Response to Brophy (2017). Commentary on “Responding to the Needs of Voice Hearers and Expanding Access to Evidence-based and Innovative Psychosocial Interventions” (Gordon Kay, Elizabeth Kendall, & Frances Dark, 2017)

Abstract

We agree with Dr Brophy that evidence-based interventions need to be promoted and not replaced. However, as Dr Brophy has described, implementation of evidence-based interventions is variable. Access to cognitive behavioural therapy for psychosis (CBTp) in Australia is particularly problematic, meaning that many potential benefits are not realised. If CBTp is not being accessed, or is out of reach, then community-based interventions like a Hearing Voices Network (HVN) that integrate components of CBTp become even more important. HVNs can engage people who are not otherwise likely to engage or may not be able to access more evidence-based programs such as CBTp. HVNs might be useful in their ability to begin building therapeutic relationships and mobilising peer support that may then impact on recovery or on the individual's willingness to take part in other psychosocial interventions. In our view, the ideal arrangement is a complementary approach where HVN groups are available to support people before, during, and after CBTp. However, HVN groups should also be available for those people who do not find CBTp helpful or prefer to engage with peers to support their own recovery. As Dr Brophy points out, this approach could be mutually useful in that CBTp practitioners may recommend HVNs to people to support the work they are doing in CBTp, but elements of the HVN approach may also become more integrated into the mental health system (e.g., peer workers and recovery frameworks). We know this type of comprehensive approach may sound optimistic in the current economic climate of constrained health care resources, but innovative or creative social workers may find ways of capitalising on both approaches.