Hearing voices network groups: experiences of eight voice hearers and the connection to group processes and recovery

Voice hearing has a diverse history but is often understood as symptomatic of a psychotic disorder. Alternatives to “treatment” include peer-support “Hearing Voices Network groups” (HVNGs) which have grown in popularity and exist alongside professional-led hearing voices groups. Few studies have investigated processes underlying change in HVNGs. Established research into therapeutic factors and personal recovery may provide frameworks elucidating change processes. This study aimed to investigate how HVNG attendees experienced change within the group and how this change influenced their lives. A qualitative design was employed using interpretative phenomenological analysis to elucidate group processes through immersion in the perspectives of group attendees. Semi-structured interviews were conducted with eight voice hearers from two HVNGs. Interviews were recorded and transcribed verbatim. Four superordinate themes emerged: “healing: connecting with humanity”; “group as an emotional container”; “making sense of the voices and me”; and “freedom to be myself and grow”. Relationships, safety, exploration of voices and group ownership were key components of HVNG, but require further study. These components were consistent with therapeutic factors and known recovery processes, so these established frameworks could be used to further investigate change processes in HVNGs. Background Voice hearing (VH) or“auditory hallucinations”are typically defined as symptoms of psychiatric illnesses requiring treatment. However, research has estimated that 5–28% of people have experienced VH during their lives (De Leede-Smith & Barkus, 2013) and not all of them become “ill”. Those reporting VH accompanied by distress or culturally unusual beliefs often end up in mental health services, diag- nosed with a psychotic illness and treated with medication. Whilst service user experiences of mental health services vary, many have felt failed by “a broken and demoralised system that does not deliver the quality of treatment that is needed for people to recover.” (Schizophrenia Commission, 2012, p. 4). An alternative approach to VH emerged from the Hearing Voices Movement (HVM) in Holland. Its foundation stemmed from a key study demonstrating that 33% of voice hearers coped with VH experi- ences (Romme & Escher, 1989). This endeavour was driven by social needs and political/emancipatory aims (Romme, Honig, Noorthoorn, & Escher, 1992): empowering voice hearers to explore their experi- ences (Coleman & Smith, 1997); disseminating coping strategies; promoting alternatives to dominant. CONTACT Tom Payne [email protected] © 2017 Informa UK Limited, trading as Taylor & Francis Grou

The benefits of giving: a study of learning in the fourth age and the role of volunteer learning mentors

Learning for the Fourth Age (L4A) is a social enterprise which recruits, trains, places and matches volunteers (‘learning mentors’) to older people living in care settings or domiciliary settings. Older people and volunteers form partnerships which develop around a focus for learning and areas of interest identified by the older person. L4A promotes the value of education as a tool for increasing wellbeing in later life and its vision is to improve quality of life through mental, social and emotional stimulation tailored towards vulnerable older people. We report on the findings of an independent evaluation, drawing on funding from the Big Lottery Silver Dreams programme. Over 12 months, using an agreed protocol, qualitative interviews with 69 people focused on five key areas determined by the organisation. Interviews included older people; learning mentors (the volunteers); L4A staff and directors; staff from care homes; and other stakeholders. Key records and documents relevant to the evaluation were examined. Our presentation focuses on key findings from the generative aspects of L4A’s work by highlighting the rich experiences of learning mentors who were unexpected mutual beneficiaries of L4A’s work. Learning mentors offer a unique contribution distinct from traditional befriending and through their relationships with older people demonstrated the importance of learning interventions in achieving more transformational outcomes. The extent of reciprocity and generativity identified further challenged stereotypes of older people’s contribution to social relationships. Further, for those learning mentors still studying, the experience had unexpected benefits – encouraging some to change their future career intentions, life choices and courses as well as employability. We encountered changes in career intentions, course intentions, changed family behaviours, changed work behaviours, and reflective comments on end of life experiences that were clearly life changing. Increased opportunities for networking became a demand from mentors, who recognised their own learning and the links between altruism and reciprocity. This paper aims to stimulate further debate about the complexity of the landscape in which members of the community interact with opportunities to volunteer and the challenge to capitalise on their contributions to transgress more traditional notions about volunteering embedded in policy. The audience will be encouraged to consider the implications for both training and supporting volunteers to capitalise on their contributions and to reconside

Quality improvement through the paradigm of learning

Purpose - If we are to achieve meaningful participation and co-production for older people in care, more radical approaches are required. This project explores an innovation where older people using social care were matched to community based learning mentors to develop partnerships within which learning interventions were facilitated. We explore how the concept of learning might be used as a paradigm to raise the quality of care in institutionalised settings using a co-productive and relationship based approach to promote wellbeing. Design/methodology/approach - A structured evaluation drew on qualitative data captured from interviews with older people (n=25) and learning mentors (n=22) to reflect on the potential benefits and challenges involved when introducing learning interventions in care settings. This was contextualised alongside data captured from stakeholders (n=10) including a care home manager, social care and education commissioners, Trustees and project staff to assess the interdisciplinary contribution of lifelong learning to quality improvement. Findings - Introducing learning interventions to older people within care settings promoted participation, advocacy and relationship-based care which in turn helped to create a positive culture. Given the current challenges to improve quality in care services, drawing on a paradigm of learning may encourage older people to retain their independence as care homes strive towards a person-centred approach. Promoting social activities and leisure using learning was found to foster closer working relationships between older people and the wider community. These had a levelling effect through reciprocity, using an asset based approach. There were benefits for the care provider as the partnerships formed enabled people to raise both individual and collective concerns about care and support. Originality/value - Raising and sustaining the quality of support for older people requires input from the wider public sector beyond health and social care. Purposeful engagement with other disciplines such as learning and leisure offers the potential to realise a more sustainable model of user choice, person-centred support and user involvement. Being engaged through learning can nourish membership in the community for marginalised populations such as older people living in care homes

Processing fluency effects: can the content and presentation of participant information sheets influence recruitment and participation for an antenatal intervention?

Objective: To assess the extent to which the title and font of participant information sheets (PISs) can influence pregnant women’s and trainee midwives’ perceptions of an antenatal intervention. Methods: Pregnant women (n = 35) and trainee midwives (n = 36) were randomly presented with one of four PISs where the title and font of the PIS had been manipulated to create four experimental conditions (i.e., Double-Fluent; Double-Awkward; Fluent Title-Awkward Font; Awkward Title-Fluent Font). After reading the PIS, participants rated their perceptions of the intervention (i.e., attractiveness, complexity, expected risk, required effort) using five-point Likert scales. Results: A 4x2 factorial multivariate analysis of variance revealed that pregnant women rated the Double-Awkward condition as significantly more complex than the Double-Fluent (p = .024) and Awkward Title-Fluent Font (p = .021) conditions. Conclusion: Font influenced pregnant women’s ratings of intervention complexity. Practice Implications: Results have implications for ethical recruitment, and in turn, the optimisation of corresponding interventions

Exploring health professionals’ and women's awareness of models of maternity care evidence

A Cochrane systematic review has shown midwife-led continuity models of care provide explicit benefits for mothers and babies compared with other models of maternity care, with a comparable level of safety. The Cochrane review has had much international impact. This study explored the local impact of the review, alongside other midwife-led care evidence and guidelines. Electronic surveys were undertaken exploring women's and health professionals' awareness of models of maternity care evidence, including midwife-led care and homebirth, and how they utilise evidence to guide their choices and practice. A low awareness of much of the available evidence was shown among the women and the professionals. There is a need for better dissemination of information to professionals as they are women's preferred source of information about the options available for place of birth and midwife-led care

Acceptability of Specialist Psychotherapy with Emotion for Anorexia in Kent and Sussex (SPEAKS): A novel intervention for anorexia nervosa

Investigate the acceptability of Specialist Psychotherapy with Emotion for Anorexia in Kent and Sussex (SPEAKS), a novel intervention for anorexia nervosa (AN), conducted as a feasibility trial to provide an initial test of the intervention. SPEAKS therapy lasting 9-12 months was provided to 34 people with AN or atypical AN by eight specialist eating disorder therapists trained in the model across two NHS Trusts in the UK (Kent and Sussex) during a feasibility trial. All participants were offered a post-therapy interview; sixteen patients and six therapists agreed. All patient participants were adult females. Interviews were semi-structured and asked questions around individuals' experience of SPEAKS, the acceptability of the intervention and of the research methods. Interviews were analyzed using thematic analysis. Key areas explored in line with research questions led to 5 overarching themes and 14 subthemes: (1) shift in treatment focus and experience, (2) balancing resources and treatment outcomes, (3) navigating the online treatment environment, (4) therapist adaptation and professional development, and (5) research processes. SPEAKS was found to be an acceptable intervention for treating AN from the perspective of patients and therapists. The findings provide strong support for delivery of a larger scale randomized control trial. Recommendations for future improvements, particularly pertaining to therapist understanding of the treatment model are detailed, alongside broader clinical implications. We aimed to evaluate the acceptability of a new anorexia nervosa treatment called SPEAKS. Interviews were conducted with patients and therapists involved in the pilot study and responses were analyzed. Results showed that both patients and therapists found SPEAKS to be an acceptable treatment for anorexia nervosa. The study suggests that SPEAKS meets the criteria for moving forward with a larger trial to assess its effectiveness. [Abstract copyright: © 2024 The Authors. International Journal of Eating Disorders published by Wiley Periodicals LLC.

Structure and evolution of magnetohydrodynamic solitary waves with Hall and finite Larmor radius effects

Nonlinear and low-frequency solitary waves are investigated in the framework of the one-dimensional Hall-magnetohydrodynamic model with finite Larmor effects and two different closure models for the pressures. For a double adiabatic pressure model, the organization of these localized structures in terms of the propagation angle with respect to the ambient magnetic field Θ and the propagation velocity C is discussed. There are three types of regions in the Θ-C plane that correspond to domains where either solitary waves cannot exist, are organized in branches, or have a continuous spectrum. A numerical method valid for the two latter cases, which rigorously proves the existence of the waves, is presented and used to locate many waves, including bright and dark structures. Some of them belong to parametric domains where solitary waves were not found in previous works. The stability of the structures has been investigated by performing a linear analysis of the background plasma state and by means of numerical simulations. They show that the cores of some waves can be robust, but, for the parameters considered in the analysis, the tails are unstable. The substitution of the double adiabatic model by evolution equations for the plasma pressures appears to suppress the instability in some cases and to allow the propagation of the solitary waves during long timesG.S.A. is supported by the Ministerio de Economía y Competitividad of Spain under Grant No. RYC-2014-15357. E.S. was supported by the Swedish Research Council, Grant No. 2016-05012, and by the Knut and Alice Wallenberg Foundation

Development and Validation of a State-Based Measure of Emotion Dysregulation: The State Difficulties in Emotion Regulation Scale (S-DERS)

Existing measures of emotion dysregulation typically assess dispositional tendencies and are therefore not well suited for study designs that require repeated assessments over brief intervals. The aim of this study was to develop and validate a state-based multidimensional measure of emotion dysregulation. Psychometric properties of the State Difficulties in Emotion Regulation Scale (S-DERS) were examined in a large representative community sample of young adult women drawn from four sites (N = 484). Exploratory factor analysis suggested a four-factor solution, with results supporting the internal consistency, construct validity, and predictive validity of the total scale and the four subscales: Nonacceptance (i.e., nonacceptance of current emotions), Modulate (i.e., difficulties modulating emotional and behavioral responses in the moment), Awareness (i.e., limited awareness of current emotions), and Clarity (i.e., limited clarity about current emotions). S-DERS scores were significantly associated with trait-based measures of emotion dysregulation, affect intensity/reactivity, experiential avoidance, and mindfulness, as well as measures of substance use problems. Moreover, significant associations were found between the S-DERS and state-based laboratory measures of emotional reactivity, even when controlling for the corresponding original DERS scales. Results provide preliminary support for the reliability and validity of the S-DERS as a state-based measure of emotion regulation difficulties