North Sydney

Lead agency
Specialist Rehabilition Service, Mental health Drug and Alcohol,

North Sydney Local Health District

Living Well domain

  • Providing the right type of care 
North Sydney

Program Overview

The Hearing Voices Recovery Support Group (the support group) is a nine-week co-facilitated group program that is underpinned by the values and knowledge of the Maastricht approach to voice hearing and the international Hearing Voices Movement. The group is developed and co- facilitated by specialist rehabilitation consumer workers and specialist rehabilitation clinicians. The aim is to facilitate personal recovery for people with voice hearing experiences and is offered through the Specialist Rehabilitation Service at Northern Sydney LHD and funded by the District’s community mental health service.


The key challenge for the support group was to identify alternative approaches that are person centered and recovery oriented to support people with mental health issues that have voice hearing experiences. Traditional approaches are medically focused, primarily through the use of medications which can have severe negative impacts on a person’s physical health and quality of life. In some cases medications may also be ineffective in addressing the impact of hearing voices.


The support group evolved from a New Zealand model with a philosophy grounded in the Hearing Voices Movement and the Maastricht interview approach. The approach embeds recovery principles and utilises aspects of dialectical behavioural therapy, cognitive behavioural therapy and mindfulness.
A co-design approach was followed in the development of the support group with involvement by clinicians and people with voice hearing experiences. Feedback is also sought from those who attend the support group to inform ongoing development.Co-facilitation of the group emphasises the bringing together of the wisdoms of lived experience and clinical knowledge in a format that expressly focuses and develops a peer support model.

The program is run as a closed group, where people with voice hearing experiences can share, talk and support each other whilst learning and developing skills in a range of different coping strategies and techniques.

Since inception in 2010, the program operates in four areas of Northern Sydney (Northern Beaches, Macquarie, Central Coast and Hornsby). The group has been delivered 27 times, with between 3 - 15 participants in each. In total, 114 people with voice hearing experiences have attended with some of those accessing the specialist rehabilitation service solely to attend the support group. Participants are welcome and encouraged to return for multiple groups.

The support group has a rigorous evaluation structure. Data is gathered from attendance rolls, participant self-rated Recovery Assessment Scale (RAS-DS) and the Beliefs about Voices Questionnaire (BAVQ-R) in addition to non-standardised feedback and evaluation forms. The Specialist Rehabilitation service has completed two major quality appraisal projects of its service provision and both projects included focus groups of people with voice hearing experiences to gather qualitative data from participants.

On average, 79% of people enrolled attended the support group, with further findings highlighted below:

  • The support group had a 76% retention rate which is significantly higher than average rates for other mental health focused group programs.
  • The Beliefs about Voices Questionnaire (BAVQ- R) data showed great shifts in engagement in beliefs about voices.
  • People with voice hearing experiences reported the group supported them to move from isolation, to engagement, to inspiration and connection and then thriving.

“I was part frightened and part scared of what I experienced, thinking I was the only one. I was very self-centered in my way of thinking. This group helped to draw me out of my shell”.

Next Steps

The Specialist Rehabilitation Service will continue to deliver the Hearing Voices Recovery Support Group across the NSLHD. They are also currently developing an online platform that will provide effective and helpful resources and interventions for those that care for, provide treatment for and experience voice hearing.