Learning Objective #1: Be more responsive to the care needs and desires of people who hear voices

Learning Objective #2: Describe the relationship of quality of voice hearing to expressed self-care needs and preferences of people who hear voices

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Clinicians often have diverging views on the care needs of people who hear voices posing serious challenges for assuring the health and safety of this population. Recent work, however, suggests that clinician appreciation and responsiveness to the care needs of voice hearers could be improved by engaging the voice hearers directly in their own appraisal of their self-care assets and deficits. A descriptive study was undertaken to identify the self-care needs of 337 community-dwelling voice hearers controlling for the negativity of the subjects' voice hearing experiences. The subjects completed an assessment of their self-care needs, and provided information about their voices and desire to talk about specific assets and deficits. Findings from the study revealed that more than two thirds of the subjects suffered from grief tied to early experiences of abuse or death. Subjects exposed to persistent, negative voice hearing experiences were most likely to abuse or neglect themselves, use drugs or alcohol, and withdraw from people. They more often reported being unable to get up for the day, and take care of their bodily or instrumental needs. They wanted help dealing with suffering, lack of energy, and an uncertain future. Subjects exposed to persistent, neutral-to-positive voice hearing experiences were less likely to feel depressed, or use drugs or alcohol. They more often reported needs to focus, solve a concrete problem, deal with a perceived stigma, meet friends, get a job, or do something important. They wanted help developing cognitive, social, or time management skills. These subjects did not seek to be rid of their voices especially those that provided comfort and guidance. Findings from the study can be used to tailor best practice guidelines for dealing with both the self-care needs and preferences of voice hearers and the quality of the voices they hear.