Relating Therapy for distressing voices: Who, or what, is changing?

Background: The experience of hearing distressing voices has recently been conceptualised within relational terms, whereby the voice is perceived as a person-like stimulus with whom the hearer has a difficult relationship. Therapeutic approaches are being developed that seek to modify the relating of the hearer towards the voice, and a conversation has begun about what or who may be changing within these therapies. We sought to empirically inform this discussion by exploring the experience of patients who had received Relating Therapy. Methods: A semi-structured change interview was used to explore the experience of nine participants. Interviews were transcribed verbatim and were analysed using thematic analysis. Results: The analysis of data generated three themes - two of which related to aspects of change (in me and in voices), and one which related to a therapy process (role plays). Conclusions: The findings suggested that changes can be evident in both the hearer and the voice, as a consequence of the hearer adopting a different (more assertive) approach to communicating with the voice. Such communication can enable the hearer to perceive themselves as less vulnerable to the communicative intentions of others.