Making Sense of Voices: a case series

ABSTRACT

The current evidence-base for the psychological treatment of distressing voices indicates the need for further clinical development. The Maastricht approach (also known as Making Sense of Voices) is popular within sections of the Hearing Voices Movement, but its clinical effectiveness has not been systematically evaluated. The aim of the approach is to develop a better understanding of the role of the voice, in part through opening a dialogue between the voice hearer and the voice. The current study was a (N = 15) case series adopting a concurrent multiple baseline design. The Maastricht approach was offered for up to 9-months. The main outcome, weekly voice-related distress ratings, was not statistically significant during intervention or follow-up, although the effect size was in the moderate range. The PSYRATS Hallucination scale was associated with a large effect size both at the end of treatment, and after a 3-month follow-up period, although again the effect did not reach statistical significance. The results suggest further evaluation of the approach is warranted. However, given the large variance in individual participant outcome, it may be that a better understanding of response profiles is required before conducting a definitive randomised controlled trial.

KEYWORDS:

• Auditory hallucinations
• Experience Focussed Counselling
• voice dialogue
• talking with voices
• Making Sense of Voices

Acknowledgments

We would like to thank the other contributors to this research, both voice hearers and non voice-hearers. Specifically, Suzanne Engelen as one of our trainers in the MsV approach, Annie Beyer, Rachel Manser, Tim Walker, Ffion Jones, Megan Kerr and Kathy Greenwood. We would also like to thank the fifteen voice hearers who participated in the study, along with the staff of Berkshire Healthcare NHS Foundation Trust who facilitated the project.

Disclosure statement

No potential conflict of interest was reported by the authors.