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Staff Experience of Delivering Clinical Care on Acute Psychiatric Wards for Service Users who Hear Voices: A Qualitative Study

Research output: Contribution to journalArticle

Emilia Kramarz, Sophie Lyles, Helen Fisher, Simon Riches

Original languageEnglish
JournalPsychosis-Psychological social and integrative approaches
Early online date29 Jun 2020
Publication statusE-pub ahead of print - 29 Jun 2020

King's Authors


Background: Research indicates that clinical staff lack confidence in delivering clinical care for voice hearers. Understanding staff experience is therefore likely to benefit staff training.
Objective: To explore staff experience of delivering clinical care for voice hearers using qualitative methodology.
Method: Eighteen multidisciplinary staff from five acute psychiatric wards participated in brief semi-structured interviews. Interviews were analysed using thematic analysis.
Results: Six themes were identified. Participants reported Challenges of Understanding Subjective Experience (N=16) of hearing voices, Empathy for Distress (N=14) caused by voices, Curiosity about Experience (N=10) and wish to understand, Anxiety about Clinical Risk (N=8), especially regarding command hallucinations, Lack of Clinical Confidence (N=7) in how to respond, and Diversity of Voices (N=6) experienced by voice hearers.
Conclusion: Staff have empathy for voice hearers’ distress but feel they lack subjective understanding of what it feels like to hear voices. Lack of understanding, perceived clinical risks, and diversity of voices may be associated with reported lack of clinical confidence. Staff training that promotes greater subjective understanding has potential to improve therapeutic relationships, clinical confidence, and quality of care. Using simulation technologies and involving people with lived experience in staff training may be ways to improve subjective understanding.

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