Tag Archives: voice-hearer

Birmingham City University – Recovery forum


We are planning to start a Recovery Forum at Birmingham City University.  In January I contributed a post about the Hearing Voices module that had been running throughout the autumn term.  The course gave students an introduction to the work of Marius Romme and Sandra Escher, whose work has inspired the Hearing Voices Network.  There are now over 170 Hearing Voices groups in the UK. 


The Hearing Voices module encourages participants to begin using Romme and Escher’s Maastricht Interview Schedule with service users.  The Maastricht Interview Schedule is not a quick assessment tool, but rather a way of helping people to talk about voice-hearing.  We also discussed ways that people have found to cope with problematic voice-hearing; and we talked about group work led by voice-hearers themselves, that has been shown to be effective in offering support, hope and meaning to people.   


The underlying premise of this work is that voice-hearing itself is not a problem which needs to be eliminated.  Many voice-hearers consider their voices to be positive, or at least an acceptable part of their experience.  Romme and Escher’s work helps people to talk about their voice-hearing experience, to accept that the voices are real – and may have meaning based on life experiences.  This respect for the experience of the person is at the heart of the recovery movement.


The recovery process according to the Mental Health Foundation 

  • provides a holistic view of mental illness that focuses on the person, not just their symptoms
  • believes recovery from severe mental illness is possible
  • is a journey rather than a destination
  • does not necessarily mean getting back to where you were before
  • happens in ‘fits and starts’ and, like life, has many ups and downs
  • calls for optimism and commitment from all concerned
  • is profoundly influenced by people’s expectations and attitudes
  • requires a well organised system of support from family, friends or professionals
  • requires services to embrace new and innovative ways of working

The recovery movement has been gaining strength within and outside of mental health services.   Many people with the recovery movement are challenging the traditional language and power structures of psychiatry – and the recovery model is as much user-led and influenced by professionals. 


In order to support those who have attended the Hearing Voices module to continue to work collaboratively with voice-hearers, and according to the recovery model we are setting up a Recovery Forum at Birmingham City University.  We anticipate the first session to take place in July 2009.  There will be more details to follow.  Members of university and trust staff with an interest in this area are also warmly invited to attend. 


Listening to Voices

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.