When Zahra arrived at Oak Lodge she was experiencing auditory hallucinations (hearing voices), low mood, delusions and was not looking after her personal care.

She had come from a home environment where she had not had the freedom to engage with the community or practice daily life skills, so needed support to learn how to live independently.

Our approach

Zahra’s named nurse and occupational therapist carried out an initial assessment to agree her goals during her stay at the hospital.

Management of symptoms

Zahra’s named nurse held weekly one to one meetings with her to discuss her symptoms and how to manage them. Zahra was encouraged to keep a voice hearing diary where she would record the content, frequency and intensity of the voices she could hear, as well as her level of distress at the time, to guide and inform these conversations. She was supported to attend an online voice hearing support group to discuss her experiences and coping strategies with others having similar experiences. 

Developing confidence and assertiveness

Zahra had not had the freedom to make her own decisions previously due to a complex family dynamic, so did not feel able to make decisions about her life, such as living away from the family home when she moved on from the service.  

Her named nurse recommended she attend a regular assertiveness and confidence group led by a local mental health service. She was initially escorted to the group by a Support Worker as she had anxiety about using public transport and attending on her own, but after two sessions she felt confident enough to attend the group independently.

Daily life skills

Zahra’s occupational therapist held weekly meal planning sessions with her to ensure she was eating a balanced diet, and she was supervised to cook her own meals. She was educated about the importance of eating vegetables, portion sizes and the risks of eating too much fast food. 

She worked with her occupational therapist to set self-care goals, such as how regularly she would shower. She attended a group session on the unit on oral hygiene and following these interventions she began to take full control of her own personal care.

Engaging with the community

Zahra was supported to do activities in the community with her support worker, such as cinema trips and going to the library. At her first clinical review, which take place every six weeks with a consultant psychiatrist, Zahra was granted unescorted leave to take part in these activities independently.


Strategies to manage hallucinations

Zahra can now manage her auditory hallucinations using knowledge and strategies gained from therapy groups and discussions with her named nurse.  

Increased independence

Zahra now lives in one of AFG’s supported living services with minimal supervision and cooks, cleans and takes care of her own personal care. She is planning to move into her own home with no support.

Volunteering and education

She is an active member of her community, volunteering twice a week in a charity shop and taking part in activities such as going to the cinema, visiting the library, and shopping for herself. She has also signed up to Maths and English courses at a local college.

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