A story: Greater than the words?

Lavinia McLean & Emmett TuiteInstitute of Technology Blanchard-

stown Ireland

L Mclean & E.Tuite SIRCC 2015

A story: Greater than the words?

http://www.free-powerpoint-templates-design.com/free-powerpoint-templates-design

L. McLean & E. Tuite SIRCC 2015 2

Aims of Presentation • Explore current research on the value of

story telling as a tool in social care settings• Identify benefits and possible barriers to

using this method effectively• Outline the development of this approach

as a tool for qualified social care practition-ers

• Discuss the use of story telling as a way of training/ aiding the development of social care professionals

L. McLean & E.Tuite 2015 3

Outline • Storytelling as a means of relationship building• The effective use of storytelling in social care

practice• Obstacles to the approach • Storytelling as a tool in social care education

The Value of Story

“...What happens is of little significance compared with the stories we tell ourselves about what happens. Events matter little, only stories of events affect us.”

― Rabih Alameddine, The Hakawati.

5

Storytelling‘Well pick up a chair and get comfortable……’‘Wait till I tell you what happened…..’• People have always told stories to help them

understand life and dilemmas• Stories give us a deeper understanding of life

and the emotions accompanying experi-ences

• The acting out of stories can occur - children and the games and rules they design

• How humans articulate their experience of the world and make sense of it

(IRISS, 2013)L. McLean & E.Tuite 2015


Stories • A story is a real or imagined account

of events that describe experience• Words and actions being used to de-

scribe a sequence of events that cap-ture the imagination of the listener

• Can be oral, written, visual or digital• Consider the role of storytelling in

your practice: How have you used it?

IRISS (2013)• Storytelling influences change at individual practice as

well as organisational level• Listening to stories facilitates better person-centred care

and can lead to improved services• Hearing personal stories can lead to greater understand-

ing, empathy and reflection• Rapport, trust and care can be nurtured in practitioner-

service user relationships through storytelling• Personal storytelling benefits the teller as it can empower,

encourage personal growth and build resilience• Due consideration needs to be given to ethical issues in

storytelling and telling stories has the potential to be demoralising and disempowering for the teller



Role of story telling when working with people

• Limited research on story telling in social care settings.• Can look at allied fields (nursing, social work etc.)• At an individual level stories can - Give meaning to experiences - Develop emotional understanding and empathy.

- Utilised in the development of relationships • At an organisational level stories can be used to influ-

ence change.• Formal and informal storytelling in social care practice.• This research details the informal use of storytelling and

the perceived benefits for the teller and the listener.


Value to Practice • Stories are used to educate, train, entertain and communicate

messages. • Significant research evidence supports the use of storytelling

in healthcare (including mental health) and healthcare education contexts– to bring about positive change for patients, and promote best prac-

tice for professionals (Kirkpatrick and colleagues, 1997; Roberts, 2000; Gaydos, 2005; Hardy, 2007; Charon, 2009; Haigh and Hardy, 2011).

• Storytelling has also been used across social services (Cox and colleagues, 2003) – Reminiscence therapy with older people– Life story work with people with trauma and attachment issues– Relationship work with service users

• However, there is less documented evaluation of how storytelling impacts on practice and the individual.


Individual Meaning• Case history and notes suggest one thing but story can

paint a very different picture• Roberts (2000) talks about a man with schizophrenia who

discusses a particular year of his life that was very diffi-cult

• Rejection and isolation from his family meant that he re-garded this year as his most difficult but this was not picked up by the clinicians at the time

• On paper he was responding well to treatment and enga-ging well with services during this year

• Story telling gives voices to what experiences mean for in-dividuals


Emotional Understanding

• Greater understanding of the emotional im-pact of decisions and acts on people– E.g. Person finally gets the resources they are bat-

tling for but it means relying more heavily on their family physically

• May seem they have achieved what was needed but through storytelling discover additional needs or stressors

• Are fluid and ever changing so can be par-ticularly relevant when working with people during times of transition or flux


Empathy • Hardy (2007) suggests the empathy may be particularly cru-

cial in relation to cultural diversity.• Empathy is key to greater understanding• Amhed (N.D) suggests storytelling allows for cultural incul-

cation • New perspectives, sometimes never considered • Allows us reflect on own moral compass, values and prac-

tice• Haynes & Livesley (2008) different languages used by two

different professionals to discuss a young boys case and how this story telling can lead to greater assumptions/bi-ases but also to greater interagency understanding and work.

• Stories can indicate the differences and similarities between peoples beliefs and assumptions.


Our research • Explore the use of and perceived value of storytelling

in social care practice and social care education.• 69 questionnaires administered to social care

practitioners (n=35) and full time social care students (n=34).

• 6 closed questions related to the use of informal storytelling, the impact and the perceived obstacles to using storytelling as a tool.

• One open question asked participants to recount a story which - They had used to develop a relationship with a service user- Had an impact on them.- Will look at social care practice research and education

separately initially


Results • Important part of my work with ser-

vice users- 34 out of 35 respond-ents

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25

Types of Stories Used

Humourous Personal

17

30

Use of Stories

KeyworkingDay to Day Work


Practice examples of use of story

• Practitioners used stories to encourage behaviour change, en-gagement with service users and for self concept development

“I talked to the young people about the journey I went on in relation to weight-loss and trying to be more health conscious, they could relate to this in lots of different ways”) SCW15.

• When asked about the use of stories, the most commonly cited use of stories was to introduce health related issues. Practitioners also referenced exploring issues around conflict resolution

• Use of stories also featured significantly in relation to discussion of current issues coming up for young people.

“Young people sometimes find it hard to know where they fit in, especially when they come into the service first so sometimes a story can help make their experience real” SCW 17.


Types of stories Two clear central themes emerged with regard to stories used 1. Humorous stories“ By use of humorous stories over time I al-lowed the service users to trust me” (Scw, 2).Humorous stories appeared to be used to build relationships and establish connections in relation to relatively ‘safe’ issues. There may be scope to extend the use of stories in inter-vention in relation to more ‘challenging’ issues.

2. Personal stories

• Use of personal stories presents many challenges in relation to boundaries, interpretation, understanding and relevance.

“Service user having difficulties with a peer group……I explained to service user how I came across this situation as a child and how I dealt with it and im-proved on my social skills” (Scw, 3)


Use of Personal Stories • Health and well being concerns/issues

(take medication)• Relationship issues (parents, romantic

relationships etc. within appropri-ate boundaries).

• Anxiety (particularly as teenagers)- Difficulties in school- Social issues - Placement issues


Further use of stories to ….

• Identify learning (open a discussion, encourage new opportunities, offer al-ternatives )

• Frequently professionals talked about using stories to normalise experiences

• Overcome difficulties (deflect from issues, handle “trigger times”)

• To develop a connection between staff and service user but also highlighted the use of stories to develop relationships between service users themselves

Personal Storytelling • Can allow the person to develop greater

self understanding• Allows for reframing of identity and

encourages personal growth• An individual expresses the significant

events in their own words, in their own time and also them to reflect on the experience

• Can be upsetting but believed to be cathartic

• May be important in practice for both staff and service users?


Obstacles to effective use of story telling in social care

L. McLean & E.Tuite 2015


Our research on obstacles to use of storytelling

Inappropriate Disclosure

Lack of Interest

Lack of Understanding

Absence of a Story

Misuse of Info

0 2 4 6 8 10 12 14 16 18 20

18

12

18

9

11

Obstacles

Relationship between teller and listener

Engage-ment

Mutuality Movement New Form

Gaydos (2005) highlights Four Pro-cesses

Both parties agreeing to nurture trust, respect, care and empathy which enables reflection and allows new meaning to emerge.


Potential Pitfalls of Storytelling• Should be used to give voice but allow for contrasting voices

to be heard rather than the main ones • Is this allowing the development of service user based prac-

tice? • Consideration of ethics of who owns the story, and this

links in with the fear that practitioners often have of the in-formation being misused once they have disclosed it. The role of reality v’s fantasy.

• Could argue that service users may have the same fear and this impacts their engagement with services and profession-als.

• We should be aware of the need and the ability to emphas-ise certain parts or omit certain parts and what this tells you also.


Story telling as a tool in social care edu-cation

• Important to understand as these are soon to be newly qualified practitioners

• Can we develop understanding but also encourage the use of story telling as a tool in their future practice?

• Can argue that it is also important in terms of the training/leadership/guidance you may provide to your own staff or the service users you are working with

• Interesting to explore the similarities and dif -ferences in storytelling for education and practice.


Case studies as stories • Case studies present realistic, complex, and

contextually rich situations and often involve a dilemma, conflict, or problem that one or more of the characters in the case must negotiate.

• Present real life situations and “bridge the gap between theory and practice and between the academy and the workplace” (Barkley, Cross, and Major 2005, p.182).

• Can be used in class but also as a form of assessment or problem based learning, and in individual and group work.


Results • 32/34 felt this was a very often/often used in their

education and that it was a very useful way to explain theories and concepts.

• All types of stories: personal, humorous, case stud-ies and professional practice stories were used.

• Students felt that the stories were particularly use-ful to extend their learning in tutorials and lectures

• In terms of outcomes they felt that the stories could be used by lecturing staff very effectively to ad-dress ethical issues, engagement with students and to develop self concept.

• In terms of discussing issues they felt that story telling offered an effective way to discuss self care and health issues and issues around peer conflict resolution.


Effective storytelling in Education • Obstacles: inappropriate disclosure (14), misuse of information (17), ab-

sence of a suitable story (14) * notable that failure understand, lack student interest did not feature significantly- students value and understand these stories • Students particularly valued the real life documented practice stories and

specifically mentioned these stories in terms of lecturers real life experi-ence of social care settings, role plays and even television documentar-ies.

• Students highlighted the use of stories to discuss innovative practice ex-amples and alternatives ways to deal with issues

• They felt that the use of storytelling could be most beneficial to teach about how to deal with issues or conflict in social care practice and for self development and self care.


Implications for education • Students value the use of real life experience and the ap-

plication of the theoretical concepts to practice examples. • Discussed issues from across the three years of study but

notable that a number of the stories were encountered in first year. This may be a time that they are particularly eager to hear these stories and a time when they are most open to them.

• The use of personal stories both a benefit but can be seen as an obstacle by some. Can develop understanding and empathy, however we need to be aware of the difficulties and challenges in relation to interpretation.

• Students did not highlight the stories from other students (al-though this is central to the practice reflection part of their module).

• There appears to be scope for formal use of story telling across all modules.

• Stories from ‘new voices’, guest lecturers etc. appear to carry particular weight.


Implications of research for social care prac-tice

• Relationship building central component of work and the development of empathy and storytelling appears to be viewed as an effective way to do this for both practitioners and service users

• Can be argued that personal stories allow young people to see practitioners as “real people” and this may be particularly relevant for young people who have been engaged with professionals for an extended period of time in their lives.

• Topics considered “safe” and ‘unsafe’ in the context of personal stories

Limitations to use of Storytelling• Hardy (2007) cites the potentially co-

ercive nature of storytelling and the associated risks.

• The nature of stories is that them may focus on exceptional cases which by definition are not the experi-ence of the average service user.

• Language, culture and understanding all need to be considered.

Under-utilised applications of storytelling.

• There may be scope to utilise storytelling in a more formal fashion in relation to as-sessment tools, care planning systems and key-working sessions.

• Peer based intervention and the sharing of peer stories was not recognised by either the practitioner or student group- this may be due to lack of awareness or lack of use of this approach.

• Formal use of storytelling at a group level appears to offer significant potential benefits

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Future research • Students own practice stories as a method to en-

hance students learning• Service users stories as a key to developing the

voice of the service user in service devel-opment

• Exploring formal story telling in education in so-cial care (does it exist/should it?)

• Use of stories among staff – in supervision, handover, case presentations etc.

• Gender differences in relation to utilisation of stories from a staff and service user per-spective.

L. McLean & E.Tuite 2015


Conclusions • Person centred approach helped by individual story telling• Seeing peoples lives as a whole rather than just seeing their prob-

lems• Understanding their perspective on what happened• Awareness of the value of storytelling in relationship building, rais-

ing relevant issues, behaviour change and the education of others.• McIntyre & Lendzionowski suggest “formal structures need to be in

place to help the storytelling process, particularly within meetings, to create outcome-focused thinking and action planning”.

• It is also necessary to retain awareness of the pitfalls to story telling and the use of irrelevant stories;

“I use story telling all the time, so much so that one service user recently asked that I be assigned to him today but I’m not to talk!”

(SCW, 1)

A Final ThoughtIf history were taught in the form of stories, it would never be forgot-ten.

— Rudyard Kipling


Bibliography • Altenberger I and Mackay R (2008) What matters with personal narratives, Aberdeen: Robert Gordon University• Ahmed, A. (N.D) The Somali Oral Tradition and the Role of Storytelling in Somalia. Minnesota • Humanities Center• Barkley, E. F, Cross, K. P. & Major, C. H. (2005) Collaborative Learning Techniques: A Handbook for College

Faculty. San-Francisco: Jossey-Bass.• Charon R (2009) Narrative medicine as witness for the self-telling body, Journal of Applied Communic-

ation Research, 37 (2), 118-131• Cox AM and Albert DH (eds) (2003) The healing heart for families: storytelling to encourage caring and

healthy families, Washington: New Society Publishers• Danks J (2014) Working with families within an in-patient setting. Meriden Newsletter; 4: 1, 2-3. tinyurl.-

com/MeridenFamily • Gaydos LH (2005) Understanding personal narratives: an approach to practice, Journal of Advanced Nursing,

49 (3), 254-259• Haines C and Livesley J (2008) Telling tales: using storytelling to explore and model critical reflective practice

in integrated children’s services, Learning in Health and Social Care, 7 (4), 227-234• Haigh C and Hardy P (2011) Tell me a story - a conceptual exploration of storytelling in healthcare education,

Nurse Education Today, 31, 408-411• Hardy P (2007) An investigation into the application of the Patient Voices digital stories in healthcare educa-

tion: quality of learning, policy impact and practice-based value, Belfast: University of Ulster• Kirkpatrick MK, Ford S and Costelloe BP (1997) Storytelling: an approach to client-centred care, Nurse Edu-

cator, 22 (2), 38-40• McIntyre, L. and Lendzionowski, S. (2015) An evaluation of storytelling in the NHS. Nursing Times; 111: 6, 18-

21.• NHS England, Midlands and East (2014) What’s the Story? Storytelling Within the NHS (Midlands

and East). Part One: Realist Evaluation Study Findings. tinyurl.com/NHSMEStorytelling• NHS Midlands and East (2012) Creating a Revolution in Patient and Customer Service Experience. Using Pa-

tient Stories. tinyurl.com/NHSMErevolutionstories• Roberts GA (2000) Narrative and severe mental illness: what place do stories have in an evidence-

based world, Advances in Psychiatric Treatment, 6, 432-441

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A story: Greater than the words?

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