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Hearing Voices: Basic Technique

  1. Empathise with the person's main problem - lack of control? Hurtful things being said? Unable to concentrate? What behaviour results from the voice hearing? Assess risks.

  2. Build up rapport that is based on valuing the person's experiences, finding meaning in the experience, helping the person gain control and lessen any damaging behaviour that is a consequence of hearing the voices.

  3. Carefully monitor medication and liaise closely with GP and Consultant Psychiatrist, as well as the voice hearer and their carers, to find the least medication with the least side effects, that reduces distress even if it does not remove the voices.

  4. Seek agreement with everyone involved that keeping a diary and autobiography may be beneficial'

  5. Ask person to start the autobiography, or timeline with special emphasis on when and how the voices started (this needs to be done carefully to support the person if early traumatic experiences are remembered).

  6. Identify the voices - do they have names? Are they distinct personalities? Are they connected to any person that the patient knew? A daily diary is useful.

  7. When do the voices start, for how long, what makes them louder, quieter?

  8. What is the content of what the voices say?

  9. Is there any positive value in the form or content of the voices? Are there positive voices? Can you and the patient change anything the voices say to something of positive value?

  10. Can the voice hearer turn the voices on? How?

  11. Can the voice hearer patient turn the voices off? How?

  12. Can the voice hearer make the voices louder? How?

  13. Can the voice hearer make the voices quieter? How?

  14. How can the content of the voices be challenged?

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Produced by Eric Davis and Keith Coupland