How do hearing voices peer-support groups work? A three-phase model of transformation

Abstract

ABSTRACT Despite decades of research and the development of many psychiatric medications, widespread suffering remains among people who hear voices. Hearing voices groups (HVGs) encourage an in-depth exploration of the meaning of voices and use peer support to develop coping strategies. Although HVGs continue to spread around the world, their effectiveness remains unknown and only a few studies have examined members’ experiences. To understand the mechanisms by which these groups operate, we recruited a diverse sample of 113 participants from across the US, who completed detailed qualitative questionnaires describing their voice-hearing histories, experiences in HVGs and changes in their lives outside the group. Asubset also participated in follow-up interviews. A collaborative team of researchers and voice hearers used phenomenological, grounded theory and thematic analyses to identify a distinctive set of elements that make HVGs unique: in their style of interaction (non-judgmental, curious, reciprocal and unstructured dialogue among people regarded as equals, in a shared community); and in the content of meetings (welcoming multiple perspectives and exploring coping strategies in non-prescriptive ways, with a focus on expertise by experience). We propose a three-phase model to explain how these elements interact within HVGs to enable significant transformation to occur.