Many people with psychosis are asked whether they hear voices but not what the voices are like, which is the detail that guides psychological treatment. After establishing that voices are present, ask how many there are, whether they are recognised, what they say, how often and how loudly, how much they distress the person, and how powerful the person believes them to be. Ask whether the voices give commands and whether the person has acted on them. Ask what makes them better or worse. The answers map onto the targets of voice-focused therapies and give a baseline against which to judge change.
- Ask what the voices say and how powerful the person believes them to be
- Ask about command content and whether the person has ever acted on it
- Rate distress and frequency so change can be measured later
- Ask what the person already does that makes the voices quieter
Why it matters
A yes-or-no answer about voices gives nothing to treat or to measure.
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