Exploring service users’ and practitioners’ priorities regarding outcomes of cognitive behavioural therapy for distressing voices: a thematic analysis

Abstract

ABSTRACT Background The outcomes of Cognitive Behavioural Therapy for distressing voices and their measurement have mostly been determined by professionals, with little focus on the outcomes that matter to people who hear voices. The aim of this qualitative study was to explore views about the outcomes of Cognitive Behavioural Therapy for distressing voices from the perspectives of lived and professional experience. Methods Fifteen service users and fourteen practitioners were recruited from mental health services. Semi-structured interview schedules were used to guide individual interviews with service users and focus groups with practitioners. All interviews were audio recorded and transcribed verbatim. Thematic analysis was applied to generate themes. Results Four themes were identified: “I want what I can’t have”, “Feeling empowered”, “Understanding and managing my emotions”, and “Doing more of what I want to do”. Two themes contained sub-themes. Discussion Valued outcomes by service users and practitioners appeared to reflect changes in voice characteristics, improvements in self-confidence and self-respect, acceptance of voices, understanding and managing emotions and personal outcomes. Findings suggest discrepancies between service users’ and practitioners’ priorities in regard to changes in voice characteristics and understanding and managing negative emotions. Recommendations include a greater focus on managing emotions by practitioners.