Background of the Tree of Life
‘Tree of Life’ is a psychosocial support tool based on Narrative Therapy for facilitating personal recovery5. It was developed in Zimbabwe to support high-risk children affected by HIV/AIDS, poverty, war and conflict in Eastern Africa5-6. The approach seeks to minimize stigmatizing narratives by focusing on strengths and resources first before addressing problems.
In UK acute mental health wards staff is often viewed as being too busy to talk to patients, under-resourced and rely on medication as the only intervention on wards1. The custodial nature of the wards in the absence of positive therapeutic interactions leads to cycles of conflict within staff and service user relationships7. Negative perceptions of staff and service users’ views reported from people following discharge who did not find their inpatient care helpful in addressing their mental health problems; are well documented8-10. There have also been concerns cited by The Equality and Human Rights Commission11 regarding equality and diversity disparities for Black and Minority Ethnic groups within mental health services.
The Tree of Life innovation aims to offer a multi-cultural talking treatment that addresses the needs of an ethnically diverse population while building positive and collaborative relationships between staff and service users. Ultimately helping to promote collaborative recovery approaches to mental health care.
Tree of Life Components
Tree of Life workshops embody participative activities that involve drawing trees in a group setting with the aim of building a forest of trees together. Each part of the tree is a metaphor for specific components of an individual’s life that define their identity (relationships, strengths, values and hopes for the future).
2. Multicultural therapy
Within the tree of life model, culture and heritage are recognized as resources, thus making the tree of life a practice that can be valued by diverse communities and services. It has proven successful in its flexible approach and adaptability and is now used internationally in a variety of contexts12-14.
3. Narrative Therapy and promoting recovery in mental health services
In mental health services, the dominant story can often be the stigmatizing mental health diagnosis. Through narrative therapy:
- The diagnosis is separated from the person and people are encouraged to first appreciate their resources
- Service users are able to stand on a firmer foundation to begin talking about their difficult experiences
- The intention of drawing a tree is to enable individuals to describe a preferred version of themselves (the person they would like others to see) rather than adopting a description imposed on them by others (mental health diagnosis)
4. Building positive therapeutic relationships between staff and service users
This model enables staff and service users to see each on equal terms as both groups participate in the Tree of Life workshop together. This allows service users to engage from a position of strength, choosing what to disclose and highlighting their strengths
The collaborative approach and reciprocal sharing in a Tree of Life group can help to build positive relationships on inpatient wards by addressing the power imbalances between staff and services users.These power relationships are often exaggerated due to the legal context of sections and other mental health law restrictions placed on a service user in a mental health system