A tripartite relationship theory of voice hearing: a grounded theory study

Abstract

ABSTRACT Background Some people receiving mental healthcare experience distress related to voice hearing and the available support. Some practitioners lack knowledge and confidence in providing this support. Furthermore, coercion in mental healthcare can negatively affect voice hearer-practitioner relationships. Previous research investigating mental health distress, including voice hearing, has largely emphasised an individual-centric perspective. Less is known about voice hearers’ and practitioners’ relational experiences within mental healthcare contexts and how this might influence voice hearing. Methods This was a qualitative study that utilised a constructivist Grounded Theory methodology to explore the experiences of voice hearers (n = 15), through semi-structured interviews, and practitioners (n = 18) through focus group discussions (n = 3). Results A tripartite relationship theory situates experiences of voice hearing within a mental healthcare context, mediated through a tripartite voice hearer – voice – practitioner relationship. This consists of five themes: Level of agency; Interpersonal dynamic; Who’s making sense; Medication: helping or hindering; and Personal bully. Discussion This paper presents a novel theory, grounded in voice hearers’ and practitioners’ experiences. This expands on current knowledge about voice hearing by situating voice hearing experiences within relational and clinical contexts.