Maintaining safety. The teaching environment including all interactions must be safe. Prompt nursing action is required if any threat to safety occurs. The topic of voices is sensitive and voice hearers may be discussing their AH for the first time in a group setting. The course facilitators provide an atmosphere where it is acceptable for group members to admit that they hear AH and talk about their experience of hearing AH. These discussions include describing situations that make AH better or worse.
Forty-seven percent of the voice hearers who participated in one study reported they heard voices to harm self or others (Buccheri et al., 2007). Based on this finding, course participants are asked to complete questions on the UVS that ask if they hear harm voices
and whether or not they intend to act on them. If they answer yes to questions about
intent to harm self or others, then course facilitators follow a supportive safety protocol
(Safety Protocol: Protocol Response to Intent to Harm Self or Others) to guide their
decision about a need for intervention to keep the course participant safe