synthesis of talk-based individual approaches for people who hear voices, including studies independently of method of study or approach, diagnosis of voice hearers nor of the professional background of interventionists. RESULTS Nine different talk-based approaches were identified. These included: (1) Cognitive Behavioral Therapy for Psychosis (CBTp); (2) AVATAR therapy; (3) Making Sense of Voices (MsV) aka Experience Focused Counselling (EFC); (4) Relating Therapy; (5) Acceptance and Commitment Therapy; (6) Smartphone-based Coping-focused Intervention; (7) Prolonged and Virtual Reality Exposure Therapy; (8) Eye Movement Desensitization and Reprocessing, and (9) Individual Mindfulness-based Program for Voice Hearing. The different approaches differed greatly in relation to the number of sessions, length of time offered and the scientific evidence on efficacy. Psychologists represented the main professional group of interventionists. CBTp and the MsV/EFC approach also included health professionals, like nurses, as implementers. Most of the approaches showed positive outcomes in relation to voice related distress levels. None identified overall or voice specific deteriorations. CONCLUSION There appears to be a strong case for the implementation of a broader heterogeneity of approaches in practice. This would also be in line with recommendations for recovery focused services and requirements of voice hearers. A greater emphasis on whole systems implementation and thus the involvement of frontline staff, like nurses, in the delivery of these approaches would likely reduce the research-practice implementation gap.
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Affiliation(s)
- Christian Burr
- Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland.,University Hospital of Psychiatry and Psychotherapy, University Hospital for Mental Health, Bern, Switzerland.,Faculty of Nursing Science, Vinzenz Pallotti University, Vallendar, Germany
| | | | - Frank Weidner
- Faculty of Nursing Science, Vinzenz Pallotti University, Vallendar, Germany
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9
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Ghelani A, Haywood A, Ye A. Listening to Voices: Helping Clients Examine the Meanings behind Auditory Verbal Hallucinations. HEALTH & SOCIAL WORK 2021; 46:75-78. [PMID: 33822078 DOI: 10.1093/hsw/hlaa035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 09/10/2020] [Indexed: 06/12/2023]
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10
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Parry S, Loren E, Varese F. Young people's narratives of hearing voices: Systemic influences and conceptual challenges. Clin Psychol Psychother 2020; 28:715-726. [PMID: 33201561 DOI: 10.1002/cpp.2532] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 10/24/2020] [Accepted: 10/26/2020] [Indexed: 12/16/2022]
Abstract
Despite the prevalence of voice hearing in childhood and adolescence, little qualitative research has been undertaken with young people directly to advance phenomenological and aetiological insights into their experiences and interpretations. Consequently, the researchers sought demographic, contextual, and qualitative data from 74 young people from eleven countries, aged 13-18 years (28% = male; 61% = female; 21% = Transgender and Gender Non-Binary [TGNB]), who self-identified as hearing voices. A Foucauldian-informed narrative analysis yielded four analytic chapters, offering novel perspectives into individual, relational, systemic, and cultural interpretative narratives surrounding multisensory and multi-self voice hearing. Overall, young people reported heterogenous experiences of voice hearing and associated sensory experiences, and most participants reported voice hearing beginning between ages 8 and 11. Further, the emotions felt by the child, as well as reactions displayed by people around the child in relation to the voices, influenced voice-related distress and the nature of the voices in a triadic relationship. A continuum of multisensory features of voice content, nature, and relational significance is tentatively proposed to capture the breadth and depth of voice hearing for adolescents to offer a possible framework for future study and intervention design. Specifically, participants described that voice-related distress could be exacerbated by observed anxiety or internalized stigma about voice hearing, social isolation, and attribution to illness. These findings suggest that we may need to reconsider how the experience of hearing voices in childhood influences their relationships and how relationships influence the voice hearing experience. Further, young people seem to have a broad understanding of what the term "hearing voices" means, which could inform how researchers and practitioners work with this group of young people. Finally, participants described benefitting from multisensory coping strategies, such as imagery and meditation, which could offer important considerations for tailoring therapeutic interventions for adolescent voice hearers.
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Affiliation(s)
- Sarah Parry
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
| | - Eve Loren
- Voice Collective, Mind in Camden Barnes House 9-15 Camden Road, London, NW1 9LQ, UK
| | - Filippo Varese
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
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11
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Maijer K, Staring T, Bartels-Velthuis AA, Palmen SJ, Sommer IE. Stronger than your voices: A cognitive behavioral therapy for youth suffering from auditory verbal hallucinations. Clin Child Psychol Psychiatry 2020; 25:386-400. [PMID: 31749371 DOI: 10.1177/1359104519888011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Auditory verbal hallucinations (AVHs) are a common feature in youth and mostly transient. Nevertheless, while present, AVH can cause considerable distress. Children and adolescents seeking help for distressing AVH represent a heterogeneous group in terms of underlying factors, yet they consistently suffer from their AVH. Until now, a youth-specific psychotherapeutic intervention for AVH was lacking. Experts in the field of treating AVH in both adults and youngsters collaborated with service users to develop the cognitive behavioral therapy (CBT) "Stronger Than Your Voices" (STYV). We investigated feasibility and clinical outcomes of the STYV therapy. METHODS Patients were derived from children and adolescents seeking help for AVH at the UMC Utrecht outpatient clinic with an indication for STYV therapy. Therapists preferably originated from referring health care facilities and were required to have sufficient general knowledge and experience with CBT. They received a short individual training to apply STYV. After, patients and their therapists could participate this naturalistic pilot study, assessing feasibility, tolerability, and clinical change when applying the STYV therapy. RESULTS Six participants (10-16 years old), all suffering from comorbid psychopathology, provided pre and post measures, all completing STYV therapy without experiencing an aggravation of symptoms. AVH total impact decreased 40% with Cohen's d within-group effect size (1.28) also suggesting clinically meaningful change. Therapists were positive about STYV therapy and manual. CONCLUSION The STYV therapy is feasible for youth with distressing AVH. First results indicate that STYV may be clinically effective. A trial to further test effectiveness in a larger sample is needed.
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Affiliation(s)
- Kim Maijer
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, The Netherlands.,De Bascule, The Netherlands
| | - Tonnie Staring
- Department for Transition Psychiatry and First Episode Psychosis, Altrecht Psychiatric Institute, The Netherlands
| | - Agna A Bartels-Velthuis
- Rob Giel Research Center, University Center for Psychiatry, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Saskia Jmc Palmen
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, The Netherlands
| | - Iris Ec Sommer
- Department of Neuroscience and Department of Psychiatry, University Medical Center Groningen, University of Groningen, The Netherlands.,Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Norway
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12
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Maijer K, Hayward M, Fernyhough C, Calkins ME, Debbané M, Jardri R, Kelleher I, Raballo A, Rammou A, Scott JG, Shinn AK, Steenhuis LA, Wolf DH, Bartels-Velthuis AA. Hallucinations in Children and Adolescents: An Updated Review and Practical Recommendations for Clinicians. Schizophr Bull 2019; 45:S5-S23. [PMID: 30715540 PMCID: PMC6357982 DOI: 10.1093/schbul/sby119] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Hallucinations in children and adolescents are now known to occur on a continuum from healthy to psychopathology-related phenomena. Although hallucinations in young populations are mostly transient, they can cause substantial distress. Despite hallucinations being widely investigated, research so far has had limited implications for clinical practice. The present article has 3 main aims: (1) to review research findings since 2014 (when the last major review of the area was published); (2) to present assessment tools validated to measure hallucinations in children and adolescents; and (3) to discuss therapeutic strategies and clinical issues. We conclude by presenting a tailored care model for clinicians and outline future challenges for research.
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Affiliation(s)
- Kim Maijer
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands,Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands,De Bascule, Amsterdam, the Netherlands,To whom correspondence should be addressed; University Medical Center Utrecht, Psychiatry department, HP A00.241, Heidelberglaan 100, 3485CX Utrecht, the Netherlands; tel: +31 88 7558180, fax: +31 88 755 54 43, e-mail:
| | - Mark Hayward
- School of Psychology, University of Sussex, Brighton, UK,Research & Development Department, Sussex Partnership NHS Foundation Trust, Hove, UK
| | | | - Monica E Calkins
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Martin Debbané
- Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland,Developmental NeuroImaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland,Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Renaud Jardri
- Univ Lille, CNRS UMR-9193, SCALab (PsyCHIC Team) & CHU Lille, CURE Platform, Fontan Hospital, Lille, France
| | - Ian Kelleher
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Andrea Raballo
- Division of Psychiatry, Clinical Psychology and Rehabilitation, Department of Medicine, University of Perugia, Perugia, Italy
| | - Aikaterini Rammou
- School of Psychology, University of Sussex, Brighton, UK,Research & Development Department, Sussex Partnership NHS Foundation Trust, Hove, UK
| | - James G Scott
- Centre for Clinical Research, Faculty of Medicine, University of Queensland, Herston, Australia,Metro North Mental Health, Herston, Australia,Queensland Centre for Mental Health Research, Wacol, Australia
| | - Ann K Shinn
- Psychotic Disorders Division, McLean Hospital, Belmont, MA,Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Laura A Steenhuis
- University of Groningen, Faculty of Behavioural and Social Sciences, Department of Clinical Psychology and Experimental Psychopathology, Groningen, the Netherlands
| | - Daniel H Wolf
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Agna A Bartels-Velthuis
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research center, Groningen, the Netherlands
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Gronholm PC, Thornicroft G, Laurens KR, Evans-Lacko S. Mental health-related stigma and pathways to care for people at risk of psychotic disorders or experiencing first-episode psychosis: a systematic review. Psychol Med 2017; 47:1867-1879. [PMID: 28196549 DOI: 10.1017/s0033291717000344] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Stigma associated with mental illness can delay or prevent help-seeking and service contact. Stigma-related influences on pathways to care in the early stages of psychotic disorders have not been systematically examined. METHOD This review systematically assessed findings from qualitative, quantitative and mixed-methods research studies on the relationship between stigma and pathways to care (i.e. processes associated with help-seeking and health service contact) among people experiencing first-episode psychosis or at clinically defined increased risk of developing psychotic disorder. Forty studies were identified through searches of electronic databases (CINAHL, EMBASE, Medline, PsycINFO, Sociological Abstracts) from 1996 to 2016, supplemented by reference searches and expert consultations. Data synthesis involved thematic analysis of qualitative findings, narrative synthesis of quantitative findings, and a meta-synthesis combining these results. RESULTS The meta-synthesis identified six themes in relation to stigma on pathways to care among the target population: 'sense of difference', 'characterizing difference negatively', 'negative reactions (anticipated and experienced)', 'strategies', 'lack of knowledge and understanding', and 'service-related factors'. This synthesis constitutes a comprehensive overview of the current evidence regarding stigma and pathways to care at early stages of psychotic disorders, and illustrates the complex manner in which stigma-related processes can influence help-seeking and service contact among first-episode psychosis and at-risk groups. CONCLUSIONS Our findings can serve as a foundation for future research in the area, and inform early intervention efforts and approaches to mitigate stigma-related concerns that currently influence recognition of early difficulties and contribute to delayed help-seeking and access to care.
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Affiliation(s)
- P C Gronholm
- Health Service and Population Research Department,Institute of Psychiatry, Psychology & Neuroscience, King's College London,London,UK
| | - G Thornicroft
- Health Service and Population Research Department,Institute of Psychiatry, Psychology & Neuroscience, King's College London,London,UK
| | - K R Laurens
- Department of Forensic and Neurodevelopmental Science,Institute of Psychiatry, Psychology & Neuroscience, King's College London,London,UK
| | - S Evans-Lacko
- Health Service and Population Research Department,Institute of Psychiatry, Psychology & Neuroscience, King's College London,London,UK
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Craig L, Cameron J, Longden E. Work-related experiences of people who hear voices: An occupational perspective. Br J Occup Ther 2017. [DOI: 10.1177/0308022617714749] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Lisa Craig
- Occupational Therapist, Sussex Partnership NHS Foundation Trust, UK
| | - Josh Cameron
- Principal Lecturer, School of Health Sciences, University of Brighton, UK
| | - Eleanor Longden
- Postdoctoral Service-User Research Manager, Psychosis Research Unit, Greater Manchester West Mental Health NHS Foundation Trust, UK
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Rácz J, Kaló Z, Kassai S, Kiss M, Pintér JN. The experience of voice hearing and the role of self-help group: An interpretative phenomenological analysis. Int J Soc Psychiatry 2017; 63:307-313. [PMID: 28347182 DOI: 10.1177/0020764017700926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Auditory verbal hallucinations (AVHs) played an important role in the psychiatric diagnostics, but in the last few decades the diagnostic-free complex phenomenological understanding of the phenomena of voice hearing became the focus of studies. MATERIALS Six semi-structured interviews with recovering voice hearers were conducted and analysed using interpretative phenomenological analysis (IPA). DISCUSSION The self-help group gives significant help in identification and dealing with the voices; therefore, it serves as turning point in the life story of voice hearers. CONCLUSION Applying self-help group in clinical context contributes to better outcomes in treatment of voice hearers.
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Affiliation(s)
- József Rácz
- 1 Institute of Psychology, Eötvös Loránd University, Budapest, Hungary.,2 Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
| | - Zsuzsa Kaló
- 1 Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Szilvia Kassai
- 1 Institute of Psychology, Eötvös Loránd University, Budapest, Hungary.,3 Doctoral School of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Márta Kiss
- 1 Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
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