“When people hear distressing voices we need to talk to them about these experiences. What voices say often reflects core issues in people's lives and we need to pay attention to these issues. Over the past twenty years we've developed a number of psychological therapies to help people to respond differently to their voices. It's important that these therapies are available to as many patients as possible because they can reduce distress and enhance the quality of their lives by helping people to see themselves differently.” 
- Dr Mark Hayward


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 the 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 therapy

Most 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 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 the research that helped develop the therapy here.



Feedback from patients:

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:


  • Normalise voice-hearing 

  • Promote personal control over voices 
  • Encourage taking an active role in ensuring one’s own wellbeing 
  • Increase confidence to evaluate the accuracy of negative voice comments 
  • Encourage the acceptance of voices 
  • Positively impacts personal and work life

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

If a patient continues to experience distress after the coping therapy, and wants further help, they may be offered a further four sessions of individual therapy that helps patients to re-evaluate the beliefs they have about themselves and their voices.


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



Feedback from patients:


  • "My life has changed for the better"

  • "I can finally start to look at getting my life back and do the hobbies my voice has never let me do"

  • "I just ignore them now and get on with it…… they’re not going to go away"

  • "I didn’t know if I would stick to it because my voices make it difficult for me. I have trouble waking up early but I’ve only missed one session."

  • "Therapy was brilliant, it taught me a lot and I still use all that stuff now (6 months later)"

  • "Every session I walked out feeling better"

4. Feedback meeting

After a patient has completed therapy, whether this is after four or eight sessions, 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.

After therapy, most people report reduced levels of distress and improvements in recovery and wellbeing. When asked, 100% of people said they would recommend this service to friends and family.