“It Felt Good to Be Able to Say That Out Loud”—Therapeutic Alliance and Processes in AVATAR Therapy for People Who Hear Distressing Voices: Peer-Led Qualitative Study

Emily Rutter-Eley   ^{1, 2} , MSci, DClinPsy ;   Thomas Craig   ^{2, 3} , MBBS, FRCP, PhD ;   Philippa Garety   ^{1, 2} , MPhil, PhD, MA ;   Mar Rus-Calafell   ^{1, 4} , ClinPsyD, PhD ;   Hannah Ball   ^{5, 6} , DClinPsy ;   Moya Clancy   ^{7, 8} , MSc, DClinPsy ;   Jeffrey McDonnell   ^{9, 10} , MSc, DClinPsy ;   Andrew Gumley   ^{7, 8} , PhD, MAppSci, CPsychol, AFBPsS ;   Gillian Haddock   ^{5, 6} , MClinPsychol, PhD ;   Sandra Bucci   ^{5, 6} , ClinPsyD ;   Miriam Fornells-Ambrojo   ^{9, 10} , DClinPsy, PhD ;   Nerys Baldwin   ¹¹ ;   Jed Harling   ¹¹ ;   Alie Phiri   ¹¹ , MSc ;   Charlie MacKenzie-Nash   ¹¹ ;   Nicholas Hamilton   ¹¹ ;   Amy Grant   ¹¹ ;   Clementine Edwards   ^{1, 2 *} , MSc, DClinPsy, PhD ;   Thomas Ward   ^{1, 2 *} , MSci, DClinPsy, PhD

¹ Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, London, United Kingdom

² South London & Maudsley NHS Foundation Trust, London, United Kingdom

³ Department of Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom

⁴ Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany

⁵ Division of Psychology and Mental Health, School of Health Sciences, University of Manchester and the Manchester Academic Health Sciences Centre, Manchester, United Kingdom

⁶ Greater Manchester Mental Health NHS Foundation Trust and the Manchester Academic Health Sciences Centre, Manchester, United Kingdom

⁷ School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom

⁸ NHS Greater Glasgow and Clyde, Glasgow, United Kingdom

⁹ Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom

¹⁰ North East London NHS Foundation Trust, London, United Kingdom

¹¹ The AVATAR2 PPI Group, London, United Kingdom

*these authors contributed equally