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Hearing voices simulation: process and outcomes of training

Sue Patterson (Principal Research Fellow, based at Department of Mental Health, Metro North Hospital and Health Service District, Brisbane, Australia)
Nicole Goulter (Clinical Academic Fellow, based at Department of Mental Health, Metro North Hospital and Health Service District, Brisbane, Australia)
Tim Weaver (Senior Lecturer, based at Centre for Mental Health, Imperial College London, London, UK)

The Journal of Mental Health Training, Education and Practice

ISSN: 1755-6228

Article publication date: 8 April 2014




The purpose of this paper is to examine the experience and impact of targeted training involving simulation of auditory hallucinations on attitudes and practice of professionals working with people with mental illness.


Pragmatic mixed-method study. Data were collected from 83 professionals who completed training using cross-sectional survey and focus groups. Descriptive, comparative and thematic analyses were performed.


Training was associated with changes in thinking and attitude related to working with people who hear voices. Participants, who commonly found the simulation confronting, drew on the experience to deepen appreciation of coping with voices that are distressing and develop a new frame of reference for practice. They positioned themselves differently and described adopting a range of practices consistent with the recovery approach. Environmental constraints variously impacted on capacity to enact these practices.

Research limitations/implications

The study was conducted in one centre using a bespoke survey instrument with a sample intrinsically motivated to complete training. Hence, caution should be exercised with regard to generalisability. However, findings are consistent with the limited published literature and the mixed-method approach provided a comprehensive understanding.

Practical implications

The paper demonstrated that the training employed can support development of patient centred, recovery-oriented practices. These are likely essential to optimising patient and service outcomes. Further research is needed to examine the impact of training on a broader cross section of professionals and the outcomes for patients.


The paper provides important new insights regarding the mechanisms by which training can contribute to development of patient-centred care.



The authors are grateful to all those who have contributed to successful completion of this study including workshop facilitators and trainees. To those who made time to participate in the survey and/or focus groups and shared generously of their experience, the authors trust that they have represented their voice fairly. This work was conducted without dedicated funding. N.G. and S.P. completed the work during employment by Metro North Hospital and Health Services and acknowledge the in-kind support of the organisation. T.W. was employed by Imperial College London and contributed his expertise voluntarily. Special thanks to Peter Bullimore for his contribution to the training and allowing the authors to cite his work. The authors also thank Jeremy Johnson for his helpful comments during preparation of the manuscript. The authors declare that they have no conflicting interests.


Patterson, S., Goulter, N. and Weaver, T. (2014), "Hearing voices simulation: process and outcomes of training", The Journal of Mental Health Training, Education and Practice, Vol. 9 No. 1, pp. 46-58.



Emerald Group Publishing Limited

Copyright © 2014, Emerald Group Publishing Limited

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