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Hearing voices and other extraordinary experiences

This is a small repository of resources relating to voice hearing including articles, handouts and web links.

Easy test Creator

I wrote Easy Test Creator (ETC) to assist in the creation, administration and analysis of computerised and on-line tests, surveys or questionnaires. In the community mental health team I worked in we often employed various questionnaires and tests. This helped save time with entry, scoring and tracking change over time. ETC is particularly useful for researchers, clinicians, or those who simply wish to add a more sophisticated questionnaire to their web page. Some people may use this software to collate routine outcome data in clinical practice.

I placed the following scales on-line:
Abnormal Involuntary Movement Scale (AIMS)
Alcohol Use Disorders Identification Test (AUDIT)
Beliefs About Voices Questionnaire (BAVQ) - Amended
Brief Psychiatric Rating Scale (BPRS)
CES-D Major Depressive Disorder Scale
Edinburgh postnatal major depressive disorder scale (EPDS)
Geriatric Depression Scale (GDS) - Short Version
Health of the Nation Outcomes Scales (HoNOS)
Life Skills Profile (LSP)
Self-defeating Beliefs Questionnaire

Coping with voices

This is a handout that I sometimes give out during 'hearing voices' workshops. It provides some practical 'evidence based' guidance on some things that may help people control aspects of the voice hearing experience or give some relief to particularly intrusive voices. The sense that people can exert some control over the voice hearing experience is exceptionally important.

Zubrinich, A., de Jong, G., Salehi, N., & Lakeman, R. (2024). Perceived barriers and enablers to utilising the Australian National Disability Insurance Scheme for adults with an intellectual disability and their families: A scoping review. Journal of Applied Research in Intellectual Disabilities, 37(4), e13240. https://doi.org/10.1111/jar.13240

Background
The introduction of the National Disability Insurance Scheme (NDIS) in Australia in 2013 promised significant improvements in the lives of adults with intellectual disabilities. Although the scheme enables support, there are challenges associated with establishing eligibility and administering funds. This scoping review explored perceived barriers and enablers to effectively utilising the NDIS for adults with intellectual disabilities and their families.

Method
A scoping review of the empirical literature on the NDIS and intellectual disabilities included nine studies in this review. These papers were subjected to thematic analysis and the findings were presented as a narrative synthesis.

Results
The key themes identified were: (1) Limited understanding of the NDIS process; (2) Language use and capacity assumptions; (3) Unrealistic goals and progress, and difficulty utilising plans; (4) Expectations of families and associated workloads; (5) Opening up opportunities not previously available; (6) Knowledgeable planners who actively seek to involve adults and their families.

Conclusion
Although qualitative studies demonstrate that adults with an intellectual disability and their families are largely satisfied with the increased opportunities the NDIS has afforded them, there are various areas in which accessibility to services can be improved. In order for the NDIS to continue to improve, the results from this scoping review underline the need for adults with an intellectual disability and their support systems to have their voices heard and be utilised.

Lakeman, R., & Cutcliffe, J. (2016). Diagnostic Sedition: Re-Considering the Ascension and Hegemony of Contemporary Psychiatric Diagnosis. Issues in Nursing, 37(2), 125-130. https://doi.org/10.3109/01612840.2015.1103341

Historically, the publication of each edition of the diagnostic and statistical manual (DSM) has been accompanied by controversy. The publication of the latest edition (the DSM-5) has led to unprecedented critical commentary from authoritative voices from within psychiatry. Whereas, critical comment by mental health nurses has been negligible. This paper attempts to address this imbalance. It explores the history of diagnosis in psychiatry and drawing on recent critical commentary, and the rejection of the DSM by the National Institute of Health in future research endeavours, argues that the DSM-5 represents the latest in a long line of failed attempts to develop a valid, coherent and unifying taxonomy of mental illness. The implications for mental health nursing are briefly explored.

Lakeman, R. (2001). Making sense of the voices. International Journal of Nursing Studies, 38(5), 523-531. https://doi.org/10.1016/S0020-7489(00)00101-2

Hearing voices is a common occurrence, and an experience of many people in psychiatric/mental health care. Nurses are challenged to provide care, which is empowering and helps people who hear voices. Nursing practice undertaken in partnership with the voice hearer and informed by a working explanatory model of hallucinations offers greater helping potential. This paper uses Slade's (1976. The British Journal of Social and Clinical Psychology 15, 415-423.) explanatory model as a framework for exploring interventions which may assist people in exerting some control over the experience and which might be used alongside pharmacological interventions. Principles and practical ideas for how nurses might assist people to cope with and make sense of the experience are explored.

Vella, D., & Lakeman, R. (2022). Mental health nurses' voices to lead. May 12. ACMHN News. https://acmhn.org/mental-health-nurses-voices-to-lead/

In this special article celebrating International Nurses Day, we hear from ACMHN Board Directors Donna Hansen-Vella and Richard Lakeman about mental health nurse (MHN) leadership: what it looks like, why Australia needs it, and how to empower MHNs to lead more.

Hurley, J. & Lakeman, R. (2018, October 14-26). Socially constructing mental health nursing: From sleepwalking zombies through to brave new worlds. Presented ACMHN's 44th International Mental Health Nursing Conference Mental Health is a Human Right. Pullman Cairns International, Cairns, Australia

This paper draws upon the philosophical stance of social constructionism to better understand how mental health nursing is presently conceived and to consider its future (if indeed there is one). We also ask whose voices are shaping the future and the discourses that are constructed around health and illness that inform the need for mental health nursing. We adopt a reflexivity to current premises about mental health nursing and search for generative new narratives that may build new futures for the profession, or alternatively make it unrecognizable as a meaningful discipline. Social constructionism places value upon the use of language; language does not mirror life (Gergen, 2015); rather it is the doing of life. Once we begin to articulate the current and future states of mental health nursing social constructionism argues that we engage in a discourse constructed by tradition and taken for granted values. Our language is not seen as an accurate reflection of our profession and neither is the language of one given rank over that of the other; indeed, multiple descriptions exist for any single phenomena, in this case mental health nursing. However, this multiplicity of descriptions of what is and what could be the future (if any) of mental health nursing generates problems in terms of being able to create shared truth, knowledge and meaning among one another, and to those outside of the profession. The generation of these shared understandings through language consequently assumes rules to apply to the use of words within the contexts in which they are uttered, and it is from within this context that the meaning is generated.

These rules of social constructionism as applied to building a future for the profession inform us that as we describe, or otherwise represent, we fashion our future and that reflections on our understandings are vital to our future well‐being. These rules ask us to consider what relational groups are having the dominant discussions about the future of mental health nursing and who is being silenced, if anyone.

Gergen, K. (2015). An invitation to social constructionism (3rd ed). Los Angles: Sage. International Journal of Mental Health Nursing (2018) 27(Suppl. s1), 3–55

Lakeman, R. (2000, 10 - 11 June 2001). Helping and hearing voices. Paper presented at the The North Queensland Sub-branch of the Australian and New Zealand College of Mental Health Nurses Winter Symposium, Arcadia Resort, Magnetic Island, AU.

This paper uses Slade's (1976) explanatory model as a framework for explaining hallucinations and considering helping interventions, which may be used alongside pharmacological interventions. Principles and practical ideas for how nurses might assist people to cope with and make sense of the experience are explored.

Lakeman, R. (2000, 3-7 September). Coping with voices: An explanatory pilot study. Paper presented at the Mental Health Nurses for a Changing World: Not just Surviving,, Broadbeach, Queensland.

Hearing voices is an experience common to many people in psychiatric care but meaningful help in coping with the experience is less common. This paper presents a model of coping behaviour specific to hearing voices. It proposes that coping with voices includes hallucinatory control, emotion and problem focused coping and is a function of context, the features of voices, and beliefs about voices. Results from a pilot study exploring coping with voices are presented. A questionnaire which combined previously tested scales including voice topography (Hustig & Häfner, 1990), beliefs about voices (Chadwick & Birchwood, 1995a) and general coping behaviour (Carver, Weintraub & Sheier, 1989) was administered to 10 consumers of a mental health service with a recent history of hearing voices. The instruments were found to be reliable and easy to complete. Results are discussed in relation to the theoretical framework and suggest that people engage in a wide range of purposeful coping behaviour in response to voices that do not fit comfortably into arbitrary coping categories. Consideration of 'coping with' rather than 'amelioration' of voices ought to be a key focus of nursing, and the model of coping presented may be useful in making sense of, and facilitating coping behaviour.

Lakeman, R. (1999, 2 - 3rd February). When the voices say more than 'thud'. Paper presented at the New and Evolving Roles for Psychiatric / Mental Health Nurses, Eastern Institute of Technology, Taradale, New Zealand.

A review of helping interventions for nursing the person who hears voices.

Lakeman, R. (1998, 27 - 29 November). Bridging social and clinical conceptions of hearing voices. Paper presented at the Centres and Margins, Eastern Institute of Technology, Taradale, New Zealand.

One cannot begin to make sense of coping experience without an understanding of the person's social world and how this informs and interacts with perceptions, and the attribution of personal meaning to the experience. The 1990s have been called the 'decade of the brain’. Today a person’s experience can be manipulated in a myriad of ways through the use of pharmacological agents. Because it is possible to completely ameliorate voices does not mean that we should. More than ever we need to extend our understanding of the voice hearing experience and bridge social and clinical conceptions.

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