Yalom’s therapeutic factors in hearing Voices Groups: a facilitator’s perspective

Over the past 35 years, peer-run Hearing Voices Groups (HVGs) have proliferated across the globe. More recently, research has begun to focus on the precise psychological mechanisms that make groups effective and enable individual psychological change. While important in their own right, theories of peer support are limited in their ability to explain the psychological mechanisms by which complex psychological transformation occurs. As such, it is necessary to look beyond peer support and borrow theories from the psychotherapeutic literature. Yalom and Leszcz’s (2005) seminal work, The Theory and Practice of Group Psychotherapy, may help shed some light on the psychological dynamics that bring about change in HVGs. Peer support and group psychotherapy differ widely in their histories, philosophical underpinnings, and approach to, and understanding of, mental distress. As such, theories of group psychotherapy cannot be broadly applied to HVGs without a nuanced understanding of the differences between HVGs and psychotherapy groups. In this paper, I use my lived experience as an HVG member and facilitator to highlight these differences, and explore where Yalom’s theory may be useful at understanding the change mechanisms at play in HVGs.