King's College London

Research portal

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

Research output: Contribution to journalArticlepeer-review

Emilia Kramarz, Sophie Lyles, Helen Fisher, Simon Riches

Original languageEnglish
JournalPsychosis-Psychological social and integrative approaches
Early online date29 Jun 2020
Accepted/In press8 Jun 2020
E-pub ahead of print29 Jun 2020


  • Kramarz et al author accepted manuscript

    Kramarz_et_al_author_accepted_manuscript.docx, 75.3 KB, application/vnd.openxmlformats-officedocument.wordprocessingml.document

    Uploaded date:30 Jun 2020

    Version:Accepted author manuscript

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: A total of 18 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 the 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.

View graph of relations

© 2020 King's College London | Strand | London WC2R 2LS | England | United Kingdom | Tel +44 (0)20 7836 5454