Service users' experience of voice hearing : the interface between the service user and the health care provider

There is an increasing body of literature to suggest that service users should be more involved in their care, and work more collaboratively with professionals within mental health services. One way of achieving this is for professionals to be more mindful of the experiences of voice hearers. The aims of the present study were to gain insight into the subjective experience of voice hearing and in particular, to explore this in relation to interactions between professionals and voice hearers. In depth interviews were conducted with six voice hearers. The resulting narratives were analysed using the qualitative methodology of grounded theory. A core category termed 'Reconstructing a sense of identity' was identified. This highlighted the different ways in which voice hearers attempted to assimilate the experience of hearing voices into their sense of identity. A process model was developed to describe the factors influencing the core category. Five main categories were identified in relation to this: 'being psychotic', 'disclosing information', 'receiving treatment', 'attempting to make sense of experience' and 'sense of self in relation to the psychiatric system'. The core category and the process model are discussed in relation to existing literature in this area. It is suggested that clinicians should focus greater attention on accessing and working within voice hearers' frames of reference in order to maximise positive outcome. The implications of the present study in terms of clinical practice and policy development are discussed. Finally, methodological considerations are explored and reflections on the research process are provided.