What happens in therapy?

It may not be possible to make voices go away for everybody who hears them but there are lots of ways to try and live well despite the continued presence of voices. This is why our therapy focuses on reducing the distress around voices, not reducing the voices themselves. 


We encourage patients in therapy to:

reacting to their voices – as this may not be helping.

QUESTION – their experience and assumptions:

Do voices have all the power and control?
Can voices make bad things happen?
Do voices speak the truth?
Do they have some control?

CHOOSE  how they want to respond, after they’ve taken a step back and re-evaluated some of their assumptions about themselves and their voice hearing experiences. 


1. Initial meeting

If a patient is referred to Sussex Voices Clinic, they will be invited to an initial meeting with one of our clinic assistants. The assistant will explore the patient’s voice hearing experience and well-being, to find out whether the clinic is right for them. The meeting will also involve the completion of a few questionnaires about the patient’s experiences.

This meeting is a chance for the patient to learn more about the clinic, if it is right for them, to consider any worries or fears that they may have, and to ask any questions.


If the clinic is right for the patient, one of the clinic assistants will contact them to arrange a course of therapy. If the clinic is not right for the patient at the present time, they will continue to receive your usual care from their clinical team.


2. Brief individual coping strategy enhancement therapy

Some of our patients coming into the clinic are initially offered four sessions of individual therapy using the principles of Coping Strategy Enhancement. This is one of the original forms of cognitive behavioural therapy and seeks to identify, adapt and systematically implement coping strategies from the patient’s existing range of strategies.
 They will also be offered access to the workbook that is used within the therapy.


They will meet with a therapist for one hour each week over the course of four weeks.

The therapy will help the patient to identify and use their helpful coping strategies as consistently as possible.


Read about the research that is helping to develop the therapy here.


Read about a service evaluation of the therapy for distressing voices in young people here 


Feedback from adults who have completed the intervention:

The first four sessions of therapy aim to encourage patients to begin a conversation about their voice hearing experiences. Feedback from patients indicates that having this conversation can be helpful:

  • “The fact that I can distract and challenge them.”
  • “Really good, talked a lot about coping and looking at what happens over a day. Work around doing more things just for you – taking photos of this. Start looking as this is the only time when voices are not there. Trying not to talk back to voices.”
  • “More practical things to distract: reading, cross-stitch, mosaic, art. Found all this really helpful. 'Gets lost' in books and can't hear the voice so much. Haven't self-harmed since starting the therapy. I was really happy with the clinic & what it has provided. The voice isn't as dominant as it used to be.”

Feedback from young people who have completed the intervention:

  • "It was good to share and open up … It was difficult at first to open up and talk about the voices, but it got a little easier and I kind of like got into it a bit".
  • "I am very satisfied with the therapy because it’s not usually something I would talk about with my therapist but it was nice to be able to get some stress off your shoulders".
  • One young person said their experience was positive, and that they felt comfortable talking to everyone in the Voices Clinic.
  • One young person said it was “difficult to unpackage everything that’s going on in my head” but that it was helpful in the end.




3. Guided Self-help Cognitive Behavioural Therapy (CBT) intervention for voices (GiVE)

Some patients coming into the clinic will be offered eight sessions of individual GiVE therapy which covers coping, re-evaluation of beliefs about self and voices, and relating assertively to the voices. 


This therapy is linked to the self-help book using CBT techniques, 'Overcoming Distressing Voices' (Mark Hayward, Clara Strauss and David Kingdon)

and guided by our published workbook, 'An introduction to self-help for distressing Voices' (Cassie Hazell, Mark Hayward, Clara Strauss and David Kingdon)


See a publication about the therapy here

See a publication about the patient experience of the therapy here



Feedback from patients:


  •  "I had difficulty opening up because I don't usually, but it got easier as the sessions went on"
  • "Very satisfied because it‘s not usually something I would talk about with my therapist. It was nice to get some stress off my shoulders"
  • "The therapy was really good, helped me to look at things differently and it was good to have the support from [therapist] to explore new avenues."
  • "Talking about it and looking at a CBT model was very helpful, [therapist] was excellent, she made me comfortable and she guided me gently into it."
  • "They helped a lot - made the voice not appear as much."
  • "The most helpful parts were the curious detective and role play. They made me see things from different angles which was refreshing. Normally I would say this is what voices are saying so it must be true. I realised they weren’t always right."



4. Relating Therapy

For some patients, we are able to offer an additional learning opportunity in the form of Relating Therapy.  This intervention was developed within Sussex Voices Clinic and can be offered over a maximum of 16 sessions by our highly trained therapists. Relating Therapy helps individuals to learn how to respond to voices in a different way – through being assertive. Assertiveness when relating to voices involves responding in an honest and respectful way; standing up for ourselves and any different views we may have, but doing this in a way that respects the views of voices. Within and beyond therapy, these assertiveness skills can be used to relate differently to people, as well as voices.

Read about the research that is helping to develop the therapy here 

Feedback from patients: 

  • "[I] feel much better equipped to deal with [the voices] if they return in the future"
  • "New found skill in being more assertive towards [the voices]."
  • "Learning how to "own [my] emotions"
  • "Since having done the Relating Therapy, [I have] been able to form more positive relationships, including [my] relationship with [my] mother."
  • "I realised that I’m strong. Stronger than what I thought I was. So that helped. "

Feedback meeting

After a patient has completed therapy they will be invited to meet with one of our clinic assistants again for a feedback meeting.

This meeting is similar to the initial meeting. The patient will be asked about any learning and progress that has been experienced, and asked to complete a few questionnaires about their voice hearing experiences and well-being.

In 2020, 95% of patients rated their overall experience of Sussex Voices Clinic as 8/10 or higher.