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Current Groups in Gloucestershire



Groupwork for People with Psychosis: Gloucestershire Hearing Voices Groups

summary of the work

Introduction
Planning
Implementation
Outcomes
Comments by group members

Introduction

The conventional approach to voice hearing in psychosis is medication. However this is not fully successful as a treatment for at least 30% of sufferers. This project grew out of the need to provide additional support for people with psychosis and it was designed to be part of a long-term project to integrate social, medical and psychological approaches to psychosis.

The theoretical underpinning for the work was the stress vulnerability model, which sees the causes and course of psychosis as many and varied and that stress and trauma can both precipitate the onset and relapses. It is also believed that reducing stress, improving coping mechanisms and having faith in your own ability to work through and control psychosis can be protective against relapse and helps the process of recovering (see stress vulnerability model). Having belief in recovering from hopelessness and despair and valuing oneself is also very important (see information for professionals).

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Planning

The group work for psychosis project was begun in 1997 following a multi-disciplinary meeting led by Keith Coupland, Eric Davis & Vicky Macdougall. The long-term plan was to produce a coherent understandable approach to psychosis that drew users, carers and professionals together. It would help to exemplify close working between disciplines, organisations, users and carers

The Hearing Voices Network (HVN) based in Manchester, an organisation dedicated to self-help approaches, inspired the project. Ron Coleman of HVN gave us hope that the group would succeed. We wanted to extend the work to a service setting, using the strong evidence base of cognitive behavioural therapy for psychosis in individuals. It had been argued by Kanas (1988), that group work in a service setting, for people with psychosis is important because group members feel less loneliness, stigma, isolation & misunderstanding about psychiatric illness.

Support was gained from the local health authority by submitting a proposal to evaluate the group in a systematic way and the local research ethics committee reviewed the proposal. It was then passed through the clinical board of psychiatry and senior managers within social services in Gloucestershire. It was given full approval. However, no specific funds were made available to the group.

To secure funding the Barnwood House charitable trust in Gloucester was approached. Initially two trust members visited the team to hear about the project; it was at this point that it was decided to ask one of the users, Steve to explain the purpose of the group. He could really articulate and present what the true meaning of psychological work on voice hearing and what it would mean to sufferers and carer's, using their own experiences, in a group setting. The visitors from the Barnwood House Trust said, "it suddenly became clear what the work was about". As a result the group was awarded £5,000 and it was agreed that we would keep using the patients' expertise wherever we could.

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Implementation

It was felt that the best way to achieve this was a group activity where patients took an active part in the "transformational process", thus encouraging the patients to realise their expertise in their own condition. The target patient group was chosen to incorporate the more severe of the "severe mentally ill", those most distressed and disabled.

The first group meeting was held at the social services day centre, Milsom St., in Cheltenham. Each session lasted for one and half hours and was divided into two forty-five minute intervals with a coffee break in between; this was to allow for the concentration abilities of the patients. Each group would require two facilitators, and ideally each would be trained in psychosocial interventions for psychosis and skilled in groupwork (see information for professionals ). Their key role would be to facilitate the sharing of patients' expertise in coping in a safe group setting.

The sessions were initially planned for a block of twelve consecutive weeks. The first session set the ground rules for the facilitators & participants. The following sessions had a prescribed format that focused on education, information on psychosis and sharing coping mechanisms. Group members often agreed to work on issues at home depending on what arose during the sessions. In this initial period the group was evaluated with the support of a research assistant, Kate Edgar. She found that it took 24 weeks for signs of recovery to take place.

The groupwork format has been duplicated across Gloucestershire. Members of the hearing voices groups continue to provide education on the subject of hearing voices throughout the county and are generally available to give presentations. Highly successful conferences have been held, which focus on providing information and support to patients, carers and professionals alike. Now, in 2006, some of the groups still continue to operate, including two sperate groups for men and women which are based at Milsom Street.

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Outcomes

A picture of David, a group member, giving a cheque for £600 to Mental Health Nurse, Georgie, at Cirencester as a contribution to the hearing voices group. He earned the money by participating in a video that educational organisations had purchased
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Comments by group members


Some comments about the group at Milsom St. Cheltenham

Group Member 1

" I found the group extremely helpful. The information and education was particularly useful. I liked the social aspect - the mixing of ideas. The group helped me understand what was happening. It gave me an understanding of myself. I know now that the voices are actually within me- I mean they're not coming from outside, from things like Angels. The group was excellent because it taught me that there was nothing to be ashamed of with my mental illness and the voices. I am not alone. Everyone had a go at speaking- it was really fairly run."

Group Member 2

" It was an open and friendly group- I felt I wasn't the only one with problems. I learnt a lot. It was good not to have to bottle it up. I looked forward to every group. I liked the way the facilitators looked to my experiences because I've been through it- they wanted to hear my insight. I'm really pleased the group was available and I'm looking forward to it's starting again."

Group Member 3

" The group was really helpful. It helped me let out my feelings- it was really relaxing not to have to bottle things up. Discussing our problems helped me. Coming to the group made my anxiety much better. I was able to identify with others problems. I felt uneasy in the first session but after that I started to enjoy it- each session went really fast."

Group Member 4

"I really enjoyed the group, particularly realising that others were in the same position. It was enlightening to understand a bit about the voices and I am pleased I could contribute my poems. The group made me feel safe. I looked forward to every meeting."

In addition, the different group members used different techniques to help them to cope with their voices.

Skills used by group members to cope with the negative voices:
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