‘In the same boat, helping each other’: a grounded theory of growth and emancipation in peer-led hearing voices groups

In this project, I present a grounded theory of how peer-led Hearing Voices Network Groups (HVNGs) impact people who attend them. By conducting intensive interviews and attending groups as an observer, I developed a theory of the outcomes and processes of change that people experience in peer-led HVNGs. I used member-checking (Charmaz, 2014) to make sure my analysis was consistent with the experience of people who took part. Through this considered and thorough process of conversation and collaboration with people who hear voices, I have developed a theory grounded in the knowledge and insight of people’s lived-experience of HVNGs.
HVNGs provide support that is fundamental to the well-being of people who attend them. Therefore research in this area has the potential to impact people’s lives by contributing not only to the growing evidence base regarding the benefit of HVNGs, but also by understanding how this benefit is achieved. Based on my analysis, I have theorised that the impact of hearing voices groups includes fundamental shifts in i) how voices and the voice-hearing experience are understood, ii) the sense of agency in their lives, and iii) an enhanced sense of valuing oneself and others, developed through sharing mutual support (the experience of ‘being in the same boat, helping each other’).
In order to understand the impact of hearing voices groups, I also consider the voice-hearing experience (Blackman, 2001) as a whole. Based on my data, I conceptualise this as a holistic experience that includes perceptual/sensory, social and meaning-making/agentic factors. I consider the stigma, loss of agency and confusion of meaning that can attend negative voice-hearing experiences in relation to trauma research, as well as other approaches.
The contribution of this research to the field of counselling psychology and psychological therapies is the creation of a theory of what voice-hearers value and experience in peer-led HVNGs. This research represents the first attempt at a full theory construction of this topic using an accepted methodology. Theory creation in this area is important for a number of reasons. Firstly, since hearing voices groups represent an increasingly popular approach both within NHS Trusts and other settings, it is increasingly necessary to understand the processes and mechanisms of change in these groups. Secondly, without basing theory construction on the actual experiences of people who hear voices, research in this area is susceptible to misinterpretation and misunderstanding. Finally, insight into the experience of hearing voices and how peer-led hearing voices groups address this experience can inform work in the wider field of hearing-voices research.