We have just finished teaching the Hearing Voices Module for post registration nurses, which can be taken as part of the ‘top-up’ to a degree qualification, or as a stand-alone course. We felt privileged to have a very keen cohort of students made up of CPNs, OTs, staff nurses, and support workers, many of whom have considerable experience in working in mental health.
The course is centred on Romme and Escher’s way of working with people who hear voices, Making Sense of Voices (2000). In their early work Romme and Escher highlighted the considerable number of people who hear voices who never come into contact with mental health services. They posited that voice-hearing in itself is not problematic. In their work with people who are distressed by hearing voices Romme and Escher attempt explore whether there are any links between the personality of the voice and the content of what is heard; and incidents of trauma in the life of the voice-hearer. They developed the Maastricht Interview Schedule to help voice-hearers to make these sorts of connections.
The Maastricht Interview Schedule is not an inventory or rating scale, but rather a series of pointers for the helper and the voice-hearer to use together at a pace which suits the voice-hearer. The questions need to be asked with care and sensitivity as they explore the nature of the experience, the personal history of voice-hearing and the childhood experiences of the voice-hearer. At first glance it looks like a daunting piece of work to undertake, however we were very pleased to see each of the students begin to use the Maastricht Interview Schedule in their day to day work with clients.
Students on the course shared how they felt, as they were beginning to work in this way – either with individuals or in setting up voice-hearing groups. Students gained confidence, and could see how powerful this way of working could be in their own practice. We heard that service-users said they felt they were being given the opportunity to talk about their experiences in a way that had not been possible before. The ‘normalising’ of the experience of voice-hearing seemed to be very helpful for many of the clients; and the formulation of a construct to help to explain the origin and meaning of the voices was felt to be very important in redressing the balance of power in the relationship between the voice-hearer and their voices.
We are hoping that part of our role, which includes an honorary contract with the mental health trust, will be to support those who have attended the course to implement this way of working wherever possible. I look forward to seeing this way of working used more widely.